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Benemei S, Boni L, Castaman G. Outcome measures in hemophilia: current and future perspectives. Expert Rev Hematol 2024; 17:329-340. [PMID: 38861342 DOI: 10.1080/17474086.2024.2365929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 06/05/2024] [Indexed: 06/13/2024]
Abstract
INTRODUCTION Hemophilia can detrimentally affect patients' quality of life and likelihood of survival. In the evolving landscape of therapies, the therapeutic gain of each treatment must be understood to accurately position it in the therapeutic armamentarium. Accordingly, appropriate outcomes must be measured with appropriate tools. AREAS COVERED Our narrative review (PubMed search for 'hemophilia AND outcome' until June 2023), provides a compendium of outcome measures used in hemophilia clinical research. To define each outcome measure's relative value and applicability, several characteristics are critically discussed. EXPERT OPINION Bleeding assessment, first annual/annualized bleeding rate, remains central in evaluating the efficacy and safety of hemophilia treatments. As modern therapies improve clinical outcomes toward zero bleeding events, this endpoint may become less sensitive to detect differences between therapeutic approaches. Technological advancements necessitate the adaptation of outcome measures to address infrequent bleeding events, age-related comorbidities, and laboratory parameters with limited comparability after different treatments. Considerable effort has been dedicated to the development of tools that comprehensively assess coagulation, such as thrombin generation assays. Patient-reported outcome measures are gaining importance although limited by their subjectivity. A definitive set of research outcome measures remains elusive. Outcomes may need to be tailored to different therapeutic interventions.
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Affiliation(s)
| | - Luca Boni
- U.O. Epidemiologia Clinica, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Giancarlo Castaman
- Center for Bleeding Disorders and Coagulation, Department of Oncology, Careggi University Hospital, Florence, Italy
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Cao ZY, Lin F, Feng C. Interpretation of course conceptual structure and student self-efficacy: an integrated strategy of knowledge graphs with item response modeling. BMC MEDICAL EDUCATION 2024; 24:563. [PMID: 38783267 PMCID: PMC11119392 DOI: 10.1186/s12909-024-05401-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/08/2024] [Indexed: 05/25/2024]
Abstract
BACKGROUND There is a scarcity of studies that quantitatively assess the difficulty and importance of knowledge points (KPs) depending on students' self-efficacy for learning (SEL). This study aims to validate the practical application of psychological measurement tools in physical therapy education by analyzing student SEL and course conceptual structure. METHODS From the "Therapeutic Exercise" course curriculum, we extracted 100 KPs and administered a difficulty rating questionnaire to 218 students post-final exam. The pipeline of the non-parametric Item Response Theory (IRT) and parametric IRT modeling was employed to estimate student SEL and describe the hierarchy of KPs in terms of item difficulty. Additionally, Gaussian Graphical Models with Non-Convex Penalties were deployed to create a Knowledge Graph (KG) and identify the main components. A visual analytics approach was then proposed to understand the correlation and difficulty level of KPs. RESULTS We identified 50 KPs to create the Mokken scale, which exhibited high reliability (Cronbach's alpha = 0.9675) with no gender bias at the overall or at each item level (p > 0.05). The three-parameter logistic model (3PLM) demonstrated good fitness with questionnaire data, whose Root Mean Square Error Approximation was < 0.05. Also, item-model fitness unveiled good fitness, as indicated by each item with non-significant p-values for chi-square tests. The Wright map revealed item difficulty relative to SEL levels. SEL estimated by the 3PLM correlated significantly with the high-ability range of average Grade-Point Average (p < 0.05). The KG backbone structure consisted of 58 KPs, with 29 KPs overlapping with the Mokken scale. Visual analysis of the KG backbone structure revealed that the difficulty level of KPs in the IRT could not replace their position parameters in the KG. CONCLUSION The IRT and KG methods utilized in this study offer distinct perspectives for visualizing hierarchical relationships and correlations among the KPs. Based on real-world teaching empirical data, this study helps to provide a research foundation for updating course contents and customizing learning objectives. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Zhen-Yu Cao
- Department of Rehabilitation Medicine, School of Acupuncture-Moxibustion and Tuina, School of Health Preservation and Rehabilitation, Nanjing University of Chinese Medicine, 210023, Nanjing, China
| | - Feng Lin
- School of Rehabilitation Medicine, Nanjing Medical University, 211100, Nanjing, China
| | - Chun Feng
- School of Medicine, Tongji University, 200331, Shanghai, China.
