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Development of the 8-Item Phlegm Pattern Questionnaire (PPQ-8) Using Rasch Analysis.

Young-Jae Park1,2

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A new 8-item Phlegm Pattern Questionnaire (PPQ-8) was developed using Rasch analysis to reduce patient burden. This validated tool effectively assesses phlegm patterns, improving clinical evaluation and quality of life research.

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Area of Science:

  • Psychometrics
  • Traditional Chinese Medicine

Background:

  • The 25-item Phlegm Pattern Questionnaire (PPQ) is widely used but has concerns regarding response burden and item difficulty.
  • Previous versions did not sufficiently address respondent abilities or item difficulty, necessitating a more efficient assessment tool.

Purpose of the Study:

  • To develop a short-form Phlegm Pattern Questionnaire (PPQ-8) using Rasch analysis to reduce response burden and enhance clinical utility.
  • To evaluate the psychometric properties, reliability, validity, and discriminative ability of the developed short-form PPQ.

Main Methods:

  • Retrospective data from 291 normal participants and 61 inpatients were analyzed using Rasch analysis.
  • Item response theory principles were applied to examine differential item functioning (DIF), dimensionality, reliability, and fitting errors.
  • Receiver operating characteristic (ROC) curve analysis was used to assess the discriminative ability of the short-form PPQ.

Main Results:

  • An 8-item questionnaire (PPQ-8) was developed, demonstrating satisfactory reliability (person separation index = 2.23) and unidimensionality.
  • The PPQ-8 exhibited good fitting levels, sensitivity (70.5%), and specificity (76.5%).
  • The PPQ-8 showed moderate discriminative ability for phlegm patterns (AUC = 0.759) with a cut-off point of 23.

Conclusions:

  • The 8-item Phlegm Pattern Questionnaire (PPQ-8) developed via Rasch analysis is a reliable and valid instrument for assessing phlegm patterns.
  • The PPQ-8 effectively reduces response burden compared to the original 25-item version.
  • The PPQ-8 is recommended for evaluating clinical severity of phlegm patterns and related quality of life aspects.