Graded response model fit, measurement invariance and (comparative) precision of the Dutch-Flemish PROMIS® Upper Extremity V2.0 item bank in patients with upper extremity disorders

Toward Advancing Precision Environmental Health: Developing a Customized Exposure Burden Score to PFAS Mixtures to Enable Equitable Comparisons Across Population Subgroups, Using Mixture Item Response Theory

Quantifying a person's cumulative exposure burden to per- and polyfluoroalkyl substances (PFAS) mixtures is important for risk assessment, biomonitoring, and reporting of results to participants. However, different people may be exposed to different sets of PFASs due to heterogeneity in the exposure sources and patterns. Applying a single measurement model for the entire population (e.g., by summing concentrations of all PFAS analytes) assumes that each PFAS analyte is equally informative to PFAS exposure burden for all individuals. This assumption may not hold if PFAS exposure sources systematically differ within the population. However, the sociodemographic, dietary, and behavioral characteristics that underlie systematic exposure differences may not be known, or may be due to a combination of these factors. Therefore, we used mixture item response theory, an unsupervised psychometrics and data science method, to develop a customized PFAS exposure burden scoring algorithm. This scoring algorithm ensures that PFAS burden scores can be equitably compared across population subgroups. We applied our methods to PFAS biomonitoring data from the United States National Health and Nutrition Examination Survey (2013-2018). Using mixture item response theory, we found that participants with higher household incomes had higher PFAS burden scores. Asian Americans had significantly higher PFAS burden compared with non-Hispanic Whites and other race/ethnicity groups. However, some disparities were masked when using summed PFAS concentrations as the exposure metric. This work demonstrates that our summary PFAS burden metric, accounting for sources of exposure variation, may be a more fair and informative estimate of PFAS exposure.

Gender-Based Differential Item Function for the Positive and Negative Semantic Dimensions of the Relationship Satisfaction Scale with Item Response Theory

Relationship satisfaction is at the core of a robust social life and is essential to mental health. The positive and negative semantic dimensions of the relationship satisfaction (PN-SMD) scale is considered in the field of relationship studies to be a reliable tool for assessing the quality of a person's interpersonal relationships. This study evaluated the psychometric properties of the PN-SMD scale by conducting multidimensional item response theory (MIRT) and differential item functioning (DIF) analyses, both of which are emerging assessment methods that focus on individual items. We recruited 511 Chinese undergraduate students for this study. Construct validity, internal consistency, and concurrent validity were assessed, and MIRT and DIF analyses were conducted. Five of the 14 items were found to have gender-based DIF traits, affecting the scale's construct validity. A revised nine-item scale (DIF items excluded) had a significantly better model fit and demonstrated comparable concurrent validity to the original scale. The implications of our results and future research directions are discussed.

A scale of parent-to-child emotions: Adaptation, factor structure, and measurement invariance

Emotions that parents feel when they think about their own child are extremely important in determining parenting approaches toward a child. Parental emotions should be defined under the rubric of human emotions that include both basic and self-conscious emotions. The Scale for Parent-to-Baby Emotions (SPBE) was developed underlying this concept, whereas an applicable scale for parent-to-child emotions for a wider age range for both mothers and fathers is needed. This study is aimed at examining the measurement invariance of this adapted scale among Japanese families. In a cross-sectional internet survey, men and women who had a child/children (including a fetus), whose eldest was aged up to 12 years old (N = 4600), were recruited. The questionnaire, which included the Scale for Parent-to-Child-Emotions-62 (SPCE-62) created from the SPBE via a process of rigorous translation, focused only on the eldest child. The feasibility of the SPCE-62 was assessed by a panel of three researchers. Each domain of both basic and self-conscious emotions was examined both in terms of robust factor structure and stable measurement invariance by multi-group confirmatory factor analysis. Responses to individual items were examined via item response theory, including differential item functioning. This resulted in a 43-item SPCE consisting of 9 domains: Happiness (four items), Anger (six items), Fear (four items), Sadness (five items), Disgust (five items), Shame (five items), Guilt (seven items), Alpha Pride (three items), and Beta Pride (four items). An empirical construct of parental emotion toward a child was derived. The SPCE makes it possible to measure parent-to-child emotions across parents' gender and the three age ranges of the child.

Psychometric properties and reference values of the Patient-Reported Outcomes Measurement Information System (PROMIS) sleep item banks in the Dutch general population

Psychometric properties of the v1.0 Patient-Reported Outcomes Measurement Information System (PROMIS®) sleep disturbance (27 items) and sleep-related impairment (SRI; 16 items) item banks, short forms derived from the item bank, and simulated computerised adaptive test (CAT), were assessed in a representative sample of 1,006 adults from the Dutch general population. For sleep disturbance all items fitted the item response theory model. Four items showed differential item functioning (i.e., lack of measurement invariance) for age and two for language but the impact on scores (expressed as T-scores) was small. Reliable scores (r > 0.90) were found for 92.2%-96.3% of respondents with the full bank, short forms with six and eight items, and CAT, but for only 25.6% with the four-item short form. For SRI two items did not fit the item response theory model. Four items showed differential item functioning for language but the impact on T-scores was small. Reliable scores were found for 82.1% with the full bank, for 47.8%-69.5% with short forms and CAT. T-scores of 49.7 and 49.3 represent the average score of the Dutch general population for sleep disturbance and SRI, respectively. In conclusion, sufficient structural validity, reliability, and cross-cultural validity was found for the full banks but short forms of four items are not reliable enough for clinical practice. For SRI we recommend the full item bank if this is the primary outcome.

