Developing item banks for measuring pediatric generic health-related quality of life: an application of the International Classification of Functioning, Disability and Health for Children and Youth and item response theory.

Pranav K Gandhi,Dennis A Revicki,Sanjeev Y Tuli,I-Chan Huang,Elizabeth Shenkman,Lindsay A Thompson,Jacobus Van Wouwe

doi:10.1371/journal.pone.0107771

Abstract

The purpose of this study was to develop item banks by linking items from three pediatric health-related quality of life (HRQoL) instruments using a mixed methodology. Secondary data were collected from 469 parents of children aged 8-16 years. The International Classification of Functioning, Disability and Health-Children and Youth (ICF-CY) served as a framework to compare the concepts of items from three HRQoL instruments. The structural validity of the individual domains was examined using confirmatory factor analyses. Samejima's Graded Response Model was used to calibrate items from different instruments. The known-groups validity of each domain was examined using the status of children with special health care needs (CSHCN). Concepts represented by the items in the three instruments were linked to 24 different second-level categories of the ICF-CY. Eight item banks representing eight unidimensional domains were created based on the linkage of the concepts measured by the items of the three instruments to the ICF-CY. The HRQoL results of CSHCN in seven out of eight domains (except personality) were significantly lower compared with children without special health care needs (p<0.05). This study demonstrates a useful approach to compare the item concepts from the three instruments and to generate item banks for a pediatric population.

Highlights

Over the past decade, pediatric research has shifted its attention from advancing treatments and survival rates for children with various diseases and disorders to improving their functional status and health-related quality of life (HRQoL)
Using a large sample of children enrolled in the Medicaid program, our previous study based on the classical test theory (CTT) method suggested that none of the existing pediatric HRQoL instruments was superior to any other in the different psychometric properties [14,15]
We examined different measurement properties to further remove some items from the item banks, including item thresholds and discrimination as well as item and test information functioning (IIF/TIF)

Summary

Introduction

Pediatric research has shifted its attention from advancing treatments and survival rates for children with various diseases and disorders to improving their functional status and health-related quality of life (HRQoL). In parallel to this paradigm shift, the World Health Organization (WHO) elaborated the concept of health by emphasizing its components and determinants, which include body functions, body structures, activities and participation, and environmental and personal factors [1,2]. Using qualitative methodologies to compare the heterogeneity of item content, followed by advanced quantitative methodologies (e.g., item response theory; IRT) [16,17] to quantify the measurement properties of individual items for the design of appropriate pediatric instruments, is important [4,18]

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Conclusion