A critique of Rasch analysis using the Dyspnoea‐12 as an illustrative example

Yorke, J, Horton, M and Jones, PW 2011, 'A critique of Rasch analysis using the Dyspnoea‐12 as an illustrative example' , Journal of Advanced Nursing, 68 (1) , pp. 191-198.

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Aim. This paper is a report of a study of the application and critique of Rasch analysis to the development of the Dyspnoea‐12 questionnaire; an instrument that measures breathlessness severity.
Background. The development of questionnaires has traditionally involved application of classical test theory. Rasch analysis has gained international momentum as a robust application of ‘modern’ psychometric testing for the development of new instruments and the refinement of existing ones.
Method. A total of 358 patients [mean age 62 (sd = 8); chronic obstructive pulmonary disease = 123, interstitial lung disease = 129, heart failure = 106], responded to an initial list of 81 items (between May 2006 and February 2008). Hierarchical modelling reduced the list to 34 items. Rasch analysis was used to inform decisions about further item removal and fit to the unidimensional model. Rasch analysis included tests of item response appropriateness, item residual, differential item functioning (including gender and diagnosis) and unidimensionality.
Results. Twenty‐two items failed to reach the requirements of the Rasch model and were removed. Reasons included high residuals and item bias associated with gender and diagnosis. The 12‐items conformed to the Rasch unidimensional parameters (number of statistically significant t‐tests 6·7%; confidence interval: 4·4–9·0%).
Conclusion. We have presented the steps involved in reducing and refining a large item‐set by identifying those items which possessed the most reliable measurement properties. The Dyspnoea‐12 is reliable and simple to use and should find utility in both practice and research settings. We recommend that nurses consider Rasch analysis in the development of health‐related questionnaires.

Item Type: Article
Additional Information: Original title of article was 'A critique of Rasch analysis for the development of patient-centred outcomes: an illustrative example using the Dyspnoea-12'
Themes: Subjects / Themes > R Medicine > RT Nursing
Health and Wellbeing
Schools: Schools > School of Health and Society > Centre for Applied Research in Health, Welfare and Policy
Journal or Publication Title: Journal of Advanced Nursing
Publisher: Wiley-Blackwell
Refereed: Yes
ISSN: 0309-2402
Related URLs:
Funders: Clinical Research Committee, Royal Brompton and Harefield NHS Foundation Trust.
Depositing User: Institutional Repository
Date Deposited: 23 May 2011 10:05
Last Modified: 15 Feb 2022 15:52
URI: https://usir.salford.ac.uk/id/eprint/14000

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