Rasch analysis of the patient-rated wrist evaluation questionnaire

Abstract

BackgroundThe Patient-Rated Wrist Evaluation (PRWE) was developed as a wrist joint specific measure of pain and disability and evidence of sound validity has been accumulated through classical psychometric methods. Rasch analysis (RA) has been endorsed as a newer method for analyzing the clinical measurement properties of self-report outcome measures. The purpose of this study was to evaluate the PRWE using Rasch modeling.MethodsWe employed the Rasch model to assess overall fit, response scaling, individual item fit, differential item functioning (DIF), local dependency, unidimensionality and person separation index (PSI). A convenience sample of 382 patients with distal radius fracture was recruited from the hand and upper limb clinic at large academic healthcare organization, London, Ontario, Canada, 6-month post-injury scores of the PRWE was used. RA was conducted on the 3 subscales (pain, specific activities, and usual activities) of the PRWE separately.ResultsThe pain subscale adequately fit the Rasch model when item 4 “Pain - When it is at its worst” was deleted to eliminate non-uniform DIF by age group, and item 5 “How often do you have pain” was rescored by collapsing into 8 intervals to eliminate disordered thresholds. Uniform DIF for “Use my affected hand to push up from the chair” (by work status) and “Use bathroom tissue with my affected hand” (by injured hand) was addressed by splitting the items for analysis. After background rescoring of 2 items in pain subscale, 2 items in specific activities and 3 items in usual activities, all three subscales of the PRWE were well targeted and had high reliability (PSI = 0.86). These changes provided a unidimensional, interval-level scaled measure.ConclusionLike a previous analysis of the Patient-Rated Wrist and Hand Evaluation, this study found the PRWE could be fit to the Rasch model with rescoring of multiple items. However, the modifications required to achieve fit were not the same across studies, our fit statistics also suggested one of the pain items should be deleted. This study adds to the pool of evidence supporting the PRWE, but cannot confidently provide a Rasch-based scoring algorithm.Electronic supplementary materialThe online version of this article (10.1186/s40945-018-0046-z) contains supplementary material, which is available to authorized users.

Manual ability in hand surgery patients: Validation of the ABILHAND scale in four diagnostic groups

“…Although reliability indices should be compared with caution across potentially different study conditions, it is noteworthy that the PSI obtained for the ABILHAND-HS (0.90) was higher than prior values obtained for the activities subscales of the PRWE [ 52 ] (0.78 and 0.81 for the usual and specific activities subscales, respectively, in DRF patients), for the Patient-Rated Wrist and Hand Evaluation [ 53 ] (0.83 in HS patients), for the QuickDASH scale [ 54 ] (0.84 in patients with various upper limb dysfunctions) and for the Manual Ability Measure [ 55 ] (MAM-16; 0.83 for HS patients), while being equal to that for the DASH manual functioning subscale [ 18 ]. PSI values reflect sensitivity to clinical evolution over time, with greater values indicating a greater number of distinguishable ability strata.…”

Validation of Persian Version of Patient-Rated Wrist and Hand Evaluation: Confirmatory Factor Analysis and Rasch Analysis

“… 11 The second was conducted on a distal radius fracture population using the PRWE version. 5 Concordance in Rasch findings between the PRWHE and PRWE can support the assumption that these measures can be used interchangeably. Rasch analysis can complement the findings obtained from FA, because it provides some overlapping information (ie, factor structure, unidimensionality) and some distinct measurement indicators such DIF and targeting.…”

“… 10 Two studies have previously reported the clinical measurement properties of the PRWHE and PRWE using Rasch analysis. 5 , 11 They found no significant differential item functioning (DIF) or scale differences between individuals with injuries in the dominant hand when compared with injuries in the nondominant hand. They reported that 2 subscales (pain and function) were well targeted and had high reliability.…”

“…Several clinimetric studies have evaluated this version and confirm similar measurement properties to the original wording of the PRWE. 3 , 4 , 5 The psychometric properties of the PRWHE have been examined in many different languages, with acceptable validity and reliability. 6…”

Application of the Rasch Model in Analysis of Exam Questions at the Faculty of Psychology of Universitas Islam Bandung

“…Rasch model is widely applied to evaluate psychological measurement tools such as personality disorders [7], patientrated wrist evaluation [8], Hospital Anxiety and Depression Scale (HADS) [9], Depression Anxiety and Stress Scale [10], and bullying [11] and so on. Besides the Rasch model is also used to evaluate examination questions in mathematics course [12].…”