Next steps for use of item response theory in the assessment of health outcomes.
OBJECTIVE
We review the NCI/DIA conference, "Improving health outcomes assessment based on modern measurement theory and computerized adaptive testing," and suggest next steps in use of item response theory (IRT) to assess health outcomes.


BACKGROUND
In recent years the level of interest and use of IRT methods has increased dramatically among health outcomes researchers. The NCI/DIA conference on June 24-25, 2004, was one of the first systematic opportunities to examine many challenging issues in applying IRT to the health outcomes field.


METHODS
Based on the conference presentations, we identified five issues important to future applications of IRT to health outcomes.


RESULTS
The five key issues are as follows: (1) collaboration between academia, government and industry; (2) common versus unique item banks; (3) educating and establishing standards for use and reporting of IRT; (4) demonstrating the value of IRT; and (5) continuing efforts to improve the user friendliness of IRT software.


CONCLUSIONS
Moving forward will require a collaborative effort between academia, government agencies, and industry to design and conduct IRT research. A common item bank developed with collaboration from investigators from multiple institutions could be very valuable to the field. The establishment of consensus standards for use and reporting of IRT results would help users and consumers of the methodology. Clear documentation of how IRT can lead to better patient-reported outcome measures and more accurate understanding of substantive issues is essential. Academia, government and industry should continue current work to enhance the user-friendliness of the IRT software.
Hays
Ron D
RD
David Geffen School of Medicine, UCLA/RAND Health Program, Santa Monica, CA 90407, USA. drhays@ucla.edu
Lipscomb
Joseph
J
D003226:Congresses as Topic; D003299:Cooperative Behavior; D006304:Health Status; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D011788:Quality of Life; D012984:Software; D011795:Surveys and Questionnaires; D014481:United States