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Modeling Verbal Behavior Deficits with the Stimulus Control Ratio Equation, SCoRE
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Validating the 28-tender joint count using item response theory.

Liseth Siemons1, Peter M ten Klooster, Erik Taal

  • 1Arthritis Center Twente, Department of Psychology, Health and Technology, University of Twente, Enschede, The Netherlands. l.siemons@utwente.nl

The Journal of Rheumatology
|October 4, 2011
PubMed
Summary
This summary is machine-generated.

The 28-tender joint count (TJC-28) demonstrates good validity for assessing early rheumatoid arthritis (RA) disease activity. Item response theory analysis confirmed its reliability but highlighted a limited measurement range for certain patient groups.

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Area of Science:

  • Rheumatology
  • Clinical Measurement
  • Psychometrics

Background:

  • The 28-tender joint count (TJC-28) is a common tool for assessing rheumatoid arthritis (RA) disease activity.
  • Evaluating the psychometric properties of clinical measures is crucial for accurate patient assessment.

Purpose of the Study:

  • To assess the construct validity of the TJC-28 using item response theory (IRT) methods.
  • To determine if the TJC-28 accurately reflects disease severity and joint involvement symmetry in early RA.

Main Methods:

  • Item response theory (IRT) analysis was applied to data from 457 early RA patients.
  • Internal construct validity was assessed using a 2-parameter logistic IRT model.
  • External validity was examined through correlations with pain, disability, general health, ESR, and 28-swollen joint count.

Main Results:

  • The TJC-28 demonstrated good fit to the IRT model with excellent reliability.
  • Joint parameters largely reflected left-right symmetry, with one exception.
  • Significant correlations were found with most disease activity measures, except ESR.
  • The instrument showed good internal and acceptable external construct validity.

Conclusions:

  • The TJC-28 is a valid instrument for assessing early RA, particularly for moderate to high disease activity.
  • IRT analysis identified a limited measurement range as a potential limitation.
  • Further research is recommended to explore instrument modifications for broader applicability.