Document Detail


Rasch analysis of the Edmonton Symptom Assessment System and research implications.
MedLine Citation:
PMID:  24764703     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Reliable and valid assessment of the disease burden across all forms of cancer is critical to the evaluation of treatment effectiveness and patient progress. The Edmonton Symptom Assessment System (esas) is used for routine evaluation of people attending for cancer care. In the present study, we used Rasch analysis to explore the measurement properties of the esas and to determine the effect of using Rasch-proposed interval-level esas scoring compared with traditional scoring when evaluating the effects of an exercise program for cancer survivors.
METHODS: Polytomous Rasch analysis (Andrich's rating-scale model) was applied to data from 26,645 esas questionnaires completed at the Juravinski Cancer Centre. The fit of the esas to the polytomous Rasch model was investigated, including evaluations of differential item functioning for sex, age, and disease group. The research implication was investigated by comparing the results of an observational research study previously analysed using a traditional approach with the results obtained by Rasch-proposed interval-level esas scoring.
RESULTS: The Rasch reliability index was 0.73, falling short of the desired 0.80-0.90 level. However, the esas was found to fit the Rasch model, including the criteria for uni-dimensional data. The analysis suggests that the current esas scoring system of 0-10 could be collapsed to a 6-point scale. Use of the Rasch-proposed interval-level scoring yielded results that were different from those calculated using summarized ordinal-level esas scores. Differential item functioning was not found for sex, age, or diagnosis groups.
CONCLUSIONS: The esas is a moderately reliable uni-dimensional measure of cancer disease burden and can provide interval-level scaling with Rasch-based scoring. Further, our study indicates that, compared with the traditional scoring metric, Rasch-based scoring could result in substantive changes to conclusions.
Authors:
O Cheifetz; T L Packham; J C Macdermid
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current oncology (Toronto, Ont.)     Volume:  21     ISSN:  1198-0052     ISO Abbreviation:  Curr Oncol     Publication Date:  2014 Apr 
Date Detail:
Created Date:  2014-04-25     Completed Date:  2014-04-25     Revised Date:  2014-04-28    
Medline Journal Info:
Nlm Unique ID:  9502503     Medline TA:  Curr Oncol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e186-94     Citation Subset:  -    
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