Differential item functioning in quality of life measurement: An analysis using anchoring vignettes

Research output: Contribution to journalArticleResearchpeer-review

3 Citations (Scopus)

Abstract

Systematic differences in the ways that people use and interpret response categories (differential item functioning, DIF) can introduce bias when using self-assessments to compare health or quality of life across heterogeneous groups. This paper reports on an exploratory analysis involving the use of anchoring vignettes to identify DIF in a commonly used measure for assessing health-related quality of life - namely the EQ-5D. Using data from a bespoke (i.e. custom) survey that recruited a representative sample of 4300 respondents from the general Australian population in 2014 and 2015, we find that the assumptions of response consistency (RC) and vignette equivalence (VE) hold in a sub-sample of respondents aged 55–65 years (n = 914), which demonstrates that vignettes can appropriately identify DIF in EQ-5D reporting for this age group. We find that the EQ-5D is indeed subject to DIF, and that failure to account for DIF can lead to conclusions that are misleading when using the instrument to compare health or quality of life across heterogeneous groups. We also provide several important insights in terms of the identifying assumptions of RC and VE. We conclude that the implications of DIF could be of considerable importance, not only for outcomes research, but for funding decisions in healthcare more broadly given the strong reliance on patient-reported outcome measures in economic evaluations for health technology assessment.

Original languageEnglish
Pages (from-to)247-255
Number of pages9
JournalSocial Science and Medicine
Volume190
DOIs
Publication statusPublished - 1 Oct 2017

Keywords

  • Anchoring vignettes
  • Australia
  • Differential item functioning
  • EQ-5D
  • Response consistency
  • Vignette equivalence

Cite this

@article{8feceee8a3e74268a8867a088e5ff15e,
title = "Differential item functioning in quality of life measurement: An analysis using anchoring vignettes",
abstract = "Systematic differences in the ways that people use and interpret response categories (differential item functioning, DIF) can introduce bias when using self-assessments to compare health or quality of life across heterogeneous groups. This paper reports on an exploratory analysis involving the use of anchoring vignettes to identify DIF in a commonly used measure for assessing health-related quality of life - namely the EQ-5D. Using data from a bespoke (i.e. custom) survey that recruited a representative sample of 4300 respondents from the general Australian population in 2014 and 2015, we find that the assumptions of response consistency (RC) and vignette equivalence (VE) hold in a sub-sample of respondents aged 55–65 years (n = 914), which demonstrates that vignettes can appropriately identify DIF in EQ-5D reporting for this age group. We find that the EQ-5D is indeed subject to DIF, and that failure to account for DIF can lead to conclusions that are misleading when using the instrument to compare health or quality of life across heterogeneous groups. We also provide several important insights in terms of the identifying assumptions of RC and VE. We conclude that the implications of DIF could be of considerable importance, not only for outcomes research, but for funding decisions in healthcare more broadly given the strong reliance on patient-reported outcome measures in economic evaluations for health technology assessment.",
keywords = "Anchoring vignettes, Australia, Differential item functioning, EQ-5D, Response consistency, Vignette equivalence",
author = "Rachel Knott and Lorgelly, {Paula K.} and Nicole Black and Hollingsworth, {Bruce Phillip}",
year = "2017",
month = "10",
day = "1",
doi = "10.1016/j.socscimed.2017.08.033",
language = "English",
volume = "190",
pages = "247--255",
journal = "Social Science and Medicine",
issn = "0277-9536",
publisher = "Pergamon",

}

TY - JOUR

T1 - Differential item functioning in quality of life measurement

T2 - An analysis using anchoring vignettes

AU - Knott, Rachel

AU - Lorgelly, Paula K.

AU - Black, Nicole

AU - Hollingsworth, Bruce Phillip

PY - 2017/10/1

Y1 - 2017/10/1

N2 - Systematic differences in the ways that people use and interpret response categories (differential item functioning, DIF) can introduce bias when using self-assessments to compare health or quality of life across heterogeneous groups. This paper reports on an exploratory analysis involving the use of anchoring vignettes to identify DIF in a commonly used measure for assessing health-related quality of life - namely the EQ-5D. Using data from a bespoke (i.e. custom) survey that recruited a representative sample of 4300 respondents from the general Australian population in 2014 and 2015, we find that the assumptions of response consistency (RC) and vignette equivalence (VE) hold in a sub-sample of respondents aged 55–65 years (n = 914), which demonstrates that vignettes can appropriately identify DIF in EQ-5D reporting for this age group. We find that the EQ-5D is indeed subject to DIF, and that failure to account for DIF can lead to conclusions that are misleading when using the instrument to compare health or quality of life across heterogeneous groups. We also provide several important insights in terms of the identifying assumptions of RC and VE. We conclude that the implications of DIF could be of considerable importance, not only for outcomes research, but for funding decisions in healthcare more broadly given the strong reliance on patient-reported outcome measures in economic evaluations for health technology assessment.

AB - Systematic differences in the ways that people use and interpret response categories (differential item functioning, DIF) can introduce bias when using self-assessments to compare health or quality of life across heterogeneous groups. This paper reports on an exploratory analysis involving the use of anchoring vignettes to identify DIF in a commonly used measure for assessing health-related quality of life - namely the EQ-5D. Using data from a bespoke (i.e. custom) survey that recruited a representative sample of 4300 respondents from the general Australian population in 2014 and 2015, we find that the assumptions of response consistency (RC) and vignette equivalence (VE) hold in a sub-sample of respondents aged 55–65 years (n = 914), which demonstrates that vignettes can appropriately identify DIF in EQ-5D reporting for this age group. We find that the EQ-5D is indeed subject to DIF, and that failure to account for DIF can lead to conclusions that are misleading when using the instrument to compare health or quality of life across heterogeneous groups. We also provide several important insights in terms of the identifying assumptions of RC and VE. We conclude that the implications of DIF could be of considerable importance, not only for outcomes research, but for funding decisions in healthcare more broadly given the strong reliance on patient-reported outcome measures in economic evaluations for health technology assessment.

KW - Anchoring vignettes

KW - Australia

KW - Differential item functioning

KW - EQ-5D

KW - Response consistency

KW - Vignette equivalence

UR - http://www.scopus.com/inward/record.url?scp=85028733992&partnerID=8YFLogxK

U2 - 10.1016/j.socscimed.2017.08.033

DO - 10.1016/j.socscimed.2017.08.033

M3 - Article

AN - SCOPUS:85028733992

VL - 190

SP - 247

EP - 255

JO - Social Science and Medicine

JF - Social Science and Medicine

SN - 0277-9536

ER -