Local Item Dependence Research Articles

Noncompensatory MIRT For Passage-Based Tests.

We consider a multidimensional noncompensatory approach for binary items in passage-based tests. The passage-based noncompensatory model (PB-NM) emphasizes two underlying components in solving passage-based test items: a passage-related component and a passage-independent component. An advantage of the PB-NM model over commonly applied compensatory models (e.g., bifactor model) is that the two components are parameterized in relation to difficulty as opposed to discrimination parameters. As a result, while simultaneously accounting for passage-related local item dependence, the model permits the assessment of how items based on the same passage may require varying levels of passage comprehension (as well as varying levels of passage-independent proficiency) to obtain a correct response. Through a simulation study, we evaluate the comparative fit of the PB-NM against the bifactor model and also illustrate the relationship between the difficulty parameters of the PB-NM and the discrimination parameters of the bifactor model. We further apply the PB-NM to an actual reading comprehension test to demonstrate the relevance of the model in understanding variation in the relative difficulty of the two components across different item types.

Evaluation of the Unidimensional Fatigue Impact Scale (U-FIS) in Crohn's Disease: The Importance of Local Item Dependency.

The Unidimensional Fatigue Impact Scale (U-FIS) was developed for use in a multiple sclerosis population. The aim was to determine whether the U-FIS is a valid tool for measuring the impact of fatigue in Crohn's disease (CD). CD patients completed the U-FIS as part of a validation study of the Crohn's Life Impact Questionnaire (CLIQ). Data were analyzed according to Rasch measurement theory (RMT). Two hundred sixty-one completed U-FIS questionnaires were available for analysis. After rescoring the items to resolve disordered thresholds, all 22 items showed acceptable RMT fit. However, there was considerable local item dependency (LID). The U-FIS did not provide unidimensional measurement in a sample of CD patients due to high levels of LID. Combining the three FIS outcomes into a single measure was not justified.

Assessment of the quality of woman-centred midwifery care from the mothers’ perspective: A structural analysis of cross-sectional survey data

ObjectiveDevelopment and psychometric evaluation of a multidimensional model and assessment scales measuring core aspects of the quality of woman-centred midwifery care processes in Germany. Design & Participants201 women, who received midwifery care during their pregnancy in 2018, were enrolled 6 to 18 months after birth. Data were assessed in a retrospective cross-sectional survey in Germany. MeasurementsEstablished scales that are used in health care were adapted to the context of woman-centred midwifery care: Shared Decision-Making (SDM-Q-9-M), Empathy (CARE-M), Internal Team Participation (TEAM-M) and Professional Competence (PC-M). Confirmatory factor analyses were adapted to prove (a) the homogeneity of the single scales and (b) the multidimensional structure of the entire item pool. FindingsAppropriate to good model fit was confirmed for both the single assessments (CFI ≥ .96; SRMR ≤ .032) and the multidimensional model (CFI=.96; SRMR=.049). Minor model modifications reflecting local item dependencies had to be considered for the scales SDM-Q-9-M, TEAM-M, and PC-M. For the CARE-M scale, Participatory Communication proved to be a separate, second structural component. ConclusionsShared Decision-Making, Empathy, Internal Team Participation, and Professional Competence constitute core components of woman-centred midwifery care processes. A multi-dimensional assessment is now available measuring women's experiences with midwifery care. The assessment provides an essential component to master the complex challenge of measuring the quality of midwifery care inside and outside the hospital by means of a standardised and validated assessment.

Psychometric evaluation of the Arabic version of the Quebec user evaluation of satisfaction with assistive technology (A-QUEST 2.0) in prosthesis users.