- The Center of Rehabilitation Therapy, The First Rehabilitation Hospital of Shanghai, Rehabilitation Hospital Affiliated to Tongji University, 200090, Shanghai, China.
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Zhou L, Feng C, Lu Y, Zhong LJ, Gao J, Liu N, Lin F, Jiang ZL. Development and validation of health-oriented personal evaluation for the community-dwelling older person based on the International Classification of Functioning, Disability and Health. Int J Older People Nurs 2024; 19:e12609. [PMID: 38622947 DOI: 10.1111/opn.12609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2023] [Revised: 03/06/2024] [Accepted: 03/20/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND The International Classification of Functioning, Disability and Health (ICF) offers a standardized international terminology to operationalize function management across multiple domains, but the summary score of the ICF qualifier scale provides limited information on the comparison of personal abilities and functioning difficulties. OBJECTIVES To enhance the interpretative power of the ICF-based Health-oriented Personal Evaluation for the community-dwelling older person (iHOPE-OP) scale through the implementation of the item response theory (IRT) modelling. METHODS This cross-sectional, multi-centre study administrated 161 ICF categories (58 on body functions, 15 on body structures, 60 on activities or participation and 28 on environmental factors) to evaluate the functional level of 338 older citizens (female = 158, male = 180) residing in community or supportive living facilities. The validation process encompassed assessing the IRT model fitness and evaluating the psychometric properties of the IRT-derived iHOPE-OP scale. RESULTS The age of participants ranged from 60 to 94.57, with the mean age of 70. The analysis of non-parametric and parametric models revealed that the three-parameter logistic IRT model, with a dichotomous scoring principle, exhibited the best fit. The 53-item iHOPE-OP scale demonstrated high reliability (Cronbach's α = 0.9729, Guttman's lambda-2 = 0.9749, Molenaar-Sijtsma Statistic = 0.9803, latent class reliability coefficient = 0.9882). There was a good validity between person abilities and the Barthel Index (p < .001, r = .83), as well as instrumental activities of daily living (p < .001, r = .84). CONCLUSIONS IRT methods generate the reliable and valid iHOPE-OP scale with the most discriminable and minimal items to represent the older person's functional performance at a comprehensive level. The use of the Wright map can aid in presby-functioning management by visualizing item difficulties and person abilities. IMPLICATIONS FOR PRACTICE Considering the intricate and heterogeneous health status of older persons, a single functional assessment tool might not fulfil the need to fully understand the multifaceted health status. For use in conjunction with the IRT and ICF framework, the reliable and valid iHOPE-OP scale was developed and can be applied to capture presby-functioning. The Wright map depicts the distribution of item difficulties and person abilities on the same scale that facilitates person-centred goal setting and tailors intervention.
