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Selection of items for a computer-adaptive test to measure fatigue in patients with rheumatoid arthritis: a Delphi approach

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Abstract

Purpose

Computer-adaptive tests (CATs) can measure precisely at individual level with few items selected from an item bank. Our aim was to select fatigue items to develop a CAT for rheumatoid arthritis (RA) and include expert opinions that are important for content validity of measurement instruments.

Methods

Items were included from existing fatigue questionnaires and generated from interview material. In a Delphi procedure, rheumatologists, nurses, and patients evaluated the initial pool of 294 items. Items were selected for the CAT development if rated as adequate by at least 80% of the participants (when 50% or less agreed, they were excluded). Remaining items were adjusted based on participants’ comments and re-evaluated in the next round. The procedure stopped when all items were selected or rejected.

Results

A total of 10 rheumatologists, 20 nurses, and 15 rheumatoid arthritis patients participated. After the first round, 96 of 294 items were directly selected. Nine items were directly excluded, and remaining items were adjusted. In the second round, 124 items were presented for re-evaluation. Ultimately, 245 items were selected.

Conclusion

This study revealed a qualitatively evaluated item pool to be used for the item bank/CAT development. The Delphi procedure is a beneficial approach to select adequate items for measuring fatigue in RA.

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Acknowledgments

We would like to thank the participants in this study; patients from the forum of Patient Research Partners of the Arthritis Centre Twente; and rheumatologists and nurses from Universitair Medisch Centrum Groningen, Medisch Centrum Leeuwarden, Ziekenhuisgroep Twente, Zorg Groep Twente, Medisch Spectrum Twente, St. Maartenskliniek Nijmegen, TweeSteden Ziekenhuis Locatie Tilburg, Universitair Medisch Centrum Utrecht, Rijnstate Ziekenhuis Arnhem, Meander Medisch Centrum Amersfoort, Ziekenhuis Gelderse Vallei Ede, Medisch Centrum Haaglanden s-Gravenhage, Tweesteden Ziekenhuis Tilburg, Evean Thuiszorg Purmerend, Streekziekenhuis Midden Twente Hengelo, Isala Klinieken Zwolle, Albert Schweitzer ziekenhuis Dordrecht, Spaarne Ziekenhuis Hoofddorp, Scheperziekenhuis Emmen, Thuiszorg West-Brabant Roosendal, Omring thuiszorg Hoorn.

This study was financed by the Foundation of Rheumatism Research Twente (Stichting Reumaonderzoek Twente) and the IBR Research Institute for Social Sciences and Technology and conducted at the Arthritis Centre Twente; a collaboration between the University of Twente and the Medical Spectrum Twente.

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Authors and Affiliations

  1. IBR Research Institute for Social Sciences and Technology, University of Twente, P.O. Box 217, 7500 AE, Enschede, The Netherlands

    Stephanie Nikolaus, Christina Bode, Erik Taal & Mart A. F. J. vd Laar

  2. Department of Rheumatology and Clinical Immunology, Medical Spectrum Twente, Enschede, The Netherlands

    Mart A. F. J. vd Laar

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  1. Stephanie Nikolaus
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  2. Christina Bode
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Correspondence to Stephanie Nikolaus.

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Nikolaus, S., Bode, C., Taal, E. et al. Selection of items for a computer-adaptive test to measure fatigue in patients with rheumatoid arthritis: a Delphi approach. Qual Life Res 21, 863–872 (2012). https://doi.org/10.1007/s11136-011-9982-8

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