Enhancing Measurement Precision of Patient-Reported Outcomes Using Item Response Theory.
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 gu...
| Published in: | Inquiry (00469580) Vol. 63; pp. 1 - 12 |
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| Main Authors: | , , , , , , , |
| Format: | research tables/charts Journal Article |
| Published: |
Sage Publications Inc.
4/13/2026
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=192982126&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 192982126 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 00469580 INQ jtl: Inquiry (00469580) issn: 00469580 maglogo: Y pubinfo: dt: 4/13/2026 vid: 63 pid: 344 pub: Sage Publications Inc. place: Thousand Oaks, California artinfo: ui: 192982126 192982126 192982126 10.1177/00469580261441163 192982126 ppf: 1 ppct: 11 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Enhancing Measurement Precision of Patient-Reported Outcomes Using Item Response Theory. aug: au: Ntumi, Simon Sakyi, Lawrence Larbi Bulala, Tapela Agbovor, Divine Amfo, Gabriel Odame Gabla, John Anakwa, Rudi Amezah, Emmanuel Ohene affil: University of Education, Winneba (UEW), West Africa, Ghana sug: subj: Patient-Reported Outcomes Models, Statistical Healthcare Disparities Reliability Evaluation Predictive Value of Tests Clinical Indicators Health Policy Outcomes (Health Care) Ghana Human Female Male Adult Cross Sectional Studies Descriptive Statistics Item Analysis Quantitative Studies Ambulatory Care Facilities Health Status Psychometrics Quality of Life Reproducibility of Results Decision Making, Clinical Stratified Random Sample Psychometrics Evaluation Coefficient alpha Correlational Studies Factor Analysis Internal Consistency Patient Compliance Self Report Summated Rating Scaling Data Analysis Software Chi Square Test Purposive Sample Questionnaires Adult: 19-44 years Female Male ab: 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. pubtype: Academic Journal doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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