’Less is more’: validation with Rasch analysis of five short-forms for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs)

Pellicciari, Leonardo; Piscitelli, Daniele; Basagni, Benedetta; Tanti, Antonio De; Algeri, Lorella; Caselli, Serena; Ciurli, Maria Paola; Conforti, Jessica; Estraneo, Anna; Moretta, Pasquale; Gambini, Maria Grazia; Inzaghi, Maria Grazia; Lamberti, Gianfranco; Mancuso, Mauro; Rinaldesi, Maria Luisa; Sozzi, Matteo; Abbruzzese, Laura; Zettin, Marina; Porta, Fabio La

doi:10.1080/02699052.2020.1836402

Cited by 12 publications

(13 citation statements)

References 39 publications

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“…Rasch analysis, a modern item response theory, allows for the transformation of ordinal measures into linear interval measures, where the distances between scores are known. Several patient-reported outcomes have been refined through Rasch analysis by adapting the instruments to the pattern defined by the Rasch model [78][79][80]. Future studies are needed to define the MCID of Rasch-transformed measures.…”

Section: Discussionmentioning

confidence: 99%

Challenges in applying minimal clinically important difference: a critical review

Podurgiel,

Piscitelli,

Denegar

2024

International Journal of Rehabilitation Research

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Healthcare clinicians strive to make meaningful changes in patient function and participation. A minimal clinically important difference (MCID) is an estimate of the magnitude of change needed to be meaningful to a patient. Clinicians and investigators may assume that a cited MCID is a valid and generalizable estimate of effect. There are, however, at least two concerns about this assumption. First, multiple methods exist for calculating an MCID that can yield divergent values and raise doubt as to which one to apply. Second, MCID values may be erroneously generalized to patients with dissimilar health conditions. With this in mind, we reviewed the methods used to calculate MCID and citations of reported MCID values for outcome measures commonly used in neurologic, orthopedic, and geriatric populations. Our goal was to assess whether the calculation methods were acknowledged in the cited work and whether the enrolled patients were similar to the sample from which the MCID estimate was derived. We found a concerning variation in the methods employed to estimate MCID. We also found a lack of transparency in identifying calculation methods and applicable health conditions in the cited work. Thus, clinicians and researchers must pay close attention and exercise caution in assuming changes in patient status that exceed a specific MCID reflect meaningful improvements in health status. A common standard for the calculation and reporting of an MCID is needed to address threats to the validity of conclusions drawn from the interpretation of an MCID.

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Section: Discussionmentioning

confidence: 99%

Challenges in applying minimal clinically important difference: a critical review

Podurgiel,

Piscitelli,

Denegar

2024

International Journal of Rehabilitation Research

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“…The latter was performed because scales' total scores are ordinal and, as such, should not be used with parametric statistical techniques such as ANCOVA ( 68 , 69 ), as this may lead to erroneous results ( 70 ). The Rasch analysis allowed to elaborate conversion tables of the scales' total scores into invariant interval-level estimates of ability (whose unit of measurement is the logit) that satisfy the mathematical requirements of a general measurement theory called Additive Conjoint Measurement ( 71 , 72 ). In other words, interval-level estimates produced by Rasch analysis are comparable in measurement properties to those delivered by instruments measuring physical variables, such as a thermometer.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a multiple-component and multifactorial personalized fall prevention program in a mixed population of community-dwelling older adults with stroke, Parkinson's Disease, or frailty compared to usual care: The PRE.C.I.S.A. randomized controlled trial

Porta

Lullini²,

Caselli³

et al. 2022

Front. Neurol.

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BackgroundFall risk in the elderly is a major public health issue due to the injury-related consequences and the risk of associated long-term disability. However, delivering preventive interventions in usual clinical practice still represents a challenge.AimTo evaluate the efficacy of a multiple-component combined with a multifactorial personalized intervention in reducing fall rates in a mixed population of community-dwelling elderly compared to usual care.DesignRandomized Controlled Trial (NCT03592420, clinicalTrials.gov).SettingOutpatients in two Italian centers.Population403 community-dwelling elderly at moderate-to-high fall risk, including subjects with Parkinson's Disease and stroke.MethodsAfter the randomization, the described interventions were administered to the intervention group (n = 203). The control group (n = 200) received usual care and recommendations to minimize fall risk factors. In addition, each participant received a fall diary, followed by 12 monthly phone calls. The primary endpoint was the total number of falls in each group over 12 months, while the secondary endpoints were other fall-related indicators recorded at one year. In addition, participants' functioning was assessed at baseline (T1) and 3-month (T3).Results690 falls were reported at 12 months, 48.8% in the intervention and 51.2% in the control group, with 1.66 (± 3.5) and 1.77 (± 3.2) mean falls per subject, respectively. Subjects with ≥ 1 fall and ≥2 falls were, respectively, 236 (58.6%) and 148 (36.7%). No statistically significant differences were observed between groups regarding the number of falls, the falling probability, and the time to the first fall. According to the subgroup analysis, no significant differences were reported. However, a statistically significant difference was found for the Mini-BESTest (p = 0.004) and the Fullerton Advanced Balance Scale (p = 0.006) for the intervention group, with a small effect size (Cohen's d 0.26 and 0.32, respectively), at T1 and T3 evaluations.ConclusionsThe intervention was ineffective in reducing the number of falls, the falling probability, and the time to the first fall at 12 months in a mixed population of community-dwelling elderly. A significant improvement for two balance indicators was recorded in the intervention group. Future studies are needed to explore different effects of the proposed interventions to reduce falls and consequences.

