Head-to-head Rasch comparison of the Prosthesis Evaluation Questionnaire-Mobility Section and the Prosthetic Mobility Questionnaire 2.0 in Italian lower-limb prosthesis users

Abstract

I hereby submit our paper entitled "Head-to-head Rasch comparison of the Prosthesis Evaluation Questionnaire-Mobility Section and the Prosthetic Mobility Questionnaire 2.0 in Italian lower-limb prosthesis users" for your consideration for publication in "Prosthetics and Orthotics International".The Prosthesis-Evaluation-Questionnaire Mobility Section (PEQ-MS) and Prosthetic Mobility Questionnaire (PMQ 2.0) are two validated self-report questionnaires assessing mobility in people with lower-limb amputation. We compared the psychometric properties of these two questionnaires head-to-head in a sample of 100 lower-limb prosthesis users. Our results show that the PMQ 2.0 has a better measurement performance and larger operational range than the PEQ-MS, making it more suitable for assessing lower-limb prosthesis users with a large range of locomotor abilities. We think that these findings will be of interest to the readers of your journal, in that understanding the psychometric strengths and weaknesses of measurement tools is important for selecting suitable outcome measures, addressing clinical and research issues, and informing healthcare policy decision-making.

Development of an item bank for measuring prosthetic mobility in people with lower limb amputation: The Prosthetic Limb Users Survey of Mobility (PLUS‐M)

“…Recent work to expand the PEQ-MS with additional items have resulted in newer instruments, termed the Prosthesis Mobility Questionnaire (PMQ) 33 and PMQ 2.0, 34 which appear to have addressed concerns related to ceiling effects. 35 While these recent PROMs offer new and potentially improved tools for measuring prosthetic mobility, a consequence to changing the instructions, items, and response options across different versions is that psychometric properties established for the original version no longer necessarily apply to the updated versions. Psychometric testing, which can be extensive if performed to contemporary standards, 36,37 will subsequently need to be conducted for each version.…”

“…38 Because scores from the various versions of these PROMs are not directly comparable, additional efforts will need to be undertaken to establish crosswalk tables or nomograms to synthesize data across individuals who were measured with different forms of the instrument. 35 Collectively, these issues illustrate challenges with adopting PROMs for research as many do not meet modern psychometric standards. 39 These issues also illustrate challenges to clinical use of PROMs, and may explain practitioners' reluctance to use PROMs as routinely as performance tests in clinical practice.…”

“…Further, as the revised versions (i.e., the PEQ‐MS 12/5 and the LCI‐5) are new instruments, scores are not comparable between the revised and original versions. Recent work to expand the PEQ‐MS with additional items have resulted in newer instruments, termed the Prosthesis Mobility Questionnaire (PMQ) 33 and PMQ 2.0, 34 which appear to have addressed concerns related to ceiling effects 35 …”

“…Testing in select populations, like those eligible for health insurance from the U.S. Centers for Medicare and Medicaid Services (CMS), may also need to be performed before such evidence could be considered to be applicable to this population 38 . Because scores from the various versions of these PROMs are not directly comparable, additional efforts will need to be undertaken to establish crosswalk tables or nomograms to synthesize data across individuals who were measured with different forms of the instrument 35 . Collectively, these issues illustrate challenges with adopting PROMs for research as many do not meet modern psychometric standards 39 .…”