Differential item functioning of the SF-12 in a population-based regional joint replacement registry
Abstract Background Joint replacement, an increasingly common procedure amongst older adults, can substantially improve health-related quality of life (HRQoL). However, differential item functioning (DIF) may affect the accurate interpretation of differences in HRQoL amongst patients with different...
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| Format: | Article |
| Language: | English |
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BMC
2019-07-01
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| Series: | Health and Quality of Life Outcomes |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12955-019-1166-1 |
| _version_ | 1818244544064389120 |
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| author | Iraj Yadegari Eric Bohm Olawale F. Ayilara Lixia Zhang Richard Sawatzky Tolulope T. Sajobi Lisa M. Lix |
| author_facet | Iraj Yadegari Eric Bohm Olawale F. Ayilara Lixia Zhang Richard Sawatzky Tolulope T. Sajobi Lisa M. Lix |
| author_sort | Iraj Yadegari |
| collection | DOAJ |
| description | Abstract Background Joint replacement, an increasingly common procedure amongst older adults, can substantially improve health-related quality of life (HRQoL). However, differential item functioning (DIF) may affect the accurate interpretation of differences in HRQoL amongst patients with different demographic and health status characteristics but the same underlying (i.e., latent) level of the investigated construct. This study tested for DIF in pre-operative SF-12 physical health (PH) and mental health (MH) sub-scale items amongst patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). Methods Data were from a population-based joint replacement registry from the Canadian province of Manitoba. TKA and THA patients who had surgery between 2009 and 2015 and completed a pre-operative assessment were included. DIF was tested using the multiple indicators multiple causes (MIMIC) method with sex, age group, body weight status, and presence of multiple comorbid conditions (i.e., multimorbidity) as covariates. Analyses were stratified by joint type. Results The study cohort included 8820 patients; 42.1% underwent THA, 57.3% were female, 32.7% were 70+ years, and 52.8% were obese. For each sub-scale, four of the six items exhibited DIF in both THA and TKA groups. Differences in the covariate effect estimates for DIF and No-DIF models on the MH latent variable were largest for age and body weight status for the THA group, and for sex and multimorbidity for the TKA group. All of the differences were small for PH. Multimorbidity had the strongest association with PH and age and sex had the strongest association with MH in the DIF models. Conclusions Demographic and health status characteristics influenced SF-12 PH and MH item responses in joint replacement populations, although the size of the effects were not large for PH. We recommend testing and adjusting for DIF effects to ensure comparability of HRQoL measures in joint replacement populations. |
| first_indexed | 2024-12-12T14:18:42Z |
| format | Article |
| id | doaj.art-ff83e1fdd6804e928e2db9263c021f03 |
| institution | Directory Open Access Journal |
| issn | 1477-7525 |
| language | English |
| last_indexed | 2024-12-12T14:18:42Z |
| publishDate | 2019-07-01 |
| publisher | BMC |
| record_format | Article |
| series | Health and Quality of Life Outcomes |
| spelling | doaj.art-ff83e1fdd6804e928e2db9263c021f032022-12-22T00:21:52ZengBMCHealth and Quality of Life Outcomes1477-75252019-07-0117111110.1186/s12955-019-1166-1Differential item functioning of the SF-12 in a population-based regional joint replacement registryIraj Yadegari0Eric Bohm1Olawale F. Ayilara2Lixia Zhang3Richard Sawatzky4Tolulope T. Sajobi5Lisa M. Lix6Department of Mathematics and Statistics, University of OttawaDepartment of Surgery, University of ManitobaDepartment of Mathematics and Statistics, University of OttawaDepartment of Mathematics and Statistics, University of OttawaSchool of Nursing, Trinity Western UniversityDepartment of Community Health Sciences, University of CalgaryDepartment of Mathematics and Statistics, University of OttawaAbstract Background Joint replacement, an increasingly common procedure amongst older adults, can substantially improve health-related quality of life (HRQoL). However, differential item functioning (DIF) may affect the accurate interpretation of differences in HRQoL amongst patients with different demographic and health status characteristics but the same underlying (i.e., latent) level of the investigated construct. This study tested for DIF in pre-operative SF-12 physical health (PH) and mental health (MH) sub-scale items amongst patients undergoing total hip arthroplasty (THA) and total knee arthroplasty (TKA). Methods Data were from a population-based joint replacement registry from the Canadian province of Manitoba. TKA and THA patients who had surgery between 2009 and 2015 and completed a pre-operative assessment were included. DIF was tested using the multiple indicators multiple causes (MIMIC) method with sex, age group, body weight status, and presence of multiple comorbid conditions (i.e., multimorbidity) as covariates. Analyses were stratified by joint type. Results The study cohort included 8820 patients; 42.1% underwent THA, 57.3% were female, 32.7% were 70+ years, and 52.8% were obese. For each sub-scale, four of the six items exhibited DIF in both THA and TKA groups. Differences in the covariate effect estimates for DIF and No-DIF models on the MH latent variable were largest for age and body weight status for the THA group, and for sex and multimorbidity for the TKA group. All of the differences were small for PH. Multimorbidity had the strongest association with PH and age and sex had the strongest association with MH in the DIF models. Conclusions Demographic and health status characteristics influenced SF-12 PH and MH item responses in joint replacement populations, although the size of the effects were not large for PH. We recommend testing and adjusting for DIF effects to ensure comparability of HRQoL measures in joint replacement populations.http://link.springer.com/article/10.1186/s12955-019-1166-1ArthroplastyClinical registryHealth-related quality of lifeMeasurement bias |
| spellingShingle | Iraj Yadegari Eric Bohm Olawale F. Ayilara Lixia Zhang Richard Sawatzky Tolulope T. Sajobi Lisa M. Lix Differential item functioning of the SF-12 in a population-based regional joint replacement registry Health and Quality of Life Outcomes Arthroplasty Clinical registry Health-related quality of life Measurement bias |
| title | Differential item functioning of the SF-12 in a population-based regional joint replacement registry |
| title_full | Differential item functioning of the SF-12 in a population-based regional joint replacement registry |
| title_fullStr | Differential item functioning of the SF-12 in a population-based regional joint replacement registry |
| title_full_unstemmed | Differential item functioning of the SF-12 in a population-based regional joint replacement registry |
| title_short | Differential item functioning of the SF-12 in a population-based regional joint replacement registry |
| title_sort | differential item functioning of the sf 12 in a population based regional joint replacement registry |
| topic | Arthroplasty Clinical registry Health-related quality of life Measurement bias |
| url | http://link.springer.com/article/10.1186/s12955-019-1166-1 |
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