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“…The latter was performed because scales’ total scores are ordinal in nature and, as such, should not be used with parametric statistical techniques such as ANCOVA (55, 56), as it may lead to erroneous results (57). The Rasch analysis allowed to elaborate conversion tables of the scales’ total scores into invariant interval-level estimates of ability (whose unit of measurement is the logit) that satisfy the mathematical requirements of a general measurement theory called Additive Conjoint Measurement (58, 59). In other words, interval-level estimates produced by Rasch analysis are comparable in measurement properties to those delivered by instruments measuring physical variables, such as a thermometer.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of a multiple-component and multifactorial personalized fall prevention program in a mixed population of community-dwelling older adults with stroke, Parkinson’s disease, or frailty compared to usual care: The PRE.C.I.S.A. Randomized Controlled Trial

Porta

Caselli

2022

Preprint

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Background: The fall risk in the elderly is a major public health issue due to the immediate injury-related consequences and the risk of associated long-term disability. However, the delivery of effective interventions for fall prevention in usual clinical practice still represents a challenge. Aim: To evaluate the efficacy of a multiple-component intervention combined with a multifactorial personalized intervention in reducing fall rates in community-dwelling older adults at moderate-to-high fall risk compared to usual care. Design: Randomized Controlled Trial (unique identifier NCT03592420, clinicaltrials.gov). Setting: Outpatients in two Italian centers. Population: 403 community-dwelling older adults at moderate-to-high fall risk, including subjects with Parkinson Disease and stroke. Methods: Subjects were randomized to the intervention (n=203) or the control group (n=200). A multiple-component and multifactorial personalized interventions were administered to the experimental intervention group. Participants allocated to the control group received usual care and recommendations to minimize the fall risk factors. In addition, each participant was given a diary to record falls and was followed for 12 months with monthly telephone contacts. The primary endpoint was represented by the total number of falls in each group over 12 months. The secondary endpoints were other fall-related indicators (fall rate of subjects with one or more falls, fall rate associated with hospitalization, fall severity, fall probability, and time to the first fall) recorded at the 12-month follow-up. Besides, several clinical scales were used to assess baseline (T1) and 3-month follow-up (T3) functioning. Results: A total of 690 falls were reported at 12-month follow-up, 337 (48.8%) in the intervention group and 353 (51.2%) in the control group with 1.66 (± 3.5) and 1.77 (± 3.2) mean falls per subject, respectively. The number of subjects with at least one fall was 236 (58.6%), with 119 (58.6%) and 117 falls (58.5%) in the intervention and control groups, respectively. No statistically significant differences were observed between groups regarding the number of falls, the fall probability, and the time to the first fall at 12-month follow-up. Furthermore, according to the subgroup analysis, no significant differences were reported between subgroups (i.e., the four etiological class categories of interest for the study). Finally, considering the two groups at pre-test (T1) and post-test (T3) evaluations, a statistically significant difference was found only for the Fullerton Advanced Balance Scale (p=0.006) and the Mini-BESTest (p=0.004) in favor of the intervention group. Conclusions: The proposed intervention was ineffective in reducing the number of falls, the fall probability, and the time to the first fall at 12-month follow-up in community-dwelling older adults at moderate-to-high fall risk. However, a lower number of falls, lower fall rates in multiple fallers, a lower mean number of falls per participant, and a lower rate of fall-related severe injuries were recorded for the intervention group, although not significant. Finally, a significant improvement for two balance-related indicators was recorded in the intervention group between pre and post-test evaluations. Future studies are needed to explore different effects of combined multiple-component and personalized multifactorial interventions to reduce falls and subsequent consequences. Future studies should also be planned with the clear aim of overcoming the limitations highlighted in the PRE.C.I.S.A. study.

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’Less is more’: validation with Rasch analysis of five short-forms for the Brain Injury Rehabilitation Trust Personality Questionnaires (BIRT-PQs)

Cited by 12 publications

References 39 publications

Challenges in applying minimal clinically important difference: a critical review

Challenges in applying minimal clinically important difference: a critical review

Efficacy of a multiple-component and multifactorial personalized fall prevention program in a mixed population of community-dwelling older adults with stroke, Parkinson's Disease, or frailty compared to usual care: The PRE.C.I.S.A. randomized controlled trial

Efficacy of a multiple-component and multifactorial personalized fall prevention program in a mixed population of community-dwelling older adults with stroke, Parkinson’s disease, or frailty compared to usual care: The PRE.C.I.S.A. Randomized Controlled Trial

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