title: Rasch analysis of the Multiple Sclerosis Impact Scale MSIS-29.
abstract: BACKGROUND
  Multiple Sclerosis (MS) is a degenerative neurological disease that causes impairments, including spasticity, pain, fatigue, and bladder dysfunction, which negatively impact on quality of life. The Multiple Sclerosis Impact Scale (MSIS-29) is a disease-specific health-related quality of life (HRQoL) instrument, developed using the patient's perspective on disease impact. It consists of two subscales assessing the physical (MSIS-29-PHYS) and psychological (MSIS-29-PSYCH) impact of MS. Although previous studies have found support for the psychometric properties of the MSIS-29 using traditional methods of scale evaluation, the scale has not been subjected to a detailed Rasch analysis. Therefore, the objective of this study was to use Rasch analysis to assess the internal validity of the scale, and its response format, item fit, targeting, internal consistency and dimensionality.
  
  
  METHODS
  Ninety-two persons with definite MS residing in the community were recruited from a tertiary hospital database. Patients completed the MSIS-29 as part of a larger study. Rasch analysis was undertaken to assess the psychometric properties of the MSIS-29.
  
  
  RESULTