Abstract：
OBJECTIVE: The self-administered version of the Amyotrophic Lateral Sclerosis Functional Rating Scale-Revised (ALSFRS-R) is used to monitor function and disease progression in individuals with amyotrophic lateral sclerosis (ALS). However, the performance of the self-administered ALSFRS-R has not been assessed using Rasch Measurement Theory. Therefore, the purpose of this study was to examine the psychometric properties of the self-administered ALSFRS-R using Rasch analysis.
METHODS: Rasch analysis was performed on self-administered ALSFRS-R data from individuals with ALS across Canada. The following 6 aspects of Rasch analysis were examined using RUMM2030: fit via residuals and chi-square statistics, targeting via person-item threshold maps, dependency via item residual correlations, unidimensionality through principal components analysis of residuals, reliability via person separation index, and stability through differential item functioning analyses for sex, age, and language.
RESULTS: Analysis was performed on 122 participants (mean age: 52.9 years; 62.8% men). The overall scale demonstrated good fit, reliability, and stability; however, multidimensionality was found. To address this issue, items were divided into 3 subscales (bulbar, motor, and respiratory function), and Rasch analysis was performed for each subscale. The subscales demonstrated good fit, reliability, stability, and unidimensionality. However, there were still issues with item dependency for all subscale and targeting for bulbar and respiratory subscales.
CONCLUSIONS: The self-administered ALSFRS-R is reliable, internally valid, and stable across sex, age, and language subgroups; however, it is recommended that the ALSFRS-R be scored by subscale. Future studies can look at revising and/or adding items to tackle misfit, redundancy, and ceiling effects.
CONCLUSIONS: Self-administered measures are simple to administer and inexpensive. The self-administered ALSFRS-R was found to be psychometrically sound and can be used as a tool to monitor disease progression and function in ALS.
METHODS: Rasch analysis was performed on self-administered ALSFRS-R data from individuals with ALS across Canada. The following 6 aspects of Rasch analysis were examined using RUMM2030: fit via residuals and chi-square statistics, targeting via person-item threshold maps, dependency via item residual correlations, unidimensionality through principal components analysis of residuals, reliability via person separation index, and stability through differential item functioning analyses for sex, age, and language.
RESULTS: Analysis was performed on 122 participants (mean age: 52.9 years; 62.8% men). The overall scale demonstrated good fit, reliability, and stability; however, multidimensionality was found. To address this issue, items were divided into 3 subscales (bulbar, motor, and respiratory function), and Rasch analysis was performed for each subscale. The subscales demonstrated good fit, reliability, stability, and unidimensionality. However, there were still issues with item dependency for all subscale and targeting for bulbar and respiratory subscales.
CONCLUSIONS: The self-administered ALSFRS-R is reliable, internally valid, and stable across sex, age, and language subgroups; however, it is recommended that the ALSFRS-R be scored by subscale. Future studies can look at revising and/or adding items to tackle misfit, redundancy, and ceiling effects.
CONCLUSIONS: Self-administered measures are simple to administer and inexpensive. The self-administered ALSFRS-R was found to be psychometrically sound and can be used as a tool to monitor disease progression and function in ALS.
摘要：
目的：肌萎缩侧索硬化功能评定量表修订版（ALSFRS-R）用于监测肌萎缩侧索硬化（ALS）患者的功能和疾病进展。然而,尚未使用Rasch测量理论评估自给ALSFRS-R的性能。因此,这项研究的目的是使用Rasch分析检查自给ALSFRS-R的心理测量特性.
方法：对来自加拿大ALS患者的自给ALSFRS-R数据进行了Rasch分析。使用RUMM2030检查了Rasch分析的以下6个方面：通过残差和卡方统计量进行拟合，通过人-项目阈值地图定位，通过项目残差相关性的依赖性，通过残差的主成分分析的一维性，通过人分离指数的可靠性，通过性别的差异项目功能分析和稳定性，年龄,和语言。
结果：对122名参与者进行了分析（平均年龄：52.9岁；62.8％为男性）。整体规模表现出良好的配合，可靠性,和稳定性；然而，发现了多维性。为了解决这个问题，项目分为3个子量表(Bulbar，电机,和呼吸功能)，并对每个分量表进行Rasch分析。分量表显示出很好的拟合，可靠性,稳定性,和单维性。然而,所有分量表的项目依赖性以及球和呼吸分量表的靶向性仍然存在问题.
结论：自给ALSFRS-R是可靠的，内部有效，性别稳定，年龄,和语言子组；然而，建议对ALSFRS-R进行分量表评分.未来的研究可以考虑修改和/或添加项目以解决不适应问题，冗余，天花板效应。
结论：自我管理的措施易于管理且价格便宜。发现自我给药的ALSFRS-R在心理上是健全的，可以用作监测ALS疾病进展和功能的工具。
方法：对来自加拿大ALS患者的自给ALSFRS-R数据进行了Rasch分析。使用RUMM2030检查了Rasch分析的以下6个方面：通过残差和卡方统计量进行拟合，通过人-项目阈值地图定位，通过项目残差相关性的依赖性，通过残差的主成分分析的一维性，通过人分离指数的可靠性，通过性别的差异项目功能分析和稳定性，年龄,和语言。
结果：对122名参与者进行了分析（平均年龄：52.9岁；62.8％为男性）。整体规模表现出良好的配合，可靠性,和稳定性；然而，发现了多维性。为了解决这个问题，项目分为3个子量表(Bulbar，电机,和呼吸功能)，并对每个分量表进行Rasch分析。分量表显示出很好的拟合，可靠性,稳定性,和单维性。然而,所有分量表的项目依赖性以及球和呼吸分量表的靶向性仍然存在问题.
结论：自给ALSFRS-R是可靠的，内部有效，性别稳定，年龄,和语言子组；然而，建议对ALSFRS-R进行分量表评分.未来的研究可以考虑修改和/或添加项目以解决不适应问题，冗余，天花板效应。
结论：自我管理的措施易于管理且价格便宜。发现自我给药的ALSFRS-R在心理上是健全的，可以用作监测ALS疾病进展和功能的工具。
