Item Response Theory analysis of the Modified Roland-Morris Disability Questionnaire in a population-based study

Details

• Alternative Title:
  Spine (Phila Pa 1976)
• Personal Author:
  Mielenz, Thelma J. ; Carey, Timothy S. ; Edwards, Michael C.
• Description:
  Study Design:
  
  This is a secondary analysis of a cross-sectional population-based survey.
  
  Objective:
  
  Shorten the 23-item Roland scale using item response theory methods and describe where in the functional disability range each scale is the most precise.
  
  Summary of Background Data:
  
  The Roland-Morris Disability Questionnaire is recommended for a functional disability outcome measure in low back pain (LBP)patients. One commonly used version is the modified 23-item Roland. It is unknown where in the functional disability range the modified 23-item Roland measures.
  
  Methods:
  
  One candidate individual with LBP in randomly selected households was interviewed, identifying 694 adults with chronic LBP. To justify the use of a unidimensional 2-parameter logistic item response theory model, we performed both exploratory and confirmatory factor analysis.
  
  Results:
  
  Exploratory factor analysis revealed one dominant eigenvalue. Confirmatory factor analysis results indicate that the one factor model fit well. Item response theory analysis revealed variability in the slopes, ranging from 1.07 to 3.10. The marginal reliability, an item response theory-based analog to coefficient alpha, was 0.88. The modified 23-item Roland produces reliable scores (i.e., with a standard error less than 0.3) from 1.4 standard deviations below the mean to roughly 0.2 above the mean.
  
  Conclusions:
  
  The modified 23-item Roland measures one construct. The modified 23-item Roland appears to be an excellent tool for measuring just-below-average levels of functional disability. The modified 23-item Roland measures high levels of functional disability with relatively poor reliability and may be more appropriate for a less disabled population with LBP. We demonstrate that the modified 23-item Roland can be shortened to 11 items with minimal loss of information. We show that there are different ways to go about selecting the set of 11 items which yield short forms with different strengths.
  
  
• Subjects:
  Adult Aged Aged, 80 And Over Article Chronic Low Back Pain Chronic Pain Cross-Sectional Studies Disability Evaluation Female Humans Item Response Theory Low Back Pain Male Middle Aged Modified Roland-Morris Disability North Carolina Surveys And Questionnaires Young Adult

  More +
• Source:
  Spine (Phila Pa 1976). 40(6):E366-E371
• Pubmed ID:
  25774468
• Pubmed Central ID:
  PMC9923782
• Document Type:
  Journal Article
• Funding:
  UL1 TR001111/TR/NCATS NIH HHSUnited States/ ; R49 CE002096/CE/NCIPC CDC HHSUnited States/ ; R0-1 AR051970/AR/NIAMS NIH HHSUnited States/ ; 1 R49 CE002096-01/CE/NCIPC CDC HHSUnited States/ ; R01 AR051970/AR/NIAMS NIH HHSUnited States/
• Volume:
  40
• Issue:
  6
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:ff63a6809a366dcb77891d09ff6f152707d6085d45146cf738bf18530f6adc66
• Download URL:
  https://stacks.cdc.gov/view/cdc/124666/cdc_124666_DS1.pdf
• File Type:
  [PDF - 356.65 KB ]