Empirical validation study and psychometric evaluation of the properties of the populist attitudes scale for the portuguese population

BACKGROUND AND OBJECTIVE

Recent developments in Europe and Portugal provide a fertile ground for the rise of populism. Despite the growing interest in the topic, there is no reliable tool to gauge Portuguese citizens' populist attitudes to date. The Populist Attitudes Scale (POP-AS), developed by Akkerman et al. [1], is one of the best-known instruments for measuring populist attitudes. However, no version for use in the Portuguese population is available. This paper describes the psychometric validation of the POP-AS for the Portuguese population.

METHODS

Trustworthy measures of validity suggested by Boateng et al. [2] to address the psychometric features of the POP-AS were approached. A robust psychometrical pipeline evaluated the reliability, construct validity, cross national/educational validity, and internal validity of the POP-AS.

RESULTS

The Portuguese version of the POP-AS exhibited sound internal consistency and demonstrated adequate properties of validity: a one-factor model was obtained, revealing evidence of construct validity; invariance was ensured for education and partially ensured for the country; All the items of the POP-AS revealed relatively good values of discrimination and contributed adequately to the total score of the scale, ensuring evidence of internal validity.

CONCLUSION

Psychometric analysis supports the POP-AS as a valid and reliable instrument for measuring populist attitudes among Portuguese citizens. A validation framework for measurement instruments in political science was proposed. Implications of the findings are discussed.

Developing an Exposure Burden Score for Chemical Mixtures Using Item Response Theory, with Applications to PFAS Mixtures

BACKGROUND

There are few existing methods to quantify total exposure burden to chemical mixtures, independent of a health outcome. A summary metric could be advantageous for use in biomonitoring, risk assessment, health risk calculators, and mediation models.

OBJECTIVE

We developed a novel exposure burden score method for chemical mixtures, applied it to estimate exposure burden to per- and polyfluoroalkyl substances (PFAS) mixtures, and estimated associations of PFAS burden scores with cardio-metabolic outcomes in the general U.S.

POPULATION

METHODS

We applied item response theory (IRT) to biomonitoring data from 1,915 children and adults 12-80 years of age in the 2017-2018 National Health and Examination Survey to quantify a latent PFAS burden score, using serum concentrations of eight measured PFAS biomarkers, each considered an "item." The premise of IRT is that through using both information about a participant's concentration of an individual PFAS biomarker, as well as their exposure patterns for the PFAS mixture, we can estimate the participant's latent PFAS exposure burden, independent of a health outcome. We used linear regression to estimate associations of the PFAS burden score with cardio-metabolic outcomes and compared our findings to results using summed PFAS concentrations as the exposure metric.

RESULTS

PFAS burden scores and summed PFAS concentrations had moderate-high correlation (ρ=0.75). Isomers of PFOS [n-perfluorooctane sulfonic acid (n-PFOS) and perfluoromethylheptane sulfonic acid isomers (Sm-PFOS)] were the most informative to the PFAS burden scores. PFAS burden scores and summed PFAS concentrations were both significantly associated with cardio-metabolic outcomes, but associations were generally closer to the null for summed PFAS concentrations vs. the PFAS burden score. Adjusted associations (95% CIs) with total cholesterol (in milligrams per deciliter) were 8.6 (95% CI: 5.2, 11.9) and 2.4 (95% CI: 0.5, 4.2) per interquartile range increase in the PFAS burden score and summed concentrations, respectively. Sensitivity analyses showed similar associations with cardio-metabolic outcomes when only a subset of PFAS biomarkers was used to estimate PFAS burden. In a validation study, associations between PFAS burden scores and cholesterol were consistent with primary analyses but null when using summed PFAS concentrations.

DISCUSSION

IRT offers a straightforward way to include exposure biomarkers with low detection frequencies and can reduce exposure measurement error. Further, IRT enables comparisons of exposure burden to chemical mixtures across studies even if they did not measure the exact same set of chemicals, which supports harmonization across studies and consortia. We provide an accompanying PFAS burden calculator (https://pfasburden.shinyapps.io/app_pfas_burden/), enabling researchers to calculate PFAS burden scores based on U.S. population exposure reference ranges. https://doi.org/10.1289/EHP10125.

Psychometric assessment of scales for measuring loneliness and social isolation: an analysis of the household, income and labour dynamics in Australia (HILDA) survey

BACKGROUND

Loneliness and social isolation are increasingly recognised as global public health threats, meaning that reliable and valid measures are needed to monitor these conditions at a population level. We aimed to determine if robust and practical scales could be derived for conditions such as loneliness and social isolation using items from a national survey.

