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Brief Report: An Evaluation of Item Bias on the Functional Activities Questionnaire
David Andrés González1,2,3, Michael J Clark4, Mitzi M Gonzales1,2
1Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
Objective:
To evaluate whether the Functional Activities Questionnaire (FAQ), a commonly used measure of functional status in neurodegenerative disease research, performs equivalently across demographically diverse subgroups of participants.
Method:
The FAQs from 30,613 National Alzheimer's Coordinating Center participants were evaluated with a hybrid graded response model-logistic ordinal regression approach to determine the presence of differential item functioning (DIF) within five demographic groups: education, ethnicity, race, language, and sex.
Results:
Measurable DIF was observed for FAQ items in all groups; however, measures of effect size, latent trait distributions, and item characteristic curves suggested that the impact was minimal for research and practice.
Conclusions:
The FAQ is able to provide minimally biased assessments of daily functioning across diverse participants, suggesting potential value for offsetting disparities in diagnosis and treatment.
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