The evaluation of patient satisfaction and perceptions plays a vital role in determining the quality of prosthesis users' devices and the competency of healthcare services. To evaluate the psychometric properties of the Arabic Quebec User Evaluation of Satisfaction with Assistive Technology (A-QUEST 2.0) with prosthetics users. A methodological study. Saudi Arabia, Turkey. A convenience sample of outpatient prosthesis users (N.=183). The A-QUEST 2.0 includes two subscales respectively evaluating the user's satisfaction with the device and the services provided. The data for each subscale were investigated using Rasch analysis to evaluate the item fit, reliability indices, item difficulty, local item dependency, and differential item functioning (DIF). Both subscales met the Rasch criteria for the functioning of rating scale categories. All items showed an acceptable fit to the Rasch model. The person separation indices for the Device and Services subscales were 2.21 (Cronbach's α=0.90) and 1.72 (Cronbach's α=0.85), respectively. Therefore, the two subscales are sensitive enough to distinguish between at least three different levels of satisfaction. The unidimensionality of each subscale was confirmed, and none of the items displayed differential item functioning across age, gender, location of amputation, country, and duration of use. Overall, the findings indicate the psychometric evaluation of A-QUEST 2.0 is effective with prosthesis users across different clinical contexts and cultures. Thus, the A-QUEST 2.0 allows for a comprehensive understanding of users' perceptions of prosthesis characteristics, particularly among subjects with lower limb amputations caused by traumatic injuries. Our paper provides clinicians dealing with Arabic patients a validated outcome measure for satisfaction with prosthesis. Besides providing information in the development of new products and service delivery. Further studies are necessary to improve the measure's metric quality in different contexts and for different prosthesis devices.

Examination of the Connor-Davidson Resilience Scale 10 (CD-RISC-10) using the polytomous Rasch model.

The Connor-Davidson Resilience Scale's (CD-RISC) 10 item variant has previously demonstrated acceptable psychometric properties of its test scores using traditional methods (e.g., confirmatory factor analysis), and concurrent validity with resilience-related outcomes, particularly in samples of younger adults. While alternative methods of examining the psychometric properties of the long-form CD-RISC exist in the literature, the short-form measure has unclear evidence of local item independence and a unidimensional structure, which are key assumptions of a polytomous Rasch model approach to examining the measure's psychometric properties. The current study employed a sample of young adult university students (n = 708, xage = 26.43 years (s = 7.77)) on their nursing practicum placements to examine the CD-RISC-10 against the polytomous Rasch measurement model criteria. The analyses suggested a seven-item variant of the CD-RISC-10 performed acceptably, and omitted issues with local item dependence and item misfit. Effect sizes of the standardized parameters estimated for the 7-item and original 10-item versions of the CD-RISC-10, when predicting compassion fatigue and compassion satisfaction, were small (s = -0.24, s = -0.23) and moderate (s = 0.48, s = 0.47) for the respective measures, which suggested similar efficacy when examining the test scores' concurrent validity. The shorter version of the CD-RISC-10 consequently demonstrated generally acceptable psychometric properties for its test scores, and remained a parsimonious approach to examining individual psychological resilience that will benefit from further development. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Cross-Cultural Evaluation of the Dutch FACE-Q Rhinoplasty Questionnaires Using Rasch Analysis.

The English version of the FACE-Q rhinoplasty module, developed according to Rasch measurement theory, has recently been translated into Dutch. Before conclusions can be drawn from the Dutch version, this translation must also fit the item analysis by the Rasch model. The primary aim of this study was to evaluate cross-cultural equivalence between the Dutch and English versions of the FACE-Q rhinoplasty module by applying Rasch methodology. Rasch analysis performed with Winsteps (Beaverton, OR) was used to evaluate the Dutch version of the FACE-Q nose and nostrils scales with data from a prospective consecutive cohort of 100 Dutch-speaking septorhinoplasty patients. New Dutch-related conversion tables were constructed for the FACE-Q nose and nostrils scales and compared to the original ones. Psychometric cross-validation was performed by receiver operating characteristics (ROC) analysis. Both questionnaires adequately met the requirement of invariance. Within an acceptable range, some issues with item and person fit were found, as well as some local item dependency and differential item functioning. However, comparison of the Dutch- and English-related conversion tables by ROC analysis demonstrated identical results for the FACE-Q nose and nostrils scales. Item analysis by the Rasch model on the data of a Dutch-speaking population proved the conceptual correspondence with the original English version.

The client satisfaction with device: a Rasch validation of the Arabic version in patients with upper and lower limb amputation

BackgroundThe Client Satisfaction with Devices (CSD) module of the Orthotics and Prosthetics Users’ Survey is an extensively used questionnaire that measures patients’ satisfaction with orthosis and prosthesis. However, the validated version for Arabic speakers (CSD-Ar) is only applicable for orthosis users.ObjectivesThe aim of this study was to evaluate the psychometric proprieties of the CSD-Ar for prosthetics users.MethodsThe study used a convenience sample of prosthesis users from Saudi Arabia and Turkey (N = 183), who completed the CSD-Ar. The collected data were analysed using Rasch analysis to evaluate item fit, reliability indices, item difficulty, local item dependency, and differential item functioning (DIF) using WINSTEPS version 4.6.1.ResultsBased on the analysis, the four-response Likert-scale was acceptable, as shown by the category functioning test, All eight items did achieve a fit to the Rasch Model [(infit) and (outfit) mean-square 0.75 to 1.3]. Person separation reliability was 0.76, and item separation reliability was 0.94. A principal component analysis (PCA) showed satisfactory unidimensionality and no local item dependency. The DIF analysis showed no notable dependency among items on participant characteristics in terms of age, gender, duration of use, country, and level of amputation.ConclusionThis study contributes to the confidence of using CSD-Ar to evaluate users’ satisfaction with different prostheses, affirming the need for further refinement of the quality of the outcome measure.

