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Development and testing of candidate items for inclusion in a new rheumatoid arthritis stiffness patient-reported outcome measure

Kirwan, John R.; Halls, Serena; Dures, Emma; Pollock, Jon; Baker, Gill; Edmunds, Avis; Hewlett, Sarah

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Authors

John R. Kirwan

Emma Dures Emma2.Dures@uwe.ac.uk
Professor in Rheumatology and Self-management

Jon Pollock Jon.Pollock@uwe.ac.uk
Associate Professor in Epidemiology

Gill Baker

Avis Edmunds



Abstract

© The Author 2017. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. Objective. To qualitatively develop and test a set of candidate items for a new RA stiffness patientreported outcome measure (PROM) that capture the patient perspective. This is an essential first step in PROM development, prior to quantitative development, assessment and validation. Methods. Focus groups further examined the previously developed stiffness conceptual model and explored the patient perspective regarding stiffness assessment. Data were analysed using thematic analysis. An iterative process of item development was then performed by the expert study team of researchers, patients and clinicians, based on the two qualitative datasets and informed by measurement theory and guidelines. Finally, these candidate items were tested using formal cognitive interview methodology and subsequently refined. Results. Sixteen RA patients from the UK participated in focus groups. Data confirmed the conceptual model of the RA patient experience of stiffness and provided insight into stiffness assessment, including suggestions regarding patient-relevant stiffness assessment categories such as impact, location and timing. These data informed the development of 77 candidate stiffness PROM items, including multiple formats for some. Eleven RA patients participated in cognitive interviews. Minor changes were made to items to enhance understanding and 32 items were removed, resulting in 45 candidate PROM items. Conclusion. Rigorous qualitative methodology and considerable patient involvement has underpinned items for a new RA stiffness PROM with strong content validity. Crucially, patient involvement broadened assessment beyond early morning stiffness duration, which may address existing PROM limitations. Items are now suitable for quantitative item reduction, structural development of the final PROM and validation.

Citation

Kirwan, J. R., Halls, S., Dures, E., Pollock, J., Baker, G., Edmunds, A., & Hewlett, S. (2018). Development and testing of candidate items for inclusion in a new rheumatoid arthritis stiffness patient-reported outcome measure. Rheumatology, 57(2), 263-272. https://doi.org/10.1093/rheumatology/kex085

Journal Article Type Article
Acceptance Date Jan 23, 2017
Online Publication Date Apr 11, 2017
Publication Date Feb 1, 2018
Deposit Date Feb 2, 2017
Publicly Available Date Mar 29, 2024
Journal Rheumatology (United Kingdom)
Print ISSN 1462-0324
Electronic ISSN 1462-0332
Publisher Oxford University Press (OUP)
Peer Reviewed Peer Reviewed
Volume 57
Issue 2
Pages 263-272
DOI https://doi.org/10.1093/rheumatology/kex085
Keywords qualitative development, cognitive testing, candidate items, rheumatoid arthritis, stiffness, patient-reported
Public URL https://uwe-repository.worktribe.com/output/889305
Publisher URL https://doi.org/10.1093/rheumatology/kex085
Additional Information Additional Information : This is a pre-copyedited, author-produced version of an article accepted for publication in Rheumatology following peer review. The version of record Halls, S., Dures, E., Kirwan, J., Pollock, J., Baker, G., Edmunds, A. and Hewlett, S. (2017) Development and testing of candidate items for inclusion in a new rheumatoid arthritis stiffness patient-reported outcome measure. Rheumatology is available online at: https://doi.org/10.1093/rheumatology/kex085

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