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Rasch analysis of the Roland disability questionnaire
1Unit of Health Care Epidemiology, Institute of Health Sciences, University of Oxford, Oxford, United Kingdom.
Spine
|January 25, 2003
Summary
The Roland Disability Questionnaire largely meets the Rasch model for unidimensionality in back pain assessment. Improvements are suggested by refining items and adding scale points for better disability measurement.
Area of Science:
- Health outcomes research
- Psychometrics
- Musculoskeletal disorders
Background:
- The Roland Disability Questionnaire is a key patient-assessed tool for back pain outcomes.
- Previous research has focused on reliability, validity, and responsiveness.
- The instrument's dimensionality and item contribution to physical disability constructs remain under-explored.
Purpose of the Study:
- To evaluate the Roland Disability Questionnaire's adherence to the Rasch model.
- To assess unidimensionality and item separation within the questionnaire.
- To identify potential improvements for the Roland Disability Questionnaire.
Main Methods:
- A cross-sectional survey was conducted using patient questionnaires.
- The Winsteps program was utilized to analyze Roland Disability Questionnaire data.
- Item fit statistics (Infit and Outfit) were employed to assess Rasch model compatibility.
Main Results:
- The Roland Disability Questionnaire generally demonstrated unidimensionality.
- Four items exhibited poor Outfit statistics, indicating insufficient contribution to the scale hierarchy.
- Item difficulty was not sufficiently distinct in the mid-range, with few items at the extremes.
Conclusions:
- The Roland Disability Questionnaire largely aligns with the Rasch model for unidimensionality.
- Optimizing the instrument involves removing poorly fitting items and adding items at scale extremes.
- Consideration of score distribution and use of Rasch-transformed scores are recommended for statistical analysis.