Item banks for measurement of refractive error-specific quality of life.

To evaluate the psychometric properties of refractive error-specific quality of life (QoL) item banks and assess their performance using computerised adaptive testing (CAT) simulations. In this cross-sectional study a 392-item questionnaire, grouped under 11 QoL domains, was interviewer-administered to 305 people with refractive error [mean age±S.D., 30.5±14.1 (range (18 to 83) years; male, 50.5%; mean±S.D. spherical equivalent refractive error -2.4±2.9 (range: -15.0 to +11.0) Dioptres; spectacles (n=257), contact lens (n=37), refractive surgery (n=25), uncorrected refractive error (n=57)]. Rasch analysis was conducted on each QoL domain using the Andrich rating scale model to investigate parameters including response category functioning, person- and item-reliability, infit and outfit statistics, unidimensionality, targeting, differential item functioning and local item dependency. The resulting item banks underwent CAT simulations in 1,000 cases with 'high' and 'moderate' precision stopping rules. Rasch analysis iterations resulted in 13 refractive error-specific item banks (Convenience, Health concerns, Economic, Activity limitation, Mobility, Emotional, Social, Visual symptoms frequency, Visual symptoms severity, Visual symptoms bothersome, Comfort symptoms frequency, Comfort symptoms severity and Comfort symptoms bothersome), containing a total of 366 items. The item banks had good psychometric properties including satisfactory measurement precision, infit and outfit statistics and unidimensionality. In CAT simulations, the mean number of items required to achieve high and moderate measurement precision was 9.4 and 4.7, respectively. Overall, refractive error-specific QoL item banks show promise in their ability to comprehensively and precisely evaluate a range of quality of life parameters. These items banks when administered using a CAT system offer unique outcome tools for implementation in clinical trials, healthcare and research.

Psychometric properties of the obsessive compulsing symptoms scale in asample of Baghdad university students

The present study aimed at detecting local item dependence (LID) between the test item pairs using Q3 index; identifying the percentage of item pairs that appear LID under different levels of examinees ability, and identifying the relationship between two Item Response Theory (IRT) assumptions: Uni-dimensionality and Local Item Independence, according to the 2Parameters Logistic Model (2-PLM). To achieve this, the researcher used data available about of obsessive compulsion scale, (OCS) prepared by Baghdad university, which is used to measure the freshman students’ level when joining the (BA) program in 2007/2008. The test consisted of (81) items measure some computer skills. The sample of the study consisted of (1108) examinees, distributed into five different sessions on the same test. To analyze the collected data, the researcher used three statistical programs (SPSS, Bilog-MG3, LDID) respectively.The results of the study indicated that the percentage of item pairs that reveal LID, using Q3 index, estimated at about 0.135. The results also indicated that the percentage of item pairs that reveal LID, using Q3 index, increased with increased examinees ability level. Finally, the results indicated that the two item response theory (IRT) assumptions: Unidimensionality and Local Item Independence were equivalent assumptions.

Rasch testlet model and bifactor analysis: how do they assess the dimensionality of large-scale Iranian EFL reading comprehension tests?

Rasch testlet and bifactor models are two measurement models that could deal with local item dependency (LID) in assessing the dimensionality of reading comprehension testlets. This study aimed to apply the measurement models to real item response data of the Iranian EFL reading comprehension tests and compare the validity of the bifactor models and corresponding item parameters with unidimensional and multidimensional Rasch models. The data collected from the EFL reading comprehension section of the Iranian national university entrance examinations from 2016 to 2018. Various advanced packages of the R system were employed to fit the Rasch unidimensional, multidimensional, and testlet models and the exploratory and confirmatory bifactor models. Then, item parameters estimated and testlet effects identified; moreover, goodness of fit indices and the item parameter correlations for the different models were calculated. Results showed that the testlet effects were all small but non-negligible for all of the EFL reading testlets. Moreover, bifactor models were superior in terms of goodness of fit, whereas exploratory bifactor model better explained the factor structure of the EFL reading comprehension tests. However, item difficulty parameters in the Rasch models were more consistent than the bifactor models. This study had substantial implications for methods of dealing with LID and dimensionality in assessing reading comprehension with reference to the EFL testing.

