Validating the 28-Tender Joint Count Using Item Response Theory

Siemons, Liseth; Klooster, Peter M. ten; Taal, Erik; Kuper, Ina H.; Riel, P.L.C.M. van; Laar, Mart A F J van de; Glas, Cornelis A.W.

doi:10.3899/jrheum.110436

Cited by 10 publications

(14 citation statements)

References 35 publications

(45 reference statements)

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“…Both the 28-and 38-joint counts of tenderness and swelling had to fit the GPCM before the contribution of the forefoot joints could be analyzed. This fit was analyzed with Lagrange Multiplier Q1 tests (15), where absolute effect sizes of Ͻ0.10 were seen as an indication of good item-model fit (16,17).…”

Section: Methodsmentioning

confidence: 99%

Contribution of assessing forefoot joints in early rheumatoid arthritis patients: Insights from item response theory

Siemons¹,

Klooster²,

Taal³

et al. 2013

Arthritis Care & Research

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Objective. To evaluate the contribution of assessing forefoot joints to the measurement range and measurement precision of joint counts in early rheumatoid arthritis (RA) using item response theory. Methods. Baseline measures of tender and swollen joint counts were analyzed in 459 early RA patients from the Dutch Rheumatoid Arthritis Monitoring remission induction cohort. The contribution of forefoot joints was studied by evaluating their effect on the measurement range and measurement precision of measures based on 28-joint counts. In addition, the alignment between the patient and joint distributions was investigated to determine whether the forefoot joints were informative for measuring joint tenderness or swelling of an early RA patient. Results. In total, 233 patients (50.76%) experienced tenderness and 200 patients (43.57%) experienced swelling in >1 forefoot joint. Forefoot joints were more informative for measuring joint tenderness than joint swelling, but did not significantly improve the measurement range and measurement precision of the 28-joint counts. Furthermore, including forefoot joints did not remove the existing discrepancy between the joint and patient distributions in both joint counts. Conclusion. Forefoot joints were frequently affected on an individual level, but did not significantly improve the measurement range or precision of 28-joint counts in patients with early RA. From a measurement perspective, reduced joint counts are appropriate for use on a population level. The contribution of assessing forefoot joints on an individual level requires further investigation. Additionally, the results should be cross-validated in patients with longer disease durations to determine whether the pattern of joint involvement is similar in later stages of RA.

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Section: Methodsmentioning

confidence: 99%

Contribution of assessing forefoot joints in early rheumatoid arthritis patients: Insights from item response theory

Siemons¹,

Klooster²,

Taal³

et al. 2013

Arthritis Care & Research

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“…13,[24][25][26] Furthermore, IRT can deal with missing data and scales that contain items with different response formats, which is an important advantage, because the PhilipsQ contains both dichotomous and polytomous items and consists of several introductory and follow-up items that result in many missing data. 22,23,27 Finally, IRT offers detailed insight in the psychometric characteristics. 27 Factor analysis was performed in two steps; first, the factor structures of the three questionnaires used in the PhilipsQ (the BerlinQ, STOPQ, and AIS) were analyzed.…”

Section: Factor Analysismentioning

confidence: 99%

“…22,23,27 Finally, IRT offers detailed insight in the psychometric characteristics. 27 Factor analysis was performed in two steps; first, the factor structures of the three questionnaires used in the PhilipsQ (the BerlinQ, STOPQ, and AIS) were analyzed. Second, factor analysis was performed on the PhilipsQ to assess if the observed responses could be explained by an underlying structure and to assess the psychometric properties of the items.…”

Section: Factor Analysismentioning

confidence: 99%

Obstructive Sleep Apnea Syndrome in Company Workers: Development of a Two-Step Screening Strategy with a New Questionnaire