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Affiliation(s)
- Liang Zhou
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Center for Rehabilitation Medicine, Rehabilitation and Sports Medicine Research Institute of Zhejiang Province, Department of Rehabilitation Medicine, Zhejiang Provincial People's Hospital, Affiliated People's Hospital, Hangzhou Medical College, Hangzhou, Zhejiang, China
| | - Chun Feng
- The Center of Rehabilitation Therapy, The First Rehabilitation Hospital of Shanghai, Rehabilitation Hospital Affiliated to Tongji University, Shanghai, China
| | - Yue Lu
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Li-Juan Zhong
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jing Gao
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Na Liu
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Feng Lin
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zhong-Li Jiang
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
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Gikaro JM, Zhu ZY, Shan HH, Liu SG, Lin F. Simplified functioning assessment for low back pain: ICF-based item response theory modelling. Eur J Phys Rehabil Med 2023; 59:731-742. [PMID: 38214044 DOI: 10.23736/s1973-9087.23.08003-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2024]
Abstract
BACKGROUND Despite the growing interest of the item response theory (IRT) in assessment of person abilities and functioning difficulties in screening tools, there is scarcity of research using IRT on ICF-based tools for persons with low back pain (LBP). AIM To generate and validate a parsimonious core set of ICF (PCSI) for LBP based on the IRT modelling. DESIGN A cross-sectional study. SETTING Nine hospitals in Jiangsu Province, China. POPULATION We recruited patients with LBP. METHODS All participants completed the 78 items of the comprehensive ICF Core Set for LBP. The five-point scoring system was converted to dichotomous data with 1 as functioning/independent and 0 as impairment/dependent. Psychometric properties of the data were examined using Mokken Scale analysis and parametric item response modelling. RESULTS This study recruited 306 participants (185 females and 121 males) with LBP. The overall median age of the study participants was 50.28 (95% CI 23.34; 82.05) years. We constructed a three-parameter logistic model with 28 ICF categories (8 of body function, 18 of activities and participation, and two of body structures). The internal consistency was good with Cronbach's alpha = 0.927 and latent class reliability coefficient (LCRC) = 0.955. The model was validated by significant correlations (P<0.001) of its estimated person abilities with the Oswestry Disability Index (ODI, r=-0.41), the Roland-Morris Disability Questionnaire (RMDQ, r=-0.57), the Physical Component Summary (PCS, r=0.63), and the Mental Component Summary (MCS, r = 0.46) of 12-Item Short Form Survey (SF-12). The person abilities and item difficulties were integrated into a Wright map that offered a background for making individualized clinical decisions. CONCLUSIONS The PCSI of LBP with 28 categories has good construct validity and internal consistency, and is a convenient instrument for assessing functioning among persons with LBP. The IRT model provided theoretical and algorithmic support for deriving a simplified model for functioning assessment hence serving a basis for formulating rehabilitation plans in clinical practice and research. CLINICAL REHABILITATION IMPACT A parsimonious core set of ICF (PCSI) for LBP based on the IRT modelling provides a background for making individualized clinical decisions based on item difficulties.
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Affiliation(s)
- John M Gikaro
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zi-Yan Zhu
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Hui-Hui Shan
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Shou-Guo Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
| | - Feng Lin
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, China -
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
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Geng BF, Feng C, Liu SG, Jiang ZL, Lin F. Haemophilia item bank based on International Classification of Functioning, Disability and Health: a systematic review. Hematology 2023; 28:2191077. [PMID: 36946880 DOI: 10.1080/16078454.2023.2191077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Haemophilia comprises a continuum of blood disorders that often include joint and muscular dysfunction, which may lead to a constellation of activity limitations and participation restrictions. However, there is scant research incorporating functional assessment scales into the common language provided by the International Classification of Functioning, Disability and Health (ICF). This study aims to identify the ICF categories to include in an item bank of functioning aspects relevant for haemophilia. DESIGN AND METHODS A systematic search was carried out in July 2021 based on the PubMed MEDLINE, CLINICAL, and Cochrane databases for qualified articles, investigating haemophilia-specific scales and the scales recommended by the World Federation of Haemophilia (WFH) linked to ICF categories between 2001 and 2021. Well-trained healthcare professionals in the haemophilia field and ICF evaluation conducted group discussions to determine the ICF items for haemophilia. RESULTS A total of 112 out of 176 items measuring function were collected for the haemophilia ICF item bank, including 32 items for body function (b), 45 items for activity and participation (d), 27 items for environmental factors (e), and 8 items for body structure(s). INTERPRETATION AND CONCLUSIONS We recommend that future haemophilia research use the haemophilia-specific ICF item bank, which could capture a whole spectrum of functional measurements and facilitate multidisciplinary and worldwide communication. This study also indicates that further development and analysis of the psychometric properties of the 112 haemophilia-related ICF items is warranted.
