Development and calibration of an item bank for the assessment of activities of daily living in cardiovascular patients using Rasch analysis

Abstract

BackgroundTo develop and calibrate the activities of daily living item bank (ADLib-cardio) as a prerequisite for a Computer-adaptive test (CAT) for the assessment of ADL in patients with cardiovascular diseases (CVD).MethodsAfter pre-testing for relevance and comprehension a pool of 181 ADL items were answered on a five-point Likert scale by 720 CVD patients, who were recruited in fourteen German cardiac rehabilitation centers. To verify that the relationship between the items is due to one factor, a confirmatory factor analysis (CFA) was conducted. A Mokken analysis was computed to examine the double monotonicity (i.e. every item generates an equivalent order of person traits, and every person generates an equivalent order of item difficulties). Finally, a Rasch analysis based on the partial credit model was conducted to test for unidimensionality and to calibrate the item bank.ResultsResults of CFA and Mokken analysis confirmed a one factor structure and double monotonicity. In Rasch analysis, merging response categories and removing items with misfit, differential item functioning or local response dependency reduced the ADLib-cardio to 33 items. The ADLib-cardio fitted to the Rasch model with a nonsignificant item-trait interaction (chi-square=105.42, df=99; p=0.31). Person-separation reliability was 0.81 and unidimensionality could be verified.ConclusionsThe ADLib-cardio is the first calibrated, unidimensional item bank that allows for the assessment of ADL in rehabilitation patients with CVD. As such, it provides the basis for the development of a CAT for the assessment of ADL in patients with cardiovascular diseases. Calibrating the ADLib-cardio in other than rehabilitation cardiovascular patient settings would further increase its generalizability.

Calibration of an item bank in 474 orthopedic patients using Rasch analysis for computer-adaptive assessment of anxiety

“…52,53 Moreover, AIB-ortho builds a further puzzle for a comprehensive psychodiagnostics in orthopedic and cardiovascular patients using RehaCAT with its already established IRT and CAT dimensions depression, activity in daily living and work capacity as well as the parallel to this study developed item bank on patients’ treatment motivation. 19,27,45,47,49–54,55…”

“…An item bank is considered unidimensional if the 95% confidence interval of the number of significant tests overlaps 5%. 19,37,46,47…”

“…The person–item distribution compares the location of items (fixed to zero logits) with the location of persons. 19,37,47…”

Development and validation of parallel short forms PaSA-cardio for the assessment of general anxiety in cardiovascular rehabilitation patients using Rasch analysis

“…This study is part of the project 'Development and validation of a computer-adaptive test for cardiac patients undergoing rehabilitation: RehaCAT-Cardio'. [22][23][24][25]…”

Development of short form questionnaires for the assessment of work capacity in cardiovascular rehabilitation patients

“…Comparing computer based assessment and paper-pencil methods Eisen et al (2004) found high correlations between these methods, indicating validity of computerized testing [24]. A computer based version of the WCIB-Cardio-SF would furthermore provide the possibility to integrate the WCIB-Cardio-SF in a battery of computer (adaptive) instruments such as the RehaCATCardio [25][26][27].…”