The Relationship between the Q3 and the Level of Testlet Variance to Examine Local Item Dependence

지역 독립성은 문항 반응 이론의 세 가지 필수적인 가정 중 하나입니다. 지역 독립성은 측정 문항이 다른 문항과 관련이 없음을 의미합니다. Q3는 국부의존성을 측정하기 위해 널리 사용되는 추정 지수입니다. testlet(하부검사)는 문항들의 그룹을 의미합니다. 예를 들어, 독해 시험에서 각 독해에 적용되는 문항들은 그 독해의 다른 문항들과 관계가 있을 수 있음을 나타냅니다. 이 연구의 목적은 시뮬레이션을 통해 Q3을 이용한 국부의존성과 probit 2PL모델을 이용한 testlet효과를 측정하고, Q3와 testlet 효과의 관계를 조사하는 것입니다. 이 연구에서 실행된 시뮬레이션의 결과, Q3와 testlet 효과는 긍정적인 관계를 가지는 것으로 나타났습니다.

Rotate and Project: Measurement of the Intended Concept with Unidimensional Item Response Theory from Multidimensional Ordinal Items

What to do when item response data are multidimensional but a unidimensional model is preferred in terms of statistical simplicity and ease of interpretability? The projection method for the compensatory logistic multidimensional item response model for dichotomous data leads to a two parameter logistic model with local item dependence. Despite the local item dependence, the model is unidimensional for many practical purposes. Here, Ip’s projection method is generalized to the case of the graded response model for polytomous variables, extending the applicability of the method to Likert-type response formats. A secondary aim of the paper is the study of rotation techniques intended for use prior to projection. In contrast to rotations aiming at a simple structure of factor loadings, the proposed techniques increase the variance explained before or after projection, facilitate the interpretation of the projected dimension by variants of target rotations or a mix of both. The method is illustrated with an application to the Highly Sensitive Person Scale and R code is provided.

Comparing Local Item Dependency from Inter-Item Correlation Matrix and Principal Component Analysis from Factor Analysis for Dimensionality of Multidimensional Dataset

Comparing Local Item Dependency from Inter-Item Correlation Matrix and Principal Component Analysis from Factor Analysis for Dimensionality of Multidimensional Dataset

Item analysis of the Eating Assessment Tool (EAT-10) by the Rasch model: a secondary analysis of cross-sectional survey data obtained among community-dwelling elders

BackgroundThe Eating Assessment Tool (EAT-10) is increasingly used to screen for self-perceived oropharyngeal dysphagia (OD) in community-dwelling elders. A summated EAT-10 total score ranges from 0 to 40, with a score ≥ 3 indicative of OD. When using cut-points of a summated score, important requirements for the measurements are specific objectivity, validity, and reliability. Analysis by the Rasch model allows investigation of whether scales like EAT-10 satisfy these requirements. Currently, a few studies have found that EAT-10 responses from clinical populations with OD do not adequately fit the Rasch model.PurposeThe aim of this study was to determine whether measurements by EAT-10 fit the Rasch model when applied in screening self-perceived OD in non-clinical populations.MethodsSecondary analysis was conducted on data from a cross-sectional survey of community-dwelling elders living in a municipal district of Tokyo, Japan, in which 1875 respondents completed the Japanese version of EAT-10 (J-EAT-10). Data were cleaned and recoded for the purpose of the analysis in this study, which resulted in inclusion of J-EAT-10 responses from 1144 respondents. Data were analyzed using RUMM2030 and included overall model fit, reliability, unidimensionality, threshold ordering, individual item and person fits, differential item functioning, local item dependency, and targeting.ResultsThe analysis identified that the response categories from zero to four were not used as intended and did not display monotonicity, which necessitated reducing the five categories to three. Considerable floor effect was demonstrated and there was an inappropriate match between items’ and respondents’ estimates. The person separation reliability (PSI = 0.65) was inadequate, indicating that it is not possible to differentiate between different levels of OD. Several items displayed misfit with the Rasch model, and there were local item dependency and several redundant items.ConclusionsJ-EAT-10 performed less than optimally and exhibited substantial floor effect, low reliability, a rating scale not working as intended, and several redundant items. Different improvement strategies failed to resolve the identified problems. Use of J-EAT-10 in population-based surveys cannot therefore be recommended. For such purpose, alternative screening tools of self-perceived OD should be chosen or a new one should be developed and validated.

