Research in Vestibular Science

The Korean Balance Society (대한평형의학회)
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Rasch Analysis of the Clinimetric Properties of the Korean Dizziness Handicap Inventory in Patients with Parkinson Disease

파킨슨병 환자에서 한국어판 Dizziness Handicap Inventory의 라쉬 분석에 의한 임상측정 특성 평가

  • Lee, Da-Young (Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Yang, Hui-Jun (Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Yang, Dong-Seok (Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Choi, Jin-Hyuk (Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Park, Byoung-Soo (Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine) ;
  • Park, Ji-Yun (Department of Neurology, Ulsan University Hospital, University of Ulsan College of Medicine)
  • 이다영 (울산대학교 의과대학 신경과학교실, 울산대학교병원 신경과) ;
  • 양희준 (울산대학교 의과대학 신경과학교실, 울산대학교병원 신경과) ;
  • 양동석 (울산대학교 의과대학 신경과학교실, 울산대학교병원 신경과) ;
  • 최진혁 (울산대학교 의과대학 신경과학교실, 울산대학교병원 신경과) ;
  • 박병수 (울산대학교 의과대학 신경과학교실, 울산대학교병원 신경과) ;
  • 박지윤 (울산대학교 의과대학 신경과학교실, 울산대학교병원 신경과)
  • Received : 2018.11.30
  • Accepted : 2018.12.03
  • Published : 2018.12.15
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Abstract

Objectives: The Korean Dizziness Handicap Inventory (KDHI), which includes 25 patient-reported items, has been used to assess self-reported dizziness in Korean patients with Parkinson disease (PD). Nevertheless, few studies have examined the KDHI based on item-response theory within this population. The aim of our study was to address the feasibility and clinimetric properties of the KDHI instrument using polytomous Rasch measurement analysis. Methods: The unidimensionality, scale targeting, separation reliability, item difficulty (severity), and response category utility of the KDHI were statistically assessed based on the Andrich rating scale model. The utilities of the orderedresponse categories of the 3-point Likert scale were analyzed with reference to the probability curves of the response categories. The separation reliability of the KDHI was assessed based on person separation reliability (PSR), which is used to measure the capacity to discriminate among groups of patients with different levels of balance deficits. Results: Principal component analyses of residuals revealed that the KDHI had unidimensionality. The KHDI had satisfactory PSR and there were no disordered thresholds in the 3-point rating scale. However, the KDHI showed several issues for inappropriate scale targeting and misfit items (items 1 and 2) for Rasch model. Conclusions: The KDHI provide unidimensional measures of imbalance symptoms in patients with PD with adequate separation reliability. There was no statistical evidence of disorder in polytomous rating scales. The Rasch analysis results suggest that the KDHI is a reliable scale for measuring the imbalance symptoms in PD patients, and identified parts for possible amendments in order to further improve the linear metric scale.

Keywords

Acknowledgement

Supported by : Daiichi-Sankyo Korea Co.

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  1. Dizziness in patients with early stages of Parkinson's disease: Prevalence, clinical characteristics and implications vol.20, pp.5, 2018, https://doi.org/10.1111/ggi.13894