Psychometric properties of the Dutch-Flemish Patient-Reported Outcomes Measurement Information System Pain Behavior item bank in patients with musculoskeletal complaints

Wouter Schuller*, Caroline B. Terwee, Thomas Klausch, Leo D. Roorda, Daphne C. Rohrich, Raymond W. Ostelo, Berend Terluin, Henrica C.W. de Vet

*Corresponding author for this work

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Abstract

We studied the psychometric properties of the 39-item v1.1 Dutch-Flemish Patient-Reported Outcomes Measurement Information System Pain Behavior item bank in a sample of 1,602 patients with musculoskeletal complaints. We evaluated the assumptions of the underlying item response theory (IRT) model (unidimensionality and local dependency with confirmatory factor analyses), and monotonicity with scalability coefficients). We studied the IRT model fit of all items and estimated the item parameters of the IRT model. Differential item functioning (DIF) was studied for age and gender, and DIF for language was studied as a measure of cross-cultural validity. Confirmatory factor analyses showed suboptimal fit of a unidimensional model, but a bifactor model showed low risk of bias when a unidimensional model was assumed (Omega H = .92, explained common variance of .70). Fifteen item pairs (2%) were locally dependent. Five items showed poor scalability. All items fitted the IRT model; slope parameters ranged from .60 to 2.00, and threshold parameters from –2.05 to 6.80. One item showed DIF for age, 1 item DIF for gender, and 5 items showed DIF for language, but the impact on total scores was low. Our study shows limitations of the Dutch-Flemish Patient-Reported Outcomes Measurement Information System Pain Behavior item bank when used in a primary care population with musculoskeletal complaints. Perspective: We studied the psychometric properties of the Dutch-Flemish Patient-Reported Outcomes Measurement Information System Pain Behavior item bank in a large primary care population of patients with musculoskeletal complaints. It showed that the Pain Behavior item bank has limitations when used in this population.

Original languageEnglish
Pages (from-to)1328-1337
Number of pages10
JournalJournal of Pain
Volume20
Issue number11
Early online date9 May 2019
DOIs
Publication statusPublished - Nov 2019

Funding

This study was approved by the Medical Ethical Committee of the VU Medical Center (2013/20). This Medical Ethical Committee decided that our observational study did not require the strict procedure for written and signed informed consent based on the law for Scientific Medical Research. Nonetheless, verbal informed consent was obtained from all patients in this study, which was recorded by the treating physician.

FundersFunder number
Dutch Association for Musculoskeletal Medicine
PROMIS
PROMIS Health Organization

    Keywords

    • item response theory
    • musculoskeletal medicine
    • Pain behavior
    • PROMIS
    • psychometric properties

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