Poor Items Research Articles

The Italian version of the Majeed pelvic score: translation, cross-cultural adaptation and validation.

The assessment of functional outcomes after pelvic ring fracture remains a controversial topic. The Majeed pelvic score (MPS) is the most commonly used pelvic-specific questionnaire in the literature. The aim of this study is translation, cross-cultural adaptation and validation of the Italian version of MPS. The study was articulated in two phases. Phase 1 consisted in translation and cross-cultural adaptation of MPS, from English into Italian. The psychometric properties were tested on 52 Italian patients (Phase 2). Construct validity was assessed by correlation with Short-Form 12 (SF-12). 33 patients repeated the questionnaire after 14days to assess its reproducibility. All data were subsequently analyzed (descriptive statistics, multitrait analysis, reliability and construct validity assessment). The questionnaire was clear and easily understood (no missing data). A ceiling effect was detected for all items of the scale. Multitrait analysis showed good results for each outcome measure, except for the item "walking distance" that showed poor item discriminant validity. A significant correlation between the MPS and the physical component summary (PCS) of the SF-12 was found, while there was a weak correlation with the mental component summary (MCS). The questionnaire showed high internal consistency (Cronbach's alpha: 0.91-0.99) and very good test-retest reliability (intraclass correlation coefficients: 0.92-0.96). The Italian version of the MPS has demonstrated to be reliable and valid in the evaluation of patients with pelvic ring fractures. There is still however a need for an instrument capable of evaluating the mental component in these types of injuries.

The Oswestry Disability Index is not a good measure for low back pain in adolescents: A Rasch analysis of data from 200 people.

To evaluate the psychometric properties of the modified Oswestry Disability Index in adolescents with low back pain through Rasch analysis. This is a psychometric study. Physical therapy clinics of a large pediatric hospital in Columbus, Ohio (United States). Two hundred adolescent patients with low back pain (112 female, 15.4 ± 1.9 years old). The modified Oswestry Disability Index. The mean modified Oswestry Disability Index score was 17.1 ± 12.1, with scores ranging from 0 to 56 on the 100-point scale. The Rasch person reliability for the Oswestry Disability Index was 0.70, representing minimal acceptable person reliability. The Oswestry Disability Index demonstrated poor item spacing, hierarchy, and targeting of the adolescents' disability level (>1 logit between person mean and item mean). A significant misfit was observed in three of 10 items. There were significant issues with the functioning of responses on all items of the Oswestry Disability Index. Principal component analysis of residuals revealed a ratio of 5.3:1, demonstrating acceptable unidimensionality. Due to multiple psychometric issues, the Oswestry Disability should not be used to assess disability in adolescents with low back pain. The Oswestry Disability Index significantly mistargets adolescent ability and only provides an acceptable assessment of the most disabled adolescents.

Assessing of Biology Test Question Quality Using Anates Software

This research uses a quantitative descriptive approach. This research aims to determine the quality and appropriateness of Class XI Biology question items consisting of validity, reliability, level of difficulty, distinguishing power and distractor quality. The subjects are SMA N 1 Driyorejo Gresik as many as 30 students. Data collection in this research was carried out through student answer sheets, then the data was processed using Anates Ver 4.0.9. The test results show that the questions are appropriate and of good quality with a correlation of 0.62 and a reality coefficient of 0.76. This resulted in the question criteria being declared as having high validity, with four levels of difficulty and a small number of the quality of the distractor has poor quality test items.

Pengembangan Instrumen Assesmen Literasi Sains Berbasis Kontekstual pada Materi Koloid

This research is a development research (Research and Development) with the objectives: (1) to assess the quality of the instrument in terms of content validity and empirical validity, (2) to determine the reliability of the developed instrument, and (3) to assess the practicality of the developed instrument. The product developed is a contextual science literacy assessment instrument on the topic of colloids. The developed contextual science literacy instrument is in the form of multiple-choice questions. The research was conducted using the 4D development model, which includes the stages of define, design, develop, and disseminate. The results of rational validation by two expert validators yielded 15 valid test items with an Aiken's index ≥ 0.75. The instrument was tested on 34 students from class XII MIPA 3 of SMAN 1 Gowa. The results of empirical validation using the point biserial formula at α=0.339 yielded 14 valid test items. The results of the reliability test using KR-20 showed that the instrument was categorized as reliable with a value of 0.831. The analysis of the item discrimination power showed that there were 2 very good items, 6 good items, 4 fair items, and 3 poor items. The distribution of the item difficulty level was 47% difficult items, 40% medium items, and 2% easy items. The practicality of the contextual science literacy assessment instrument on the topic of colloids was categorized as practical based on the positive results of the student questionnaire (85%) and the teacher questionnaire (95%).