METHODS

We conducted psychometric analyses of ten items in two waves of the Household, Income and Labour Dynamics in Australia Survey, which included over 15,000 participants. We used the Hull method, exploratory structural equation modelling, and multidimensional item response theory analysis in a calibration sample to determine the number of factors and items within each factor. We cross-validated the factor structure using confirmatory factor analysis in a validation sample. We assessed construct validity by comparing the resulting sub-scales with measures for psychological distress and mental well-being.

RESULTS

Calibration and cross-validation consistently revealed a three-factor model, with sub-scales reflecting constructs of loneliness and social isolation. Sub-scales showed high reliability and measurement invariance across waves, gender, and age. Construct validity was supported by significant correlations between the sub-scales and measures of psychological distress and mental health. Individuals who met threshold criteria for loneliness and social isolation had consistently greater odds of being psychologically distressed and having poor mental health than those who did not.

CONCLUSIONS

These derived scales provide robust and practical measures of loneliness and social isolation for population-based research.

Development and validation of a short version of the Sarcopenia Quality of Life questionnaire: the SF-SarQoL

PURPOSE

To facilitate the measurement of quality of life in sarcopenia, we set out to reduce the number of items in the previously validated Sarcopenia Quality of Life (SarQoL®) questionnaire, and to evaluate the clinimetric properties of this new short form.

METHODS

The item reduction process was carried out in two phases. First, information was gathered through item-impact scores from older people (n = 1950), a Delphi method with sarcopenia experts, and previously published clinimetric data. In the second phase, this information was presented to an expert panel that decided which of the items to include in the short form. The newly created SFSarQoL was then administered to older, community-dwelling participants who previously participated in the SarcoPhAge study. We examined discriminative power, internal consistency, construct validity, test-retest reliability, structural validity and examined item parameters with a graded response model (IRT).

RESULTS

The questionnaire was reduced from 55 to 14 items, a 75% reduction. A total of 214 older, community-dwelling people were recruited for the validation study. The clinimetric evaluation showed that the SF-SarQoL® can discriminate on sarcopenia status [EWGSOP2 criteria; 34.52 (18.59-43.45) vs. 42.86 (26.56-63.69); p = 0.043], is internally consistent (α = 0.915, ω = 0.917) and reliable [ICC = 0.912 (0.847-0.942)]. A unidimensional model was fitted (CFI = 0.978; TLI = 0.975; RMSEA = 0.108, 90% CI 0.094-0.123; SRMR = 0.055) with no misfitting items and good response category separation.

CONCLUSIONS

A new, 14-item, short form version of the Sarcopenia Quality of Life questionnaire has been developed and shows good clinimetric properties.

Measurement properties of the Dutch-Flemish patient-reported outcomes measurement information system (PROMIS) physical function item bank and instruments: a systematic review

BACKGROUND

Limitations in physical functioning are a big concern especially for patients with chronic or musculoskeletal diseases. Therefore, physical functioning is often used as a core outcome of treatments. The generic patient-reported outcomes information system (PROMIS) physical function (PF) item bank has shown potential to measure PF with better precision, interpretability and lower respondent burden compared with traditional patient-reported outcome measures. This study provides an overview of the current evidence on the quality of the measurement properties of the translated Dutch-Flemish PROMIS-PF item bank and its subdomains, and their derived short forms and computer adaptive tests (CATs).

METHODS

PubMed was searched up to June 17th 2020 for validation studies of Dutch-Flemish PROMIS-PF in Dutch and Flemish adults. Quality assessment of the included studies was conducted using the COSMIN Risk of bias checklist. The COSMIN criteria for good measurement properties were used to judge the results of the studies, which were adjusted and added to where needed for this review, in the context of IRT instruments and item banks. The quality of evidence was summarized for each measurement property based on the Grading of Recommendation Assessment, Development, and Evaluation (GRADE) approach.

RESULTS

Eleven studies were included, evaluating the PROMIS-PF item bank, the Upper Extremity (UE) subdomain, and/or their derived short forms and CATs in different clinical populations. There is evidence for sufficient structural validity, measurement precision, construct validity, and cross-cultural validity of the Dutch-Flemish PROMIS-PF item bank. The upper extremity subdomain item bank shows high quality evidence for structural validity and measurement precision. Content validity of these item banks has not been thoroughly demonstrated in a Dutch-Flemish population. Furthermore, the derived instruments have far less robust evidence: there are fewer validation studies available and none examined their performance as stand-alone administered instruments.

CONCLUSIONS

The first studies into the Dutch-Flemish PROMIS-PF item bank and the UE subdomain show promising results, with especially high quality evidence for sufficient structural validity and measurement precision. However, more studies, and with higher methodological quality, are needed to study the instruments derived from these item banks. These studies should also evaluate content validity, reliability and responsiveness.