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Quality of Life Research

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21-11-2022

Using Rasch measurement theory to explore the fitness for purpose of the genetic counseling outcome scale: a tale of two scales

Auteurs: Kennedy Borle, Jehannine Austin, Skye Barbic

Gepubliceerd in: Quality of Life Research | Uitgave 3/2023

Abstract

Background

The genetic counseling outcome scale (GCOS-24) is commonly used in clinical genetics to measure patient empowerment; however, there is inconclusive psychometric evidence about this scale.

Methods

Using data from an urban Canadian clinic where the GCOS-24 is routinely administered before (T1) and 1 month after (T2) genetic counseling, we used Rasch measurement theory (RMT) to test the ordering of response option thresholds, fit, spread of item locations, residual correlations, person separation index (PSI), and stability across time.

Results

Data from 379 participants showed that the original GCOS-24 items had poor fit to the Rasch model (χ² = 367.8, p < 0.001). Two models emerged that demonstrated excellent fit to the Rasch model. In Model 1, the response scale options were collapsed and 8 items were removed, leading to an excellent fit to the Rasch model (χ² = 112.4, df = 144, p = 0.975), good reliability (rp = 0.82), and responsiveness to change (mean = 0.75 logits, F = 125.68, p < 0.001). In Model 2, the response scale options were collapsed, 3 items were removed, and the scale divided into two sets (GCOS-Pos, GCOS-Neg). The GCOS-Pos set showed excellent overall fit to the Rasch model (χ² = 92.5, df = 90, p = 0.407), good reliability (rp = 0.73), and responsiveness to change (mean = 0.74 logits, F = 80.12, p < 0.001). The GCOS-Neg set showed excellent overall fit to the Rasch model (χ² = 84.55, df = 97, p = 0.81), but poor reliability (rp = 0.19) and small, but significant responsiveness to change (mean = 0.19 logits, F = 28.73, p < 0.001).

Conclusion

These models show that there are psychometric issues with the GCOS-24 scale, and our study provides options for how to measure empowerment more robustly.

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Titel: Using Rasch measurement theory to explore the fitness for purpose of the genetic counseling outcome scale: a tale of two scales
Auteurs: Kennedy Borle
Jehannine Austin
Skye Barbic
Publicatiedatum: 21-11-2022
Uitgeverij: Springer International Publishing
Gepubliceerd in: Quality of Life Research / Uitgave 3/2023
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI: https://doi.org/10.1007/s11136-022-03289-7

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Abstract

Background

Methods

Results

Conclusion

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