Effect of changing multiple choice questions from “all of the above” to “select all that apply”

Introduction: The purpose of this study was to describe the effect of converting multiple choice questions (MCQs) that include an “all of the above” (AOTA) answer option to a “select all that apply” (SATA) question type on question performance.Methods: A summative assessment at the end of the first professional pharmacy year was comprised of approximately 50 multiple choice questions covering material from all courses taught. Eight questions contained AOTA answer options and were converted to SATA items in the subsequent year by eliminating the AOTA option and including the words “select all that apply” in the stem. Majority of the other questions included on the exam remained the same between the two years. Item difficulty, item discrimination, point biserial, and distractor efficiency were used to compare the MCQs on exams in the two years.Results: The AOTA questions were significantly easier and less discriminating than the SATA items. The performance of the remaining questions on the exam did not differ between the years. The distractor efficiency increased significantly when the questions were converted to SATA items.Conclusions: MCQs with AOTA answer options are discouraged due to poor item construction resulting in poor discrimination between high and low performing students. The AOTA questions are easily converted to the SATA format. The result of this conversion is a more difficult and more discriminating question with all answer options chosen, which prevents students from easily guessing the correct answer.

The representation of child-parent relation: validation of the Italian version of the child-parent relationship scale (CPRS-I).

This study proposes a psychometric validation of the Italian version of the Child-Parent Relationship Scale (CPRS) developed by Pianta in 1992. Based on attachment theory, the scale assesses parents' relationship perceptions with their own child and comprises three scales: Closeness, Conflict, and Dependency. A sample of 501 parents (188 fathers and 313 mothers) completed 30 items of the Italian version of the Child-Parent Relationship Scale (CPRS-I) online, but only 437 answered 85% of the entire protocol; hence, the analyses only focused on 437 participants. The first analysis of the original theoretical model revealed poor fit, item loadings, and internal consistency. Therefore, a follow-up analysis was conducted. Exploratory and confirmatory analyses with a split sample (EFA = 218; CFA = 219) confirmed the original three-factor structure of the Italian sample, although some items were eliminated. The validity and reliability of the Italian version of the CPRS-I were also verified by correlating the above three factors with measures of adult attachment styles and children's internalizing and externalizing behaviors. The CPRS-I showed significant correlations with all tested constructs, in line with those found by Driscoll and Pianta for the short form of the scale. Our results confirm that the CPRS-I has the same structure as the original scale; therefore, it can be a useful tool for assessing parents' perceptions of their relationship with their children. The implications for educational and clinical settings are also discussed.

Learning Motivation Scale (LMS): Development and Validation with Prospective-Teachers in West Bengal, India

Background: Learning motivation is the collective term for the internal and external factors that support or strengthen a learner's desire and willingness to acquire new knowledge. Every prospective teacher must acquire the skills necessary to do their job well, and learning is accelerated by learning motivation. Therefore, developing a standardised Learning Motivation Scale (LMS) is crucial for assessing the level of learning motivation among prospective teachers in West Bengal. The goal of the present study was to create a LMS to assess learning motivation level among prospective teachers.
 Method: Fifty (50) prospective teachers from West Bengal, India, were given a self-administered version of the LMS, which consists of twenty-eight (28) items, to collect the data. The learning motivation scale was subjected to item analysis following the data collection in order to remove the poor items. Following that, the final scale's internal consistency was evaluated using the 225 participants (prospective teachers) who participated in the Cronbach's alpha method.
 Result: The scale primarily consists of two subscales, intrinsic motivation and extrinsic motivation, each with twenty-eight (28) items measuring learning motivation. Following item analysis, the learning motivation scale's seven (7) poor items are eliminated in accordance with the discrimination index. As a result, 21 items from each of the two LMS subscales were kept. The scale's final iteration discovered 0.783 alpha values, a high level of statistically significant correlation.
 Conclusion: The findings indicate that the Scale is a useful tool that researchers and instructors can use to effectively gauge the level of learning motivation among prospective teachers.

