Rasch-based scoring offered more precision in differentiating patient groups in measuring upper limb function

Khan, Asaduzzaman, Chien, Chi-Wen and Brauer, Sandra G. (2013) Rasch-based scoring offered more precision in differentiating patient groups in measuring upper limb function. Journal of Clinical Epidemiology, 66 6: 681-687. doi:10.1016/j.jclinepi.2012.12.014


Author Khan, Asaduzzaman
Chien, Chi-Wen
Brauer, Sandra G.
Title Rasch-based scoring offered more precision in differentiating patient groups in measuring upper limb function
Journal name Journal of Clinical Epidemiology   Check publisher's open access policy
ISSN 0895-4356
1878-5921
Publication date 2013-06
Sub-type Article (original research)
DOI 10.1016/j.jclinepi.2012.12.014
Volume 66
Issue 6
Start page 681
End page 687
Total pages 7
Place of publication Philadelphia, PA, United States
Publisher Elsevier
Collection year 2014
Language eng
Formatted abstract
Objective: To compare the discriminatory ability of Rasch-based and summative scoring in the context of assessing upper limb function of patients with stroke.

Study Design and Setting: Data were from a cohort study of 497 adults with stroke undergoing physiotherapy. Upper limb function was assessed at admission and discharge using the upper limb subscale of the Motor Assessment Scale (UL-MAS). Rasch analysis was used to transform raw UL-MAS scores into interval measures. A relative precision (RP) index was used to differentiate patients by discharge destination.

Results: The analysis confirmed the unidimensional structure of UL-MAS at both admission and discharge and demonstrated the adequate fit of the items. The RP index favored the Rasch-based scoring over the summative scoring in differentiating between the two patient groups, with significant gains in precision at admission (15%) and discharge (11%). When examining patients in the upper or lower quartile of UL-MAS, the gains in precision were statistically significant in favor of the Rasch-based scoring, with 20% precision at admission and 19% precision at discharge.

Conclusion: Rasch-based scoring was more precise in differentiating patient groups by discharge destination than the summative scoring used to measure upper limb function, especially at the extreme range of the scale.
Keyword Item response theory
Patients with stroke
Rasch analysis
Relative precision
Summative scoring
UL-MAS
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2014 Collection
School of Health and Rehabilitation Sciences Publications
 
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Created: Wed, 10 Apr 2013, 17:42:51 EST by Dr Chi-wen Chien on behalf of School of Health & Rehabilitation Sciences