Item response theory and factor analysis as a mean to characterize occurrence of response shift in a longitudinal quality of life study in breast cancer patients

Health and Quality of Life Outcomes

Franck Bonnetain¹  Zeinab Hamidou²  Olivier Graesslin⁶  Jean Cuisenier⁸  Sylvain Causeret⁸  Mariette Mercier¹  Damien Jolly⁵  Michel Velten⁴  Francis Guillemin⁷  Thierry Conroy⁹  Caroline Bascoul-Mollevi³  Amélie Anota¹ 

[1] EA 3181, University of Franche-Comte, Besançon, France;Public health laboratory, EA 3279, Aix-Marseille University, Marseille, France;Department of Biostatistics, Institut Régional du Cancer Montpellier, Montpellier, France;Department of Epidemiology and Public Health, Faculty of Medicine, EA 3430, University of Strasbourg, Strasbourg, France;Pôle Recherche – Innovations, University Hospital of Reims, Reims, France;Gynecological and Obstetric Department, Institut Mère Enfant, University Hospital of Reims, Reims, France;Clinical Epidemiology and Evaluation Department, Inserm, CIC-EC, and CHU, Nancy, France;Surgery Department, Centre Georges François Leclerc, Dijon, France;Medical Oncology Department, Centre Alexis Vautrin, Nancy, France

关键词: Item Response Theory;    Factor analysis;    Response shift;    Longitudinal analysis;    Health-related quality of life;   

Others  :  820356
DOI  :  10.1186/1477-7525-12-32

 received in 2014-01-27, accepted in 2014-03-01,  发布年份 2014

【 摘 要 】

Background

The occurrence of response shift (RS) in longitudinal health-related quality of life (HRQoL) studies, reflecting patient adaptation to disease, has already been demonstrated. Several methods have been developed to detect the three different types of response shift (RS), i.e. recalibration RS, 2) reprioritization RS, and 3) reconceptualization RS. We investigated two complementary methods that characterize the occurrence of RS: factor analysis, comprising Principal Component Analysis (PCA) and Multiple Correspondence Analysis (MCA), and a method of Item Response Theory (IRT).

Methods

Breast cancer patients (n = 381) completed the EORTC QLQ-C30 and EORTC QLQ-BR23 questionnaires at baseline, immediately following surgery, and three and six months after surgery, according to the “then-test/post-test” design. Recalibration was explored using MCA and a model of IRT, called the Linear Logistic Model with Relaxed Assumptions (LLRA) using the then-test method. Principal Component Analysis (PCA) was used to explore reconceptualization and reprioritization.

Results

MCA highlighted the main profiles of recalibration: patients with high HRQoL level report a slightly worse HRQoL level retrospectively and vice versa. The LLRA model indicated a downward or upward recalibration for each dimension. At six months, the recalibration effect was statistically significant for 11/22 dimensions of the QLQ-C30 and BR23 according to the LLRA model (p ≤ 0.001). Regarding the QLQ-C30, PCA indicated a reprioritization of symptom scales and reconceptualization via an increased correlation between functional scales.

Conclusions

Our findings demonstrate the usefulness of these analyses in characterizing the occurrence of RS. MCA and IRT model had convergent results with then-test method to characterize recalibration component of RS. PCA is an indirect method in investigating the reprioritization and reconceptualization components of RS.

【 授权许可】

   
2014 Anota et al.; licensee BioMed Central Ltd.

【 图 表 】

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