Interitem Psychometric Validation of the Stanford Integrated Assessment for Transplant Scale Among Thoracic Transplant Candidates.

Psychosocial evaluations are mandatory for transplant listing, however the methodology for creating psychosocial risk stratifications is unclear. The Standford Psychosocial Integrated Psychosocial Assessment for Transplant Scale is the most commonly used instrument, however its interitem validity has never been examined. To investigate the interitem validity of a psychosocial assessment tool for transplant candidates among a sample of thoracic transplant candidates. Clinic data consisting of Stanford Integrated Psychosocial Assessment for Transplant administrations from 173 heart and lung transplant candidates were fit to a partial credit model. Data were subsequently fit to 4 separate partial credit models based on subscale categories, demonstrating the discrimination parameter estimate of each item. Differential item functioning analyses were conducted on the data within each subscale by sex to investigate potential bias produced by each item. The initial partial credit model using the full scale did not converge, indicating the subscales possibly did not measure the same underlying construct. Subscale discrimination parameter estimates demonstrated that most items were adequately or highly discriminative. The item measuring history of substance use demonstrated poor fit and differential item functioning. While the Stanford Integrated Psychosocial Assessment for Transplant has demonstrated strong potential as a standardized framework for psychosocial assessments in transplant, this study identified some areas for improvement in the scoring system. The subscale scores appeared to show greater construct validity when utilized individually than when aggregated to form a total score. The substance use/abuse/dependence item did not fit well into its respective subscale. Future studies should aim to optimize the scoring system and re-asses its construct validity to improve its accuracy in discriminating between high-risk candidates and those needing psychosocial assistance.

Optimization of a production inventory model of imperfect quality items for three-layer supply chain in fuzzy environment

PurposeGood management strives to align and corporate processes for more attention being paid to supply chain management. Firms realize that greater co-operation and improved coordination can help to manage the entire supply chain more efficiently. The imperfect quality item is one of the most important issues that affect the expected profit of green supply chain. The imprecise cost with screening process of poor quality items posed in supply chain is the subject of this study.Design/methodology/approachThe present study explores production model for imperfect items having uncertain cost parameters with three-layer supply chain encompassing supplier, manufacturer and retailer. The model is considering the impact of business tactics such as order size, production rate, production cost and appropriate times in various sectors on collaborative marketing systems. Due to imprecise cost parameters, the pentagonal fuzzy numbers are set to fuzzify the total cost and defuzzifition by using graded mean integration.FindingsThis study offers an explicit condition in uncertain environment to manage the imperfect quality item to increase the potential profit of the supply chain. The influence of changes in parameter values on the optimal inventory policy under fuzziness is provided managerial insights.Originality/valueThis model makes a significant contribution to fuzzy inference. The results of the study provide a trading strategy for the industry to avoid losses. The prescribed study can be suitable for the industries like sculpture, jewelry, pottery, etc.

Interrater Reliability of the Scale for the Assessment and Rating of Ataxia, Berg Balance Scale, and Functional Independence Measure Motor Domain in Individuals With Hereditary Cerebellar Ataxia

