Structural validity and construct validity of the Dutch-Flemish PROMIS^® physical function-upper extremity version 2.0 item bank in Dutch patients with upper extremity injuries

Abstract

Introduction: Aim of this study was to validate the Dutch-Flemish Patient-Reported Outcomes Measurement Information System Physical Function-Upper Extremity version 2.0 item bank in patients with upper extremity injuries. Materials and methods: Cross-sectional study. Structural validity was assessed using Confirmatory Factor Analysis examining unidimensionality. In addition, a bi-factor model was fitted. Internal consistency was assessed by Cronbach's alpha. Construct validity was examined by assessing correlations with legacy instruments Disability of Arm Shoulder and Hand, Patient Reported Wrist Evaluation and Michigan Hand Questionnaire subscale Activities in Daily Life. Results: A total of 303 patients (144 female) with mean age of 50 years (standard deviation 18) were included. Confirmatory Factor Analysis showed Comparative Fit Index of 0.94, a Tucker Lewis Index of 0.93, a Root Mean Square Error of Approximation of 0.12 and a Standardized Root Mean Residual of 0.09. Factor loadings were all above 0.70. Bifactor analysis showed an omega-H of 0.79 and Explained Common Variance of 0.67. The correlations with the legacy instruments were as expected or higher than expected. Conclusion: The Dutch-Flemish Patient-Reported Outcomes Measurement Information System Physical Function-Upper Extremity version 2.0 item bank measures a unidimensional trait and sufficient construct validity was found. ä IMPLICATIONS FOR REHABILITATION Completing Patient Reported Outcomes is time-consuming for patients and interpretability of outcomes is sometimes unclear due to some variation in psychometric properties. Computerized Adaptive Testing reduces the burden for patients by using an algorithm which decreases the amount of questions that need to be answered to 4 to 7 items. The Dutch-Flemish Patient-Reported Outcomes Measurement Information System Physical Function-Upper Extremity version 2.0 item bank measures a unidimensional trait and has sufficient structural validity, internal consistency and construct validity. After calibration of the Patient-Reported Outcomes Measurement Information System Physical Function-Upper Extremity version 2.0, the item bank is operable to use with Computerized Adaptive Testing.

Graded response model fit, measurement invariance and (comparative) precision of the Dutch-Flemish PROMIS® Upper Extremity V2.0 item bank in patients with upper extremity disorders

“…We validated the DF-PROMIS-UE v2.0 item bank in a Dutch population with upper extremity disorders. Together with two recent publications from our research group, this study provides the first complete foreign language validation of this item bank [16,17]. Although we found some problems with the unidimensionality and the measurement invariance assumptions of the IRT model, a good IRT model fit and a high reliability across a wide range of the construct for the DF-PROMIS-UE v2.0 item bank were found.…”

“…However, for clinical practice, a more practical 'lean' core set is advisable including a PROM with low burden for the patient and clinician. An advantage of the incorporating the DF-PROMIS-UE v2.0 in this 'lean' core set is that it has high correlation with other PROMs reporting on UE disorders, it decreases burden for patients and clinicians and it will allow clinicians to speak a 'common language' with regard to outcome reporting [61,62]. However, the PROM should be able to detect clinical relevant change as expressed in the Minimal Important Change (MIC).…”

“…Patients were eligible if they were 18 years or older, had an UE disorder, were able to read Dutch and provided informed consent. Because we deemed a sample of at least 500 patients mandatory for item parameter estimation, data of studies performed by van Bruggen et al [17] and Haan et al [16] were pooled [18]. To study measurement invariance for language, we used additional data of US patients from an online panel, aged 18 years or older, who endorsed having some difficulty due to UE pain or function [15].…”

“…PROMIS included an item bank that measures UErelated physical functioning and this bank has recently been updated, from v1.2 to v2.0, to measure a wider range of upper extremity functioning and showed higher precision when used in patients with UE disorders [15]. The v2.0 item bank was translated into Dutch-Flemish (DF-PROMIS-UE v2.0) and some of the psychometric properties of this bank have been studied in patients with UE disorders from a general [16] and an academic hospital [17]. Evidence was found for the following psychometric properties: internal consistency [17], structural validity [17], construct validity [16,17] and crosscultural validity [16].…”

“…The v2.0 item bank was translated into Dutch-Flemish (DF-PROMIS-UE v2.0) and some of the psychometric properties of this bank have been studied in patients with UE disorders from a general [16] and an academic hospital [17]. Evidence was found for the following psychometric properties: internal consistency [17], structural validity [17], construct validity [16,17] and crosscultural validity [16]. In addition, absence of floor and ceiling effects in the full bank and the 7-item short form was shown [16].…”