Eijsvogel

Wiegersma

Randerath

et al. 2016

Journal of Clinical Sleep Medicine

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costly further investigations (like polysomnography [PSG]). This can be achieved by a test with a high specificity, mostly at the expense of reduced sensitivity, so accepting some missed cases. In addition, a confirmation test (in OSAS a sleep study) in subjects with positive test results should be performed. The Study Objectives: To develop and evaluate a screening questionnaire and a two-step screening strategy for obstructive sleep apnea syndrome (OSAS) in healthy workers. Methods: This is a cross-sectional study of 1,861 employees comprising healthy blue-and white-collar workers in two representative plants in the Netherlands from a worldwide consumer electronic company who were approached to participate. Employees were invited to complete various sleep questionnaires, and undergo separate single nasal flow recording and home polysomnography on two separate nights. Results: Of the 1,861 employees, 249 provided informed consent and all nasal flow and polysomnography data were available from 176 (70.7%). OSAS was diagnosed in 65 (36.9%). A combination of age, absence of insomnia, witnessed breathing stops, and three-way scoring of the Berlin and STOPBANG questionnaires best predicted OSAS. Factor analysis identified a six-factor structure of the resulting new questionnaire: snoring, snoring severity, tiredness, witnessed apneas, sleep quality, and daytime well-being. Subsequently, some questions were removed, and the remaining questions were used to construct a new questionnaire. A scoring algorithm, computing individual probabilities of OSAS as high, intermediate, or low risk, was developed. Subsequently, the intermediate risk group was split into low and high probability for OSAS, based on nasal flow recording. This two-step approach showed a sensitivity of 63.1%, and a specificity of 90.1%. Specificity is important for low prevalence populations. Conclusion: A two-step screening strategy with a new questionnaire and subsequent nasal flow recording is a promising way to screen for OSAS in a healthy worker population. Keywords: home recording, polysomnography, questionnaire, screening, sleep apnea syndrome Clinical Trial Registration: Development and validation of a screening instrument for obstructive sleep apnea syndrome in healthy workers. Netherlands Trial Register (www.trailregister.nl), number: NTR2675. Citation: Eijsvogel MM, Wiegersma S, Randerath W, Verbraecken J, Wegter-Hilbers E, van der Palen J. Obstructive sleep apnea syndrome in company workers: development of a two-step screening strategy with a new questionnaire. J Clin Sleep Med 2016;12(4):555-564. I NTRO DUCTI O NObstructive sleep apnea syndrome (OSAS) is a prevalent and treatable disease with often impaired daytime performance and increased cardiovascular and metabolic risks. Recently, increasing awareness for these consequences is reflected in a growing interest in screening for OSAS.1-3 Screening for OSAS can be important in a hospital setting (preoperative patients), primary care, work environment or in specific groups such as commercial...

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“…To a lesser extent, studies applied IRT to PRO measures of specific functioning [27,[29][30][31][32][33][34][35][36][37], pain [35,[38][39][40][41][42][43], psychological constructs [44][45][46], and work disability [47][48][49][50][51]. Studies also applied IRT to CMs such as measures of disease activity [52][53][54] and disease damage or radiographic severity [55][56][57].…”

Section: General Information Of Included Studiesmentioning

confidence: 99%

“…factors on the level of inflammatory markers [22,[47][48][49][50][51][52][53][54][55][56][57][58][59][60][61][62], and the inclusion of a subjective patient-reported outcome measure [44,45]. The aim of this thesis is to address some of these issues to improve our understanding of the complexities behind the measurement of disease activity in early rheumatoid arthritis patients.…”

Section: Introductionmentioning

confidence: 99%

Measuring disease activity in patients with early rheumatoid arthritis

Tjin-Kam-Jet-Siemons¹

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Validating the 28-Tender Joint Count Using Item Response Theory

Cited by 10 publications

References 35 publications

Contribution of assessing forefoot joints in early rheumatoid arthritis patients: Insights from item response theory

Contribution of assessing forefoot joints in early rheumatoid arthritis patients: Insights from item response theory

Obstructive Sleep Apnea Syndrome in Company Workers: Development of a Two-Step Screening Strategy with a New Questionnaire

Measuring disease activity in patients with early rheumatoid arthritis

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