ObjectiveTo determine the interrater reliability of the Scale for the Assessment and Rating of Ataxia (SARA), Berg Balance Scale (BBS), and motor domain of the FIM (m-FIM) administered by physiotherapists in individuals with a hereditary cerebellar ataxia (HCA). DesignParticipants were assessed by 1 of 4 physiotherapists. Assessments were video-recorded and the remaining 3 physiotherapists scored the scales for each participant. Raters were blinded to each other's scores. SettingAssessments were administered at 3 clinical locations in separate states in Australia. ParticipantsTwenty-one individuals (mean age=47.63 years; SD=18.42; 13 male and 8 female) living in the community with an HCA were recruited (N=21). Main Outcome MeasuresTotal and single-item scores of the SARA, BBS, and m-FIM were examined. The m-FIM was conducted by interview. ResultsIntraclass coefficients (2,1) for the total scores of the m-FIM (0.92; 95% confidence interval [CI], 0.85-0.96), SARA (0.92; 95% CI, 0.86-0.96), and BBS (0.99; 95% CI, 0.98-0.99) indicated excellent interrater reliability. However, there was inconsistent agreement with the individual items, with SARA item 5 (right side) and item 7 (both sides) demonstrating poor interrater reliability and items 1 and 2 demonstrating excellent reliability. ConclusionsThe m-FIM (by interview), SARA, and BBS have excellent interrater reliability for use when assessing individuals with an HCA. Physiotherapists could be considered for administration of the SARA in clinical trials. However, further work is required to improve the agreement of the single-item scores and to examine the other psychometric properties of these scales.

THE CURRENT STATUS AND NEED OF PHARMACOVIGILANCE CENTERS IN THE HOSPITALS TO MINIMIZE THE DRUG PROBLEMS

The science and exercises identifying with the identification, appraisal, comprehension and counteractive action of antagonistic impacts or some other medication related issue”. It is a vital and indistinguishable piece of clinical research. Both clinical preliminaries safety and post-showcasing pharmacovigilance are essential all through the item life cycle. With a sensibly high number of late prominent medication withdrawals, both the pharmaceutical business and in addition different administrative offices over the globe have expanded the bar. Early flag identification from the post- advertising observation thinks about and clinical preliminaries in early stages have now been adjusted by significant pharmaceutical organizations so as to recognize the dangers related with their therapeutic item/s as right on time as could be expected under the circumstances. The indications of ADRs rely upon the age, sex, hereditary, poly pharmacy, portion exactness and ecological and other interior variables like illness conditions. ADRs ordinarily answered in because of known or obscure pharmacological highlights, poor item quality, prescription mistakes in recommending, getting ready, overseeing, or taking the medicine which requires hospitalization. ADRs in hospitalized patients can be partitioned into two classes: those that are the reason for clinic confirmation and those that happen amid hospitalization. A strengthening and commitment of network pharmacists to patient record check and electronic announcing may likewise lessen ADR related occasions. Without successful distinguishing proof and satisfaction of preparing needs of pharmacists and other medicinal services experts, the effectiveness of national pharmacovigilance frameworks is probably not going to enhance, which may bargain patient safety.

Working Memory Constrains Long-Term Memory in Children and Adults: Memory of Objects and Bindings

We explored how individual and age-related differences in working memory (WM) capacity affected subsequent long-term memory (LTM) retrieval. Unlike past studies, we tested WM and LTM not only for items, but also for item-color bindings. Our sample included 82 elementary school children and 42 young adults. The participants performed a WM task with images of unique everyday items presented sequentially at varying set sizes in different colors. Later, we tested LTM for items and item-color bindings from the WM task. The WM load during encoding constrained LTM, and participants with a higher WM capacity retrieved more items in the LTM test. Even when accounting for young children's poor item memory by considering only the items that they did remember, they exhibited an exacerbated difficulty with remembering item-color bindings in WM. Their LTM binding performance, however, as a proportion of remembered objects, was comparable to that of older children and adults. The WM binding performance was better during sub-span encoding loads, but with no clear transfer of this benefit to LTM. Overall, LTM item memory performance was constrained by individual and age-related WM limitations, but with mixed consequences for binding. We discuss the theoretical, practical, and developmental implications of this WM-to-LTM bottleneck.

Developing Script Concordance Test Items in Otolaryngology to Improve Clinical Reasoning Skills: Validation using Consensus Analysis and Psychometrics.

