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Classical test theory and Rasch analysis validation of the Recent-Onset Arthritis Disability questionnaire in rheumatoid arthritis patients

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Abstract

Disability has been identified as a core outcome measure in rheumatoid arthritis (RA). The aim of this study was to perform a comprehensive psychometric analysis of the Recent-Onset Arthritis Disability (ROAD) questionnaire in patients with RA. The questionnaire was completed by 583 patients with RA: 196 subjects participating in the NEW INDICES study and 387 subjects who were taking part in a long-term observational study. At confirmatory factor analysis for categorical data, data fit for a three-factor model was adequate to good (non-normed fit index = 0.98, comparative fit index = 0.99, root mean square error of approximation = 0.079, standardized root mean square residual = 0.047), with standardized item-to-factor loadings ranging from 0.60 to 0.90 and a cumulative explained variance of 83 %. The bifactor model of ROAD presented a clean independent cluster structure. The loadings in the unidimensional model were very similar to those on the general factor in the bifactor model. Rasch analysis showed a correct functioning of rating categories, a good fit of the data to the model for all three subscales, and satisfactory separation indexes and respective reliability (for both persons and items). This study, using both classical test theory and Rasch analysis methods, provides psychometric evidence of the reliability and internal and structural validity of ROAD in RA patients. Our results support the use of separate subscores for upper limb function, lower limb function, and activities of daily living/work, and the appropriateness of reporting an overall score (i.e., the mean of the three subscales).

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Acknowledgments

We thank Giardino A., Ori A., Zanoli L., and Manfredi A. for their contribution to the organization of the study and data management. The authors also wish to thank the other members of the NEW INDICES Study Group, as follows: Laganà B. (Roma), Varcasia G. (Mormanno, Cosenza), Pomponio G. (Ancona), Mozzani F. (Parma), Scarpa R. (Napoli), Maier A. (Bolzano), Romeo N. (Cuneo), Migliore A. (Roma), Scarpellini M. (Magenta, Milano), Corsaro S.M. (Napoli), Pusceddu M. (Iglesias, Cagliari), Foti R. (Catania), Rotondi M. (Velletri, Roma), Marasini B. (Rozzano, Milano), Ferraccioli G. (Roma), Malavolta N. (Bologna), Sabadini L. (Arezzo), Cimmino M. (Genova), Ricioppo A. (Vimercate, Milano), Triolo G. (Palermo), Mascia M.T. (Modena), Minisola G. (Roma), Botsios K. (Montebelluna, Treviso), Pellerito R. (Torino), Noto A. (Cosenza), Cazzato M. (Pisa), Bombardieri S. (Pisa). Part of the study (data collection) was supported by an unrestricted educational grant from Pfizer S.p.A., Italy. Editorial support was provided by Kim Brown of UBC Scientific Solutions and was funded by Pfizer Inc.

Disclosures

FS has attended advisory board meetings for Bristol-Myers Squibb, Abbott Immunology, Wyeth Lederle, and Pfizer, and has received research support from Bristol-Myers Squibb. The remaining authors have no financial or other competing interests to declare.

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Authors and Affiliations

  1. Department of Rheumatology, Polytechnic University of Marche, Ospedale “C. Urbani”, Via dei Colli 52, 60035, Jesi, Ancona, Italy

    Fausto Salaffi, Alessandro Ciapetti & Stefania Gasparini

  2. Department of Physical and Rehabilitation Medicine, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Nervi, Genoa, Italy

    Franco Franchignoni & Marcella Ottonello

  3. Unit of Bioengineering, Salvatore Maugeri Foundation, Clinica del Lavoro e della Riabilitazione, IRCCS, Veruno, Novara, Italy

    Andrea Giordano

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  1. Fausto Salaffi
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  2. Franco Franchignoni
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  4. Alessandro Ciapetti
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  5. Stefania Gasparini
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  6. Marcella Ottonello
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on behalf of the “NEW INDICES” Study Group

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Correspondence to Fausto Salaffi.

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Salaffi, F., Franchignoni, F., Giordano, A. et al. Classical test theory and Rasch analysis validation of the Recent-Onset Arthritis Disability questionnaire in rheumatoid arthritis patients. Clin Rheumatol 32, 211–217 (2013). https://doi.org/10.1007/s10067-012-2101-6

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  • DOI: https://doi.org/10.1007/s10067-012-2101-6

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