Related Experiment Video
Updated: May 3, 2026
The Multiple Sclerosis Performance Test MSPT: An iPad-Based Disability Assessment Tool
Published on: June 30, 2014
Use of Rasch analysis to refine a patient-reported questionnaire on satisfaction with communication of the multiple
A Solari1, M Grzeda2, A Giordano3
1Unit of Neuroepidemiology, Foundation IRCCS Neurological Institute C. Besta, Italy solari@istituto-besta.it.
Background:
The Comunicazione medico-paziente nella Sclerosi Multipla - Revised (COSM-R) is a patient self-assessed questionnaire probing the moment of multiple sclerosis (MS) diagnosis disclosure (section 1, five items) and following period (section 2, 15 items).
Objectives:
This study examined COSM-R dimensionality and measurement properties through Rasch analysis (partial-credit model) and proposed a revised questionnaire.
Methods:
Cross-sectional COSM-R data were obtained from 1068 people with MS (PwMS, 1065 questionnaires) participating in four studies (102 centres). Mean age was 40 years (range 17-73); 70% were women; 53% were from Northern, 25% from Central, and 21% from Southern Italy.
Results:
Unidimensionality was not confirmed for COSM-R section 1, but was for section 2 after removal of three items. The revised instrument (COSM-S, Shortened) consisted of the original five-item checklist (section 1), modified by removing the table grouping of three items, and 12 of the original 15 section 2 items, which could now be summed and transformed into an interval scale. Scores were higher for items assessing emotional satisfaction than for those assessing informational satisfaction.
Conclusions:
The proposed COSM-S is a composite measure of satisfaction with MS diagnosis communication with improved metric properties over the original COSM-R, and whose section 2 satisfies Rasch model expectations.
Insights
A revised questionnaire, COSM-S, improves patient satisfaction assessment after multiple sclerosis (MS) diagnosis communication. It offers better measurement properties than the original COSM-R, with section 2 meeting Rasch model expectations.
Area of Science:
- Neurology
- Psychometrics
- Patient-Reported Outcomes
Background:
- The Comunicazione medico-paziente nella Sclerosi Multipla - Revised (COSM-R) questionnaire assesses patient satisfaction with communication following a multiple sclerosis (MS) diagnosis.
- It comprises two sections: diagnosis disclosure (5 items) and the subsequent period (15 items).
Purpose of the Study:
- To examine the dimensionality and measurement properties of the COSM-R questionnaire using Rasch analysis.
- To propose a revised, more psychometrically sound questionnaire for assessing patient satisfaction with MS diagnosis communication.
Main Methods:
- Cross-sectional data from 1068 people with MS (PwMS) across 102 centers were analyzed using Rasch analysis (partial-credit model).
- The COSM-R underwent evaluation for unidimensionality, and items were assessed for removal or modification to improve measurement properties.
Main Results:
- The COSM-R section 1 was not found to be unidimensional.
- Section 2 demonstrated unidimensionality after the removal of three items, leading to the development of the revised COSM-S (Shortened) questionnaire.
- The COSM-S includes the original 5-item checklist and 12 items from section 2, allowing for summed scores on an interval scale.
- Patients reported higher emotional satisfaction than informational satisfaction.
Conclusions:
- The proposed COSM-S is a composite measure with improved metric properties compared to the COSM-R.
- Section 2 of the COSM-S satisfies Rasch model expectations, providing a reliable tool for assessing satisfaction with MS diagnosis communication.
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