Script concordance testing is widely practiced to foster and assess clinical reasoning. Our study aimed to develop script concordance test (SCT) in the specialty of otolaryngology and test the validation using panel response pattern and consensus index. The methodology was an evolving pattern of constructing SCTs, administering them to the panel members, and optimizing the panel with response patterns and consensus index. The SCT's final items were chosen to be administered to the students. We developed 98 items of SCT and administered them to 20 panel members. The mean score of the panel members for these 98 items was 79.5 (standard deviation [SD] = 4.4). The consensus index calculated for the 98-item SCT ranged from 25.81 to 100. Sixteen items had bimodal and uniform response patterns; the consensus index improved when eliminated. We administered the rest 82 items of SCT to 30 undergraduate and ten postgraduate students. The mean score of undergraduate students was 61.1 (SD = 7.5) and that of postgraduate students was 67.7 (SD = 6.3). Cronbach's alpha for the 82-item SCT was 0.74. Excluding the 22 poor items, the final SCT instrument of 60 items had a Cronbach's alpha of 0.82. Our study revealed that a consensus index above 60 had a good item-total correlation and be used to optimize the items for panel responses in SCT, necessitating further studies on this aspect. Our study also revealed that the panel response clustering pattern could be used to categorize the items, although bimodal and uniform distribution patterns need further differentiation.

Taking More Society for Academic Emergency Medicine Practice Tests Does Not Lead to Improved National EM-M4 Exam Scores

Emergency medicine (EM) is a required clerkship for third-year medical students, and an elective EM acting internship (AI) is available to fourth-year students at our institution. The Society for Academic Emergency Medicine's (SAEM) National Emergency Medicine M4 Examination (EM-M4) is administered to students at the end of the EM AI experience. To prepare for the exam, students gain access to 23 practice tests available from SAEM. In this study we investigate the correlation between the number of practice tests taken and EM-M4 performance. We collected data for EM-M4 and the US Medical Licensing Exam (USMLE) Step 2 Clinical Knowledge (CK) from students completing a MS4 EM clerkship in consecutive medical school classes from 2014-2017 at a private medical school. In addition, we collected data during the clerkship on the number of practice exams taken and whether a comprehensive practice exam was taken. We analyzed the study population three ways to determine whether the number of practice tests impacted final exam results: a binary distribution (1-11 or 12-23 tests taken); quaternary distribution (1-6, 7-12, 13-18, or 19-23 tests taken); and individual test variability (1,2,3,…22,23 tests taken). Complete data for 147 students was used for data analysis. The EM-M4 showed moderate (r = 0.49) correlations with USMLE Step 2 CK. There was no significant difference in EM-M4 performance in the binary analysis (P ≤ 0.09), the quaternary analysis (P ≤ 0.09), or the continuous variable analysis (P ≤ 0.52). Inclusion of a comprehensive practice test also did not correlate with EM-M4 performance (P ≤ 0.78). Degree of utilization of SAEM practice tests did not seem to correlate with performance on the EM-M4 examination at our institution. This could be due to many factors including that the question bank is composed of items that had poor item discrimination, possible inadequate coverage of EM curriculum, and/or use of alternative study methods. While further investigation is needed, if our conclusions prove generalizable, then using the SAEM practice tests is an extraneous cognitive load from a modality without proven benefit.

Arsenic in mind: Construction of knowledge and attitude scales

Chronic arsenic toxicity (arsenicosis) as a result of drinking arsenic-contaminated groundwater is a major environmental health hazard throughout the world, including India. During the last four decades arsenic contamination of groundwater in nine districts out of twenty in West Bengal has become a serious problem. About 20% population of West Bengal in nine districts (Malda, Murshidabad, Nadia, North 24- Parganas, and South 24-Parganas, Kolkata, Howrah, Hooghly and Burdwan) are affected by arsenic problem. To prevent this harmful effect, every people need to have proper knowledge and positive attitude towards arsenic. In this study, the researcher constructed a standardized tool of knowledge and attitude towards arsenic to assess the knowledge and attitude level of arsenic among the people of arsenic contaminated area. The researcher took item analysis method to assess the quality of the items of every section. Then the tools were measured the reliability by the Pearson’s product moment correlation method. Primarily two self-administered tools of 39 knowledge items and 32 attitude items regarding arsenic was applied among the people of Nadia district of West Bengal. Therefore, the researcher analyzed the collecting data and eliminated the poor items on the basis of difficulty value and discrimination index. After elimination of distracting items, 25 items in knowledge section and 25 items in the attitude section were retained as a final form of tool regarding arsenic. Thereafter the final form of tools applied among 60 general people to calculate the reliability of the tools by test-retest reliability method. The researcher found significant reliability in knowledge and attitude tools. These standard tools can assess the knowledge and attitude level regarding arsenic among the people of arsenic contamination area with accuracy.

