Author/Editor		Tennant, Alan; Penta, Massimo; Tesio, Luigi; Grimby, Gunnar; Thonnard, Jean-Louis; Slade, Anita; Lawton, Gemma; Simone, Anna; Marinček, Črt; Burger, Helena
Title		Assessing and adjusting for cross-cultural validity of impairment and activity limitation scales through differential item functioning within the framework of the Rasch model: the PRO-ESOR project
Type		članek
Source		Med Care
Vol. and No.		Letnik 42, št. 1 Suppl
Publication year		2004
Volume		str. I-37 - 48
Language		eng
Abstract		Introduction: In Europe it is common for outcome measures to be translated for use in other languages. This adaptation may be complicated by culturally specific approaches to certain tasks; for example, bathing. In this context the issue of cross-cultural validity becomes paramount. Objective: To facilitate the pooling of data in international studies, a project set out to evaluate the cross-cultural validity of impairment and activity limitation measures used in rehabilitation from the perspective of the Rasch measurement model. Methods: Cross-cultural validity is assessed through an analysis of Differential Item Functioning (DIF) within the context of additive conjoint measurement expressed through the Rasch model. Data from patients undergoing rehabilitation for stroke was provided from 62 centers across Europe. Two commonly used outcome measures, the Mini-Mental State Examination (MMSE) and the Functional Independence Measure (FIM) motor scale are used to illustrate the anoroach. Results: Pooled data from 3 countries for the MMSE were shown to fit the Rasch model with only 1 item displaying DIF by country. In contrast, many items from the FIM expressed DIF and misfit to the model. Consequently they were allowed to be unique across countries, so resolving the lack of fit to the model. Conclusions: Where data are to be pooled for international studies, analysis of DIF by culture is essential. Where DIF is observed, adjustments can be made to allow for cultural differences in outcome measurement.
Descriptors		CEREBROVASCULAR DISORDERS ACTIVITIES OF DAILY LIVING DISABILITY EVALUATION CROSS-CULTURAL COMPARISON OUTCOME ASSESSMENT (HEALTH CARE) ADAPTATION, PSYCHOLOGICAL ANALYSIS OF VARIANCE SEX FACTORS EUROPE MODELS, THEORETICAL PSYCHOMETRICS QUESTIONNAIRES REPRODUCIBILITY OF RESULTS SENSITIVITY AND SPECIFICITY SICKNESS IMPACT PROFILE