Abstract
Objectives: Chronic obstructive pulmonary disease is a major global health problem. Although several patient-reported outcome (PRO) measures of chronic obstructive pulmonary disease exist, none were developed using patient-driven concept development. We developed an item bank for dyspnea severity and related functional limitations on the basis of a PRO conceptual framework derived from patient input. Methods: We identified a large pool of existing items based on a conceptual framework and literature review. Using patient and expert review panels and an item refinement/modification process, we developed an item bank aligned with the conceptual framework, which subsequently underwent psychometric testing via an online Internet panel of dyspnea patients (N = 608). Results: Exploratory factor analysis suggested a dominant first factor accounting for about 78% of the total variance. Confirmatory factor analysis supported a unidimensional model. Item response theory analysis demonstrated good model fit, and differential item functioning analyses indicated that the 33-item scale showed potential for measurement equivalence across sex. A 10-item short form produced comparable scores (r = 0.98) and a computerized adaptive-testing simulation indicated efficient measurement with fewer items (mean 4.65 items). Conclusions: An efficient patient-reported measure of dyspnea severity and related functional limitations, based on a patient-driven PRO conceptual framework, is now available for further validation and use.
Original language | English (US) |
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Pages (from-to) | 291-306 |
Number of pages | 16 |
Journal | Value in Health |
Volume | 14 |
Issue number | 2 |
DOIs | |
State | Published - 2011 |
Funding
Funding: This work was supported in part by a grant from Boehringer Ingelheim Pharmaceuticals .
Keywords
- COPD
- Computer adaptive testing
- Dyspnea
- Measurement
- Scale development
ASJC Scopus subject areas
- Health Policy
- Public Health, Environmental and Occupational Health