Analyzing the science achievement test: Perspective of classical test theory and Rasch analysis

Assessment in teaching and learning allows both instructor and students to evaluate the achievement, performance and improve upon it. The achievement test appears as one of the most commonly used assessment tools to determine students' gains in the cognitive domain. The study analysed science achievement test (SAT), a multiple-choice test for grade 10 senior secondary school students. The 50 SAT items were developed in compliance with the Malaysian science curriculum specification. The face and content validity of SAT were validated by experts in the science field. The SAT was administered with 50 students in a pilot study. The collected data was analysed using item analysis based on classical test theory (CTT) and Rasch analysis. In terms of difficulty index (p), item analysis showed that there were five difficult items, 33 moderately difficult items, and 12 easy items. Findings also reported eight items presented as poor items due to the poor discriminating power. The SAT showed a good coefficient of 0.862 for Kuder-Richardson 20 (KR-20) and 0.851 for the split half method. While the Rasch analysis showed a reliable and good separation for both item and person. Besides, the Rasch analysis displayed that there are two items should be refreshed or removed. The study revealed that the SAT was a solid, valid, and reliable tool, which is suitable to be used to measure the student’s achievement in science.

Item Response Theory Analysis of the Dark Factor of Personality Scale for College Students in China.

The Dark Factor of Personality (D) describes the common core of dark traits and is a stable indicator for socially aversive behaviors. This study investigated the psychometric properties of the Chinese version of the Dark Factor of Personality Scale for college students using item response theory (IRT). A total of 762 students—251 males and 511 females (M = 19.99, SD = 1.30)—were recruited. Item response theory methods were utilized to evaluate the properties of the scale. Four items with poor item properties were excluded, obtaining a final 28-item scale (D28-C) that included highly discriminative items showing high measurement precision in various levels of the D factor. Furthermore, a test of differential item functioning (DIF) by gender was conducted. The result indicated that the scale as a whole could be seen as gender invariant. Lastly, according to the detailed information provided by IRT and the content of items, a reliable short form of the D28-C comprising 15 items was obtained. The study enriched the existing knowledge of the dark factor of personality in the Chinese background and made some revisions to the corresponding scale to make it a more reliable tool for measurement in China. In addition, the shortened version of the scale based on item information and content helps to improve the efficiency of the measurement.

A-220 Hooper Visual Organization Test: Item Analyses and Scale Performance in a Nonclinical Adult Sample

Abstract Objective: The 30-item Hooper Visual Organization Test (HVOT) measures visuospatial synthesis. While satisfactory reliability estimates have been reported, some items show poor discrimination and items do not appear to be ordered by increasing difficulty level. Little psychometric evidence, however, has been gathered with healthy nonclinical adults in North America. Examination of item performance in healthy adult samples aids in understanding what might be clinically noteworthy in neurological or psychiatric patients. Thus, we examined HVOT total score performance, item difficulty and discrimination, internal consistency reliability, and correlations of HVOT total scores with demographic and neuropsychological variables in a healthy adult sample in Canada. Method: Participant were 71 cognitively intact, non-depressed men and women ages 21-82 years (M=51.5, SD=18.3), with 9-21 years of education (M=15.0, SD=2.79), recruited from the general community. Participants were tested individually on various neuropsychological tests (HVOT, MMSE, Block Design, ROCF, Trails, Five Point Test, FAS/Animals, Vocabulary). Results: Items ranged in difficulty (0.16-1.00) but tended to be easy (M=0.82). Item discrimination ranged from -.17 to.47. Cronbach’s alpha was 0.62. Total scores ranged from 17-29.5 out of 30 (M=25.4) and correlated significantly with age, MMSE, Block Design, ROCF, Trails, and Animals (r=|.29|-|.44|). Conclusions: Our results suggest that some HVOT items are too easy and/or show poor discrimination. Items are not well-ordered by difficulty. We discuss some notable divergences from proposed re-orderings from clinical samples. Demographic results fit with the literature; correlations with other measures extend previous findings. Our results serve as a guide for revisions and a useful baseline for clinical comparison.