Rasch Strategies for Evaluating Quality of The Conceptions and Alternative Assessment Survey (CETAS)

Due to society demand for educational development, education in Malaysia has begun to utilize alternative assessment approach in schools and universities. This study developed Conceptions and Alternative Assessment Survey (CETAS) to examine lecturers’ conceptions of assessment (AC) and their practice of alternative assessment (AAP). In order for CETAS to be useful, a pilot study was conducted to examine quality of items in using Rasch Analysis approach. A total of 38 lecturers involved in this study. After item analysis, this study found that four items, Item 7 (AC), Item 8 (AC), Item 16 (AAP) and Item 30 (AAP) did not meet the requirement of fit statistics analysis and local item dependency. Therefore, four items were deleted while other 58 are suitable to be used for measuring the intended constructs. In addition, the scale calibration analysis also revealed that Scale 3 (slightly disagree) was not well-functioning. Therefore, after consideration of analysis and expert review, Scale 3 was collapsed leaving CETAS with 5 scales. Nevertheless, CETAS has a good item and person reliability and can be used to examine lecturers’ conceptions of assessment and their practices of alternative assessment.

Measuring posttraumatic growth and depreciation after spinal cord injury: A Rasch analysis.

Individuals with spinal cord injury (SCI) may experience both positive (posttraumatic growth, PTG) and negative (posttraumatic depreciation, PTD) psychological changes following the injury. PTG and PTD were assessed using the 10-item short form of the Posttraumatic Growth Inventory (PTGI-SF) and 10 matched negatively worded items for PTD (selected from the PTGI-42) within the Swiss Spinal Cord Injury Cohort Study (SwiSCI). This item selection is henceforth called PTG/D-SF. The objective of this study was to test the metric properties of the PTG/D-SF to determine the best strategy to derive reliable sum scores and to test the validity of several different structural conceptualizations. Using cross-sectional data (N = 278), a series of unidimensional and multidimensional Rasch analyses of the PTG/D-SF (N = 20) were performed. Rasch analyses were conducted separately for the items or by domains to investigate dimensionality, monotonicity, item and model fit, and local item dependency of the instrument. The separate PTG and PTD items or their domains can be summated to form a unidimensional scale. Aggregation into domains improved the score distribution and increased the scope of the instruments. The reliability of the sum score for PTG was good (Person Separation: 0.81); the one for PTD was admissible (Person Separation: 0.77). PTG and PTD should be understood as distinct constructs rather than two ends of a continuum. Findings support the use of a PTG total score and to some degree the PTD total score. Future work could adapt the PTD items to improve the performance of the scale. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Measuring Pain in TBI: Development of the TBI-QOL Pain Interference Item Bank and Short Form

ObjectiveTo develop a pain interference item bank, computer adaptive test (CAT), and short form for use by individuals with traumatic brain injury (TBI). DesignCross-sectional survey study. SettingFive TBI Model Systems rehabilitation hospitals. ParticipantsIndividuals with TBI (N=590). InterventionsNot applicable. Outcome MeasuresTraumatic Brain Injury–Quality of Life (TBI-QOL) Pain Interference item bank. ResultsConfirmatory factor analysis provided evidence of a single underlying trait (χ2 [740]=3254.030; P<.001; Comparative Fix Index=0.988; Tucker-Lewis Index=0.980; Root Mean Square Error of Approximation=0.076) and a graded response model (GRM) supported item fit of 40 Pain Interference items. Items did not exhibit differential item functioning or local item dependence. GRM calibration data were used to inform the selection of a 10-item static short form and to program a TBI-QOL Pain Interference CAT. Comparative analyses indicated excellent comparability and reliability across test administration formats. ConclusionThe 40-item TBI-QOL Pain Interference item bank demonstrated strong psychometric properties. End users can administer this measure as either a 10-item short form or CAT.

Measuring Fatigue in TBI: Development of the TBI-QOL Fatigue Item Bank and Short Form.

