Single-item screens identified patients with elevated levels of depressive and somatization symptoms in outpatient physical therapy

Abstract

Lack of differential item functioning suggested depressive and somatization screening could be useful in routine clinical practice and allowed the development of single-item screens that accurately identified patients with elevated depressive or somatization symptoms. Item response theory-based single-item screens may facilitate evaluation and management of heterogeneous populations receiving outpatient physical therapy.

The Concurrent Validity of Brief Screening Questions for Anxiety, Depression, Social Isolation, Catastrophization, and Fear of Movement in People With Low Back Pain

“…This mirrors the finding of Hart et al 20,43 who, measuring Differential Item Functioning across a broad range of clinical characteristics, found stability of concurrent validity in their screening questions for fear of movement, depression, and somatization. One was primary care, mostly fee-for-service, with episode durations that ranged from subacute to chronic, in an individualistic society (Australia).…”

“…There are now alternative statistical approaches, based on Item Response Theory, that have been used to identify suitable screening questions, such as that used by Hart et al 20,43 The novelty of this approach is that these techniques, such as the Graded Response Model 24,25 and Rasch analysis, 44,45 allow description of Differential Item Functioning (whether items are stable across key patient subgroups), item fit, item difficulty, response option performance, and appropriate cut-off points in ways that vary from traditional methods, and have shown greater precision for the construction of multi-item questionnaires with ideal measurement properties. However, the approach used by Hart and colleagues to identify screening questions used factor analysis (a Classical Test Theory method) to test questionnaire unidimensionality and local item independence, and also used ROC curve analysis to identify which screening questions were best, thereby following the traditional method pathways for these components of the selection process.…”

Physical Therapists' Level of McKenzie Education, Functional Outcomes, and Utilization in Patients With Low Back Pain

“…Second, the regression model of the present study, though robust, did not include additional potential confounders, such as patients' psychosocial status 35,36,64 and therapist-patient working alliance, 40,52 because these variables were not available. There is increasing evidence that the therapist-patient therapeutic relationship contributes significantly to improving patient outcomes.…”

Pain assessment in context: a state of the science review of the McGill pain questionnaire 40 years on

“…Item response theory has been used to identify suitable screening questions 64,65 which have proved as effective as longer Table 4 Implications of advances in pain measurement and methodology. * Increased precision in experimental pain measurement and in psychophysical methodology has clarified the relationship between nociception, pain perception, and the immediate response to pain Improved understanding of representativeness and use of composite ratings has led to the development of clearer assessment protocols There are significant differences however in the context and significance of experimental and of clinical pain which limit the extent to which laboratory findings can be translated into clinical applications Although assessment of pain quality has remained at the heart of pain research and treatment, consideration of the process and the outcome of clinical care requires attention to the style and context of care as well as treatment content Careful consideration should be given to the measurement of change, including consideration of the determinants of change, process evaluation and measurement error Longitudinal designs with repeated measurement, the identification of moderators and mediators, and powerful statistical processing can enable more accurate estimates of treatment effects and assist the design and targeting of interventions Implications of research into the psychology of pain.…”