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Affiliation(s)
- Bao-Feng Geng
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Chun Feng
- The Center of Rehabilitation Therapy, The First Rehabilitation Hospital of Shanghai, Rehabilitation Hospital Affiliated to Tongji University, Shanghai, People's Republic of China
| | - Shou-Guo Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
| | - Zhong-Li Jiang
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, People's Republic of China
| | - Feng Lin
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, People's Republic of China
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, People's Republic of China
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Chen JJ, Zhu ZY, Bian JJ, Lin F. Nutrition-associated health levels in persons with cancer: item response modelling based on the International Classification of Functioning, Disability and Health. Eur J Phys Rehabil Med 2023; 59:593-604. [PMID: 37733333 PMCID: PMC10664767 DOI: 10.23736/s1973-9087.23.07987-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 06/06/2023] [Accepted: 07/21/2023] [Indexed: 09/22/2023]
Abstract
BACKGROUND The nutritional status of individuals with cancer is a crucial determinant of their health and well-being, and addressing nutrition-related functioning conditions is essential for maintaining physical activity levels and participating in daily activities. AIM This study aims to identify an evidence-based International Classification of Functioning, Disability and Health (ICF) scale using item response theory for nutrition conditions in patients with cancer, which can differentiate and assess nutrition-related functioning conditions of cancer survivors. DESIGN Cross-sectional study. SETTING Sir Run Run Hospital, Nanjing Medical University. POPULATION One hundred cancer patients were enrolled. METHODS Via convenience sampling, the study administered a questionnaire consisting of 89 ICF items to participants. The original five-point rating system was binarized (1 = no problem, 0 = problem). Through data shaping, non-parametric IRT analysis and parametric IRT analysis, psychometric properties of nutritional ICF scale were calculated using R software. RESULTS The study extracted a unidimensional scale with 32 items and constructed 2-parameter logistic model with good fitness, whose root mean square error approximation (RMSEA) = 0.0759, Tucker-Lewis Index (TLI) = 0.9655, and Comparative Fit Index (CFI) = 0.9677. The model demonstrated high reliability, as indicated by a Cronbach's α of 0.95, Guttman λ2 of 0.95, Molenaar Sijtsma statistic of 0.96 and a latent class reliability coefficient (LCRC) of 0.98. Besides, there was a strong correlation between the total score of 32 ICF items and the score of Patient-Generated Subjective Global Assessment (PG-SGA, P<0.001, r=-0.77) and Mini Nutritional Assessment (MNA, P<0.001, r=0.76), suggesting the 32-item scale had high validity. CONCLUSIONS The study constructed an evidence-based ICF scale for nutrition conditions in patients with cancer with 32-item and 2PLM for evaluating nutrition-associated health level in persons with cancer, including high validity and reliability. CLINICAL REHABILITATION IMPACT The IRT model based on ICF provided a promising assessment tool to discriminate nutrition-associated health level of persons with cancer, and offered an auxiliary method for selecting rehabilitation intervention targets. This has the potential to lead to improved outcomes in cancer treatment and increased quality of life for cancer survivors.
