Abstract
The Dutch-Flemish PROMIS Group translated the adult PROMIS Pain Interference item bank into Dutch-Flemish. The aims of the current study were to calibrate the parameters of these items using an item response theory (IRT) model, to evaluate the cross-cultural validity of the Dutch-Flemish translations compared to the original English items, and to evaluate their reliability and construct validity. The 40 items in the bank were completed by 1085 Dutch chronic pain patients. Before calibrating the items, IRT model assumptions were evaluated using confirmatory factor analysis (CFA). Items were calibrated using the graded response model (GRM), an IRT model appropriate for items with more than two response options. To evaluate cross-cultural validity, differential item functioning (DIF) for language (Dutch vs. English) was examined. Reliability was evaluated based on standard errors and Cronbach’s alpha. To evaluate construct validity correlations with scores on legacy instruments (e.g., the Disabilities of the Arm, Shoulder and Hand Questionnaire) were calculated. Unidimensionality of the Dutch-Flemish PROMIS Pain Interference item bank was supported by CFA tests of model fit (CFI = 0.986, TLI = 0.986). Furthermore, the data fit the GRM and showed good coverage across the pain interference continuum (threshold-parameters range: -3.04 to 3.44). The Dutch-Flemish PROMIS Pain Interference item bank has good cross-cultural validity (only two out of 40 items showing DIF), good reliability (Cronbach’s alpha = 0.98), and good construct validity (Pearson correlations between 0.62 and 0.75). A computer adaptive test (CAT) and Dutch-Flemish PROMIS short forms of the Dutch-Flemish PROMIS Pain Interference item bank can now be developed.
Highlights
The prevalence of chronic pain is high in western populations, ranging from 10.1 to 55.2% [1,2,3]
The Dutch-Flemish PROMIS Group aims to improve the measurement of patient reported outcomes in the Netherlands and Flanders by providing and supporting the implementation of IRT-based, efficient, highly reliable and valid PROMIS item banks and computerized adaptive testing (CAT) [16]
PROMIS item banks and CATs have better content validity compared to traditional Patient-Reported Outcome Measures (PROMs) [13]
Summary
The prevalence of chronic pain is high in western populations, ranging from 10.1 to 55.2% [1,2,3]. Chronic pain often leads to substantial limitations in daily activities [4]. Pain interference refers to the degree to which pain interferes with or limits person’s social, mental and physical activities [5]. Self-reported pain interference has increasingly become an important indicator of the experiences of patients with pain and has recently been recommended as a core outcome in international core sets [6,7]. Pain interference is an important construct to measure in patients with chronic pain
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