TY - JOUR
T1 - An alternative application of Rasch analysis to assess data from ophthalmic patient-reported outcome instruments
AU - Moutari, Salissou
AU - McNeely, Richard
AU - Arba-Mosquera, Samuel
AU - Verma, Shwetabh
AU - Moore, Jonathan
PY - 2018/6/21
Y1 - 2018/6/21
N2 - Purpose: To highlight the potential shortcomings associated with the current use Rasch analysis for
validation of ophthalmic questionnaires, and to present an alternative application of Rasch
analysis to derive insights specific to the cohort of patients under investigation.
Methods: An alternative application of Rasch analysis was used to investigate the quality of vision
(QoV) for a cohort of 481 patients. Patients received multifocal intraocular lenses and completed
a QoV questionnaire one and twelve months post-operatively. The rating scale variant
of the polytomous Rasch model was utilized. The parameters of the model were
estimated using the joint maximum likelihood estimation. Analysis was performed on data at
both post-operative assessments, and the outcomes were compared.
Results: The distribution of the location of symptoms altered between assessments with the most
annoyed patients completely differing. One month post-operatively, the most prevalent
symptom was starbursts compared to glare at twelve months. The visual discomfort from
the most annoyed patients is substantially higher at twelve months. The current most advocated
approach for validating questionnaires using Rasch analysis found that the questionnaire
was “Rasch-valid” one month post-operatively and “Rasch-invalid” twelve months
post-operatively.Conclusion: The proposed alternative application of Rasch analysis to questionnaires can be used as an
effective decision support tool at population and individual level. At population level, this
new approach enables one to investigate the prevalence of symptoms across different
cohorts of patients. At individual level, the new approach enables one to identify patients
with poor QoV over time. This study highlights some of the potential shortcomings associated
with the current use of Rasch analysis to validate questionnaires.
AB - Purpose: To highlight the potential shortcomings associated with the current use Rasch analysis for
validation of ophthalmic questionnaires, and to present an alternative application of Rasch
analysis to derive insights specific to the cohort of patients under investigation.
Methods: An alternative application of Rasch analysis was used to investigate the quality of vision
(QoV) for a cohort of 481 patients. Patients received multifocal intraocular lenses and completed
a QoV questionnaire one and twelve months post-operatively. The rating scale variant
of the polytomous Rasch model was utilized. The parameters of the model were
estimated using the joint maximum likelihood estimation. Analysis was performed on data at
both post-operative assessments, and the outcomes were compared.
Results: The distribution of the location of symptoms altered between assessments with the most
annoyed patients completely differing. One month post-operatively, the most prevalent
symptom was starbursts compared to glare at twelve months. The visual discomfort from
the most annoyed patients is substantially higher at twelve months. The current most advocated
approach for validating questionnaires using Rasch analysis found that the questionnaire
was “Rasch-valid” one month post-operatively and “Rasch-invalid” twelve months
post-operatively.Conclusion: The proposed alternative application of Rasch analysis to questionnaires can be used as an
effective decision support tool at population and individual level. At population level, this
new approach enables one to investigate the prevalence of symptoms across different
cohorts of patients. At individual level, the new approach enables one to identify patients
with poor QoV over time. This study highlights some of the potential shortcomings associated
with the current use of Rasch analysis to validate questionnaires.
U2 - 10.1371/journal.pone.0197503
DO - 10.1371/journal.pone.0197503
M3 - Article
SN - 1932-6203
VL - 13
JO - PLoS ONE
JF - PLoS ONE
IS - 6
M1 - e0197503
ER -