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Development and calibration data for the Illness Burden item bank: a new computer adaptive test for persons with type 2 diabetes mellitus

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Abstract

Purpose

The purpose of this study was to develop a new measure, the Re-Engineered Discharge for Diabetes Computer Adaptive Test (REDD-CAT) Illness Burden item bank, to evaluate the impact that a chronic condition has on independent living, the ability to work (including working at home), social activities, and relationships.

Methods

Semi-structured interviews were used to inform the development of an item pool (47 items) that captured patients’ beliefs about how a diagnosis of type 2 diabetes interferes with different aspects of their lives. The Illness Burden item bank was developed and tested in 225 people with type 2 diabetes mellitus.

Results

No items had sparse response option cells or problems with monotonicity; two items were deleted due to low item-rest correlations. Factor analyses supported the retention of 29 items. With those 29 remaining items, a constrained (common slope) graded response model fit assessment indicated that two items had misfit; they were excluded. No items displayed differential item functioning by age, sex, education, or socio-economic status. The final item bank is comprised of 27 items. Preliminary data supported the reliability (internal consistency and test–retest reliability) and validity (convergent, discriminant, and known-groups) of the new bank.

Conclusion

The Illness Burden item bank can be administered as a computer adaptive test or a 6-item short form. This new measure captures patients’ perceptions of the impact that having type 2 diabetes has on their daily lives; it can be used in conjunction with the REDD-CAT measurement system to evaluate important social determinants of health in persons with type 2 diabetes mellitus.

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Acknowledgements

We thank the investigators and research associates/coordinators who worked on the study, the study participants, and organizations who supported recruitment efforts. The content is solely the responsibility of the authors and does not necessarily represent the official views of the funding agencies.

Funding

Work on this manuscript was supported by grant number R21DK12121092 (PIs Carlozzi; Mitchel [admin]) from the National Institutes of Health (NIH), National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), as well as by UL1TR00240 from the National Center for Advancing Translational Sciences (this funding supports co-author J.P. Troost). 

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Authors and Affiliations

  1. Department of Family Medicine, Boston University School of Medicine, Boston, MA, USA

    Suzanne Mitchell, Alexa Bragg & Brian W. Jack

  2. Department of Family Medicine, Boston Medical Center, Boston, MA, USA

    Suzanne Mitchell, Jessica Martin-Howard, Ioana Moldovan & Brian W. Jack

  3. Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Michael A. Kallen

  4. Michigan Institute for Clinical and Health Research, University of Michigan, Ann Arbor, MI, USA

    Jonathan P. Troost

  5. Department of Physical Medicine and Rehabilitation, Center for Clinical Outcomes Development and Application (CODA), University of Michigan, North Campus Research Complex, 2800 Plymouth Road, Building NCRC B14, Room G216, Ann Arbor, MI, 48109-2800, USA

    Jennifer A. Miner & Noelle E. Carlozzi

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  1. Suzanne Mitchell
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Contributions

SM: principal investigator; data collection site; study design; initial draft of the introduction; review and feedback on manuscript drafts. MAK: study co-investigator and statistician; assistance with analysis design; primary statistician for measurement development portions of manuscript (e.g., factor analyses and IRT analyses); drafted statistical analysis section and a template for the results section. JPT: statistician and data analyst; primary statistician for reliability and validity analyses; assistance writing methods and results sections; review and feedback on manuscript drafts. AB: Study Research Coordinator; responsible for data collection; review and feedback on manuscript drafts (critical review of the methods). JM-H: study grants manager and project coordinator; review and feedback on manuscript drafts; assistance with study regulatory documents. BDeLaC: project manager; review and feedback on manuscript drafts; assistance with synthesis of revisions. JAM: study data manager; critical review of the methods; review and feedback on manuscript drafts. IM: study research coordinator; responsible for data collection; review and feedback on manuscript drafts (critical review of the methods). BWJ: principal investigator of the PRET study; review and feedback on manuscript drafts (critical review of the summary of the qualitative work that informed this study). NEC: principal investigator; data coordination and analysis site; analysis design; initial draft of, methods, results and discussion; incorporation of revisions.

Corresponding author

Correspondence to Noelle E. Carlozzi.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest or non-financial interest in the subject matter or materials discussed in this manuscript.

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Approval was obtained from the ethics committee of Boston Medical Center. The procedures used in this study adhere to the tenets of the Declaration of Helsinki.

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Informed consent was obtained from all participants prior to their participation in this study.

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Mitchell, S., Kallen, M.A., Troost, J.P. et al. Development and calibration data for the Illness Burden item bank: a new computer adaptive test for persons with type 2 diabetes mellitus. Qual Life Res 32, 797–811 (2023). https://doi.org/10.1007/s11136-022-03282-0

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