Psychometric properties of the 26-item eating attitudes test (EAT-26): an application of rasch analysis

BackgroundThe 26-item Eating Attitudes Test (EAT-26) is a commonly used tool to assess eating disorder risk. The purpose of this study was to examine the psychometric properties of the EAT-26 with a combined sample: (1) of adults with overweight and obesity enrolled in a behavioral weight loss program and (2) general adult sample (n = 469; age = 36.17 ± 17.83 years; female = 72.5%; white = 66.3%; obese BMI category = 58%).MethodsRasch modeling was used to assess model-data fit, create an item-person map to evaluate relative distribution items and persons, item difficulty, and person’s eating disorder (ED) risk level of the EAT-26. Differential item functioning (DIF) and rating scale functioning of the EAT-26 were also evaluated using Rasch analysis.ResultsA total of 7 misfit items were removed from the final analysis due to unacceptable Infit and Outfit mean square residual values. The item-person map showed that the items were biased toward participants with moderate to high levels of ED risk and did not cover those who had low risk for having an ED (< − 1 logits). The DIF analyses results showed that none of the items functioned differently across sex, but 5 items were flagged based on obesity status. The six-category Likert-type rating scale did not function well indicating a different response format may be needed.ConclusionSeveral concerns were identified with the psychometric evaluation of the EAT-26 that may question its utility in assessing ED risk in individuals at low risk for ED, within samples of people who have overweight and obesity seeking weight loss treatment.Plain English SummaryThe 26-item Eating Attitudes Test is a self-rated measure of eating attitudes that measures symptoms and concerns of eating disorders (ED). Very little is known about how this instrument performs differently based on individual factors like body mass index (BMI) and sex (male/female). We used an advanced measurement theory (i.e., Rasch analysis) to determine if the EAT-26 is an adequate measure to detect disordered eating in men and women of different BMIs. Results indicated that the EAT-26 was biased toward participants with moderate to high levels of disordered eating risk and did not adequately detect individuals at low risk for disordered eating. The EAT-26 did not function differently based on sex (male/female). However, five questions did function differently based on obesity status (those without obesity/ those with obesity). Finally, we observed the six-category rating scale did not function appropriately and that a new response format may be warranted. In sum, there were several issues (e.g., poor rating scale and different item functioning) with the EAT-26 and future work should develop screening tools that detect low risk of disordered eating as well as function well in adults with overweight and obesity.

Item Analysis of Multiple Choice Questions of Anatomy at Aziz Fatimah Medical and Dental College, Faisalabad

Objective: The aim of our study was to evaluate MCQs in send up exam of 2nd year MBBS. To discard or change poor items with low discriminatory index, very easy and very difficult items and items with more than one non functional distracters. Study design: The cross-sectional study. Place: Department of Anatomy, Aziz Fatimah Medical and Dental College. Faisalabad. Duration of study: One month (December 2021) Methodology: Total 45 MCQs for the subject of Anatomy were constructed for 100 students of 2nd year MBBS send up Examination 2021. The MCQs consisted of one statement with four distractor &amp; one correct option. Data of MCQs attempted by the students was analyzed by using Microsoft Excel 2010. The difficulty index, discrimination index and distractor efficiency were the parameters used for analysis. Results: Total 180 distractors were evaluated. The average number for difficulty index was 55.57 while that for discrimination index was 0.44. Out of 180 distractors, 41 nonfunctional distractors were seen in 26 items. Conclusion: Most MCQs fall within an average to easy difficulty index level i.e. 30 out of 45 MCQs. Most MCQs fulfill the criteria of very good discrimination index i.e. 27 out of 45. Most MCQs have either nil, or one or two non-functional distractors. i.e. 43 out of 45. Key Words: MCQs, Difficulty index, Nonfunctional distractors, Discrimination index, Distractor efficiency.