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Using item response theory improved responsiveness of patient-reported outcomes measures in carpal tunnel syndrome

Lyren, Per-Erik and Atroshi, Isam LU (2012) In Journal of Clinical Epidemiology 65(3). p.325-334
Abstract
Objective: To compare responsiveness based on item response theory (IRT) with that based on conventional scoring for two patient-reported outcomes measures in carpal tunnel syndrome (CTS); the short disabilities of the arm, shoulder, and hand (QuickDASH) measure, and the 6-item CTS symptoms scale (CTS-6). Study Design and Setting: Prospective cohort study of patients with CTS undergoing carpal tunnel release at one orthopedic department. Of 455 consecutive patients, 343 completed the QuickDASH and the CTS-6 before and within 1 year after surgery. IRT-based and conventional scores were compared in subgroups according to global rating of change in hand status and treatment satisfaction. The effect size (ES) and the area under the receiver... (More)
Objective: To compare responsiveness based on item response theory (IRT) with that based on conventional scoring for two patient-reported outcomes measures in carpal tunnel syndrome (CTS); the short disabilities of the arm, shoulder, and hand (QuickDASH) measure, and the 6-item CTS symptoms scale (CTS-6). Study Design and Setting: Prospective cohort study of patients with CTS undergoing carpal tunnel release at one orthopedic department. Of 455 consecutive patients, 343 completed the QuickDASH and the CTS-6 before and within 1 year after surgery. IRT-based and conventional scores were compared in subgroups according to global rating of change in hand status and treatment satisfaction. The effect size (ES) and the area under the receiver operating characteristic (ROC) curve were used as measures of responsiveness. Results: The mean value for the IRT-based QuickDASH estimate was -0.09 (standard deviation [SD] = 1.13) preoperatively and -2.14 (SD = 1.79) postoperatively (ES = -1.8) and for the CTS-6 estimate was 0.29 (SD = 1.36) preoperatively and -3.87 (SD = 2.3) postoperatively (ES = -3.1), indicating very large improvement. The ES for the QuickDASH and CTS-6 were very large (-2.4 and -3.8), respectively, in the group with the largest perceived improvement and decreased with lower perceived improvement. The ES was consistently larger with IRT-based scoring than conventional scoring. The AUC for the QuickDASH and CTS-6 exceeded 0.85. Conclusion: IRT-based scoring showed high responsiveness for the QuickDASH and CTS-6, and the ES were larger than those estimated using conventional scoring. (C) 2012 Elsevier Inc. All rights reserved. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Carpal tunnel syndrome, QuickDASH, CTS symptoms scale, Item response, theory, Patient-reported outcomes, Effect size, AUC
in
Journal of Clinical Epidemiology
volume
65
issue
3
pages
325 - 334
publisher
Elsevier
external identifiers
  • wos:000299754800016
  • scopus:84855991044
ISSN
1878-5921
DOI
10.1016/j.jclinepi.2011.08.009
language
English
LU publication?
yes
id
da28c6d0-d063-4421-9702-24681bae64bb (old id 2416076)
date added to LUP
2012-04-02 09:34:05
date last changed
2017-01-15 03:17:27
@article{da28c6d0-d063-4421-9702-24681bae64bb,
  abstract     = {Objective: To compare responsiveness based on item response theory (IRT) with that based on conventional scoring for two patient-reported outcomes measures in carpal tunnel syndrome (CTS); the short disabilities of the arm, shoulder, and hand (QuickDASH) measure, and the 6-item CTS symptoms scale (CTS-6). Study Design and Setting: Prospective cohort study of patients with CTS undergoing carpal tunnel release at one orthopedic department. Of 455 consecutive patients, 343 completed the QuickDASH and the CTS-6 before and within 1 year after surgery. IRT-based and conventional scores were compared in subgroups according to global rating of change in hand status and treatment satisfaction. The effect size (ES) and the area under the receiver operating characteristic (ROC) curve were used as measures of responsiveness. Results: The mean value for the IRT-based QuickDASH estimate was -0.09 (standard deviation [SD] = 1.13) preoperatively and -2.14 (SD = 1.79) postoperatively (ES = -1.8) and for the CTS-6 estimate was 0.29 (SD = 1.36) preoperatively and -3.87 (SD = 2.3) postoperatively (ES = -3.1), indicating very large improvement. The ES for the QuickDASH and CTS-6 were very large (-2.4 and -3.8), respectively, in the group with the largest perceived improvement and decreased with lower perceived improvement. The ES was consistently larger with IRT-based scoring than conventional scoring. The AUC for the QuickDASH and CTS-6 exceeded 0.85. Conclusion: IRT-based scoring showed high responsiveness for the QuickDASH and CTS-6, and the ES were larger than those estimated using conventional scoring. (C) 2012 Elsevier Inc. All rights reserved.},
  author       = {Lyren, Per-Erik and Atroshi, Isam},
  issn         = {1878-5921},
  keyword      = {Carpal tunnel syndrome,QuickDASH,CTS symptoms scale,Item response,theory,Patient-reported outcomes,Effect size,AUC},
  language     = {eng},
  number       = {3},
  pages        = {325--334},
  publisher    = {Elsevier},
  series       = {Journal of Clinical Epidemiology},
  title        = {Using item response theory improved responsiveness of patient-reported outcomes measures in carpal tunnel syndrome},
  url          = {http://dx.doi.org/10.1016/j.jclinepi.2011.08.009},
  volume       = {65},
  year         = {2012},
}