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Affiliation(s)
- Jin-Jin Chen
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Zi-Yan Zhu
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Jia-Jia Bian
- School of Rehabilitation Medicine, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Feng Lin
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, China -
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu, China
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Dickson KS, Boateng ENK, Adzrago D, Addo IY, Acquah E, Nyarko SH. Silent suffering: unveiling factors associated with women's inability to seek help for intimate partner violence in sub-Saharan Africa (SSA). Reprod Health 2023; 20:110. [PMID: 37496013 PMCID: PMC10373244 DOI: 10.1186/s12978-023-01651-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 07/14/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND Evidence shows that intimate partner violence (IPV) occurs more frequently in sub-Saharan Africa (SSA) than in other regions of the world. However, limited empirical studies exist on the help-seeking behaviour of women who had experienced IPV in SSA. This study aimed to examine the help-seeking behaviour of women who had experienced IPV in SSA and the factors associated with their inability to seek help after experiencing IPV. METHODS This is a quantitative study based on data from the latest demographic and health surveys (DHS) of 24 SSA countries. A sample of 53,446 women aged 15-49 years was included in the study. Associations between women's background characteristics and their help-seeking behaviour after experiencing IPV were examined using proportions and multivariate logistic regression models. RESULTS Overall, 60.7% of the sample did not seek help after experiencing IPV. Women's inability to seek help for IPV was highest in Mali (80.4%) and lowest in Tanzania (43.1%). Women's level of education, wealth status, marital status, age, occupation, and country of residence had significant associations with 'not seeking help' for any type of IPV. Those who experienced generational violence (AOR = 1.26, CI = 1.19, 1.33) and those who justified wife-beating (AOR = 1.09, CI = 1.07, 1.15) had higher odds of not seeking help for any type of IPV compared to those who did not experience generational violence or did not justify wife beating. Women who experienced emotional violence (AOR = 0.53, CI = 0.51, 0.55) and physical violence (AOR = 0.74, CI = 0.70, 0.76) had lower odds of not seeking help for any type of IPV compared to their counterparts who did not experience these types of violence. CONCLUSION Women's inability to seek help for IPV is common in many SSA countries. This study shows that several socio-demographic factors, such as women's age, educational levels, wealth status, and marital status are associated with their inability to seek help for IPV. Additionally, women's justification of wife beating and experience of generational abuse are strongly associated with their inability to seek help for IPV. These factors need to be considered critically in IPV interventions in SSA.
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Affiliation(s)
- Kwamena S Dickson
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
| | - Ebenezer N K Boateng
- Department of Geography and Regional Planning, University of Cape Coast, Cape Coast, Ghana.
| | - David Adzrago
- Center for Health Promotion and Prevention Research, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Isaac Y Addo
- Centre for Social Research in Health, The University of New South Wales, Sydney, Australia
| | - Evelyn Acquah
- Centre for Health Policy and Implementation Research, Institute of Health Research, University of Health, and Allied Sciences, Ho, Ghana
| | - Samuel H Nyarko
- Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, SC, USA
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Jiang YE, Zhang DM, Jiang ZL, Tao XJ, Dai MJ, Lin F. ICF-Based simple scale for children with cerebral palsy: Application of Mokken scale analysis and Rasch modeling. Dev Neurorehabil 2023; 26:71-88. [PMID: 36659872 DOI: 10.1080/17518423.2023.2166614] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Children with cerebral palsy (CP) are faced with long-term dysfunction. The International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY) has been proposed but the complicated procedure limits the feasibility of clinical application and the exploration of health degrees. This study was aimed to establish a Mokken scale based on the ICF-CY for CP, and then to estimate psychometric properties through the derived Rasch model. 150 children with CP were assessed by the categories of "b" and "d" components in the core set. The binarized data was screened by the Mokken scale analysis and utilized for generating a reliable Rasch model. The validity of the final model was checked by the correlation between person ability, Gross Motor Function Classification System (GMFCS) and total scores. Using the Mokken scale to guide Rasch modeling, we can parameterize the properties of ICF-CY and realize the simple assessment of person abilities for children with CP.
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Affiliation(s)
- Yu-Er Jiang
- Department of Rehabilitation Medicine, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, JS, China
| | - Dong-Mei Zhang
- Department of Rehabilitation Medicine, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, JS, China
| | - Zhong-Li Jiang
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, JS, China
| | - Xue-Jiao Tao
- Department of Rehabilitation Medicine, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, JS, China
| | - Min-Jun Dai
- Department of Rehabilitation Medicine, the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, JS, China
| | - Feng Lin
- Department of Rehabilitation Medicine, Sir Run Run Hospital, Nanjing Medical University, Nanjing, JS, China
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