Abstract
Background: Measurement models inform the approach to assess a measure’s validity and also how a measure is understood, applied and interpreted. With preference-based measures, it is generally accepted that they are formative; however, if they are applied without preferences, they may be reflective, formative or mixed. In this study, we sought to empirically test whether the reflective, formative or mixed measurement model best describes PBMs of social care-related quality of life (ASCOT, ASCOT-Carer). We also explored the network approach, as an alternative. Methods: ASCOT and ASCOT-Carer data were analyzed using confirmatory factor analysis and Multiple Indicators Multiple Causes models to test reflective, formative or mixed measurement models, respectively. Network analysis of partial correlations using the Gaussian graphical model was also conducted. Results: The results indicated that the reflective measurement model is the worst fit for ASCOT and ASCOT-Carer. The formative or mixed models may apply to ASCOT. The mixed model was the best fit for ASCOT-Carer. The network analysis indicated that the most important or influential items were Occupation and Personal cleanliness and comfort (ASCOT) and Time and space and Self-care (ASCOT-Carer). Conclusions: The ASCOT and ASCOT-Carer are best described as formative/mixed or mixed models, respectively. These findings may guide the approach to the validation of cross-culturally adapted and translated versions. Specifically, we recommend that EFA be applied to establish structural characteristics, especially if the measure will be applied as a PBM and as a measure of SCRQoL. Network analysis may also provide further useful insights into structural characteristics.
Highlights
The theoretical and philosophical questions of measurement models are important to psychometric research
We will draw on a preference-based measure (PBM) used in economic evaluation of long-term care services, the Adult Social Care Outcomes Toolkit for service users (ASCOT)[1] and carers (ASCOT-Carer)[2,3], to illustrate the issues related to applying measurement models to PBMs
There was a wide range of social care needs in the sample, with 9.4% of respondents reporting no needs for activities of daily living. (The study sample included users of services for support with mental health difficulties, where the eight ADLs may not relate to the person’s needs.)
Summary
The theoretical and philosophical questions of measurement models are important to psychometric research And explicitly, they inform the approach to assess a measure’s validity and how a measure is understood, applied and interpreted. We sought to empirically test whether the reflective, formative or mixed measurement model best describes PBMs of social care-related quality of life (ASCOT, ASCOT-Carer). Methods: ASCOT and ASCOT-Carer data were analyzed using confirmatory factor analysis and Multiple Indicators Multiple Causes models to test reflective, formative or mixed measurement models, respectively. The network analysis indicated that the most important or influential items were Occupation and Personal cleanliness and comfort (ASCOT) and Time and space and Self-care (ASCOT-Carer). Conclusions: The ASCOT and ASCOT-Carer are best described as formative/mixed or mixed models, respectively These findings may guide the approach to the validation of cross-culturally adapted and translated versions. Network analysis may provide further useful insights into structural characteristics
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