To develop a traumatic brain injury (TBI)-specific, item response theory (IRT)-calibrated Fatigue item bank, short form, and computer adaptive test (CAT) as part of the Traumatic Brain Injury-Quality of Life (TBI-QOL) measurement system. Five TBI Model Systems rehabilitation centers in the US PARTICIPANTS:: Adults with complicated mild, moderate, or severe TBI confirmed by medical record review. Cross-sectional field testing via phone or in-person interview. TBI-QOL Fatigue item bank, short form, and CAT. A total of 590 adults with TBI completed 95 preliminary fatigue items, including 86 items from the Patient-Reported Outcomes Measurement Information System (PROMIS) and 9 items from the Quality of Life in Neurological Disorders (Neuro-QOL) system. Through 4 iterations of factor analysis, 22 items were deleted for reasons such as local item dependence, misfit, and low item-total correlations. Graded response model IRT analyses were conducted on the 73-item set, and Stocking-Lord equating was used to transform the item parameters to the PROMIS (general population) metric. A short form and CAT, which demonstrate similar reliability to the full item bank, were developed. Test-retest reliability of the CAT was established in an independent sample (Pearson's r and intraclass correlation coefficient = 0.82 [95% confidence interval: 0.72-0.88]). The TBI-QOL Fatigue item bank, short form, and CAT provide rehabilitation researchers and clinicians with TBI-optimized tools for assessment of the patient-reported experience and impact of fatigue on individuals with TBI.

Improving Scoring Precision and Internal Construct Validity of the Bath Ankylosing Spondylitis Disease Activity Index Using Rasch Measurement Theory.

To test the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) according to Rasch Measurement Theory and investigate whether measurement precision can be improved. Secondary analysis of a BASDAI database. The data had been collected from individuals starting an Ankylosing Spondylitis Exercise Course at the Royal National Hospital for Rheumatic Diseases in Bath, UK. Data were available for 250 participants (23.6% female) aged between 18 and 85 years (mean 52.8, SD 14.6). Initial fit of the data to the Rasch model appeared good and item thresholds were consistent, but local item dependence (LID) was identified. After addressing the LID, a unidimensional measure was achieved. The Person Separation Index (reliability) was 0.83 and the location of the items was well matched to that of the respondents. A transformation table was generated to convert total raw BASDAI scores into linearized Rasch transformed scores that form an interval scale. The Smallest Detectable Difference improved from 2 to 1.2. This finding suggests that a change score of > 1.2 points on the modified BASDAI is required to achieve meaningful change. Applying the Rasch transformed scores simplifies completion and scoring of the measure and confirms internal construct validity. It also ensures linear measurement and justifies the use of parametric statistical analyses when analyzing datasets. The transformation table can be used with existing BASDAI datasets to allow direct comparisons of disease activity scores with those generated from future studies.

Cross-cultural adaptation and Rasch validation of the Slovene version of the Orthotics and Prosthetics Users' Survey (OPUS) Client Satisfaction with Device (CSD) in upper-limb prosthesis users.

To validate the Slovene version of the Orthotics and Prosthetics Users' Survey (OPUS) 8-item Client Satisfaction with Device (CSD) questionnaire in upper-limb prosthesis users and to further verify measurement properties of this tool with Rasch analysis. Participants consisted of a convenience sample of 76 adults (54 men) using a prosthesis after unilateral upper-limb amputation who consecutively attended a follow-up visit at our centre. After translation and cross-cultural adaptation of the CSD into the Slovene language, we evaluated functioning of the rating scale categories, item fit (internal construct validity), reliability indices and dimensionality, as well as convergent and discriminant construct validity of the questionnaire. Rasch analysis indicated that: (1) functioning of the 4 response options was acceptable; (2) all items fitted the measured construct [information-weighted (infit) and outlier-sensitive (outfit) mean-square statistics 0.60 to 1.40]; (3) person separation reliability was 0.62 (and Cronbach α=0.76), item separation reliability was 0.83; (4) on principal component analysis (PCA) on the standardised residuals, the CSD showed borderline but acceptable unidimensionality and no local item dependency. Moreover, as expected, the CSD score showed good correlation with the QUEST 2.0 score (rs=0.57) and little to fair correlation with the OPUS Upper Extremity Functional Status score (rs=0.21). The metric properties of the Slovene version of CSD agree with previous studies. The present study confirms the validity of CSD for measuring patient satisfaction with an upper-limb device, enhances the confidence in this tool for assessing upper-limb prosthesis users, and contributes to further refining the technical quality of this measure.