Enhancing Measurement Precision of Patient-Reported Outcomes Using Item Response Theory.
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| Title: | Enhancing Measurement Precision of Patient-Reported Outcomes Using Item Response Theory. |
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| Authors: | Ntumi, Simon1 (AUTHOR) sntumi@uew.edu.gh, Sakyi, Lawrence Larbi2 (AUTHOR), Bulala, Tapela3 (AUTHOR), Agbovor, Divine1 (AUTHOR), Amfo, Gabriel Odame1 (AUTHOR), Gabla, John1 (AUTHOR), Anakwa, Rudi1 (AUTHOR), Amezah, Emmanuel Ohene1 (AUTHOR) |
| Source: | Inquiry (00469580). 4/13/2026, Vol. 63, p1-11. 11p. |
| Subject Terms: | *Predictive tests, *Statistical correlation, *Self-evaluation, *Research methodology evaluation, *Quality of life, *Research, *Clinics, *Factor analysis, Statistical models, Clinical medicine, Cross-sectional method, Patient compliance, Scale analysis (Psychology), Health status indicators, Cronbach's alpha, Key performance indicators (Management), Health policy, Research evaluation, Statistical sampling, Questionnaires, Evaluation of medical care, Descriptive statistics, Quantitative research, Decision making in clinical medicine, Chi-squared test, Judgment sampling, Psychometrics, Health outcome assessment, Health equity, Data analysis software, Reliability (Personality trait) |
| Geographic Terms: | Ghana |
| Abstract: | Accurate assessment of patient-reported outcomes (PROs) is essential for informing clinical decision-making and guiding health policy. Item Response Theory (IRT) enhances measurement by providing detailed evidence on item discrimination, difficulty, fairness, and precision, consistent with COSMIN guidelines. A quantitative, cross-sectional design was employed, involving 500 adult patients attending outpatient facilities across public, private, and community-based healthcare centers in southern Ghana. Stratified random sampling was used to ensure representativeness across settings. Psychometric evaluation combined CTT analyzes Cronbach's alpha, item-total correlations, and factor analysis with IRT modeling, specifically the graded response model (GRM). CTT analyses indicated good internal consistency (Cronbach's α =.84), while IRT modeling (graded response model) showed higher reliability (marginal reliability = 0.91) and revealed patterns of precision across the health spectrum. IRT-based scores were meaningfully associated with treatment adherence (β =.45), quality of life (β =.41), and self-reported health status (β =.38), illustrating predictive validity. Differential item functioning analyses indicated limited subgroup bias. Integrating CTT and IRT strengthens the rigor, precision, and fairness of PRO measurement. IRT-calibrated instruments demonstrate practical value for clinical monitoring and health system evaluation and are recommended for routine implementation in diverse healthcare settings. [ABSTRACT FROM AUTHOR] |
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| Database: | Education Research Complete |
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| Abstract: | Accurate assessment of patient-reported outcomes (PROs) is essential for informing clinical decision-making and guiding health policy. Item Response Theory (IRT) enhances measurement by providing detailed evidence on item discrimination, difficulty, fairness, and precision, consistent with COSMIN guidelines. A quantitative, cross-sectional design was employed, involving 500 adult patients attending outpatient facilities across public, private, and community-based healthcare centers in southern Ghana. Stratified random sampling was used to ensure representativeness across settings. Psychometric evaluation combined CTT analyzes Cronbach's alpha, item-total correlations, and factor analysis with IRT modeling, specifically the graded response model (GRM). CTT analyses indicated good internal consistency (Cronbach's α =.84), while IRT modeling (graded response model) showed higher reliability (marginal reliability = 0.91) and revealed patterns of precision across the health spectrum. IRT-based scores were meaningfully associated with treatment adherence (β =.45), quality of life (β =.41), and self-reported health status (β =.38), illustrating predictive validity. Differential item functioning analyses indicated limited subgroup bias. Integrating CTT and IRT strengthens the rigor, precision, and fairness of PRO measurement. IRT-calibrated instruments demonstrate practical value for clinical monitoring and health system evaluation and are recommended for routine implementation in diverse healthcare settings. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 00469580 |
| DOI: | 10.1177/00469580261441163 |