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Scoring the EQ-HWB-S: can we do it without value sets? A non-parametric item response theory analysis
You-Shan Feng1, Thomas Kohlmann2, Tessa Peasgood3
1Institute for Clinical Epidemiology and Applied Biometrics, Medical University of Tübingen, Silcherstraße 5, 72076, Tübingen, Germany. you-shan.feng@med.uni-tuebingen.de.
Summary
The EQ Health and Wellbeing Instrument short version (EQ-HWB-S) can be reliably scored using a level summary score (LSS). Mokken scaling analysis confirms LSS as a valid, weighting-free scoring method for the EQ-HWB-S.
Area of Science:
- Psychometrics
- Health Outcomes Measurement
Background:
- Limited value sets exist for the EQ Health and Wellbeing Instrument short version (EQ-HWB-S), with only the UK pilot available.
- Preference-weighted scoring is the standard for EQ-HWB-S, necessitating exploration of alternative methods.
Purpose of the Study:
- To evaluate the appropriateness of a level summary score (LSS) as an alternative to preference-weighted scoring for the EQ-HWB-S.
- To assess the psychometric properties of the EQ-HWB-S using Mokken scaling analyses.
Main Methods:
- Mokken scaling analyses, including the monotone homogeneity model and automated item selection procedure (AISP), were applied to EQ-HWB-S data from Australia, US, and UK.
- Loevinger's scaling coefficients (HS) were calculated to assess scalability.
- Manifest monotonicity was evaluated by examining response probabilities across summary scores.
Main Results:
- Mokken scaling analysis demonstrated that all 9 items of the EQ-HWB-S form a single, strongly scalable dimension (HS = 0.561).
- Subscales for psychosocial (HS = 0.683) and physical sensation (HS = 0.713) items showed even stronger scalability.
- No significant violations of monotonicity were observed, except for specific items in certain subgroups.
Conclusions:
- The EQ-HWB-S items demonstrate strong scalability as a single scale and as distinct subscales.
- Level summary score (LSS) is a viable and promising weighting-free approach for scoring the EQ-HWB-S.
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