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An Introduction to Item Response Theory for Patient-Reported Outcome Measurement

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Abstract

The growing emphasis on patient-centered care has accelerated the demand for high-quality data from patient-reported outcome (PRO) measures. Traditionally, the development and validation of these measures has been guided by classical test theory. However, item response theory (IRT), an alternate measurement framework, offers promise for addressing practical measurement problems found in health-related research that have been difficult to solve through classical methods. This paper introduces foundational concepts in IRT, as well as commonly used models and their assumptions. Existing data on a combined sample (n = 636) of Korean American and Vietnamese American adults who responded to the High Blood Pressure Health Literacy Scale and the Patient Health Questionnaire-9 are used to exemplify typical applications of IRT. These examples illustrate how IRT can be used to improve the development, refinement, and evaluation of PRO measures. Greater use of methods based on this framework can increase the accuracy and efficiency with which PROs are measured.

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Acknowledgments

None of the authors have any conflicts of interest, perceived or real, relevant to this paper. This work was not externally funded. THN and KSC conceived, designed, and wrote the manuscript. THN conducted all data analyses. HRH and MTK provided the datasets used in the analyses. They also reviewed and provided substantial feedback on earlier drafts. All authors reviewed and approved the final draft of this manuscript. KSC will act as the overall guarantor of this article.

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Authors and Affiliations

  1. Boston College, Connell School of Nursing, 140 Commonwealth Avenue Cushing Hall, #336C, Chestnut Hill, MA, 02467, USA

    Tam H. Nguyen

  2. School of Nursing, Johns Hopkins University, 525 North Wolfe Street, #526, Baltimore, MD, 21205, USA

    Hae-Ra Han

  3. School of Nursing, The University of Texas at Austin, 1710 Red River, NUR 5.141, Austin, TX, 78701, USA

    Miyong T. Kim

  4. Department of Health Policy and Management, Bloomberg School of Public Health, Johns Hopkins University, 624 N. Broadway, #633, Baltimore, MD, 21205, USA

    Kitty S. Chan

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Correspondence to Kitty S. Chan.

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Nguyen, T.H., Han, HR., Kim, M.T. et al. An Introduction to Item Response Theory for Patient-Reported Outcome Measurement. Patient 7, 23–35 (2014). https://doi.org/10.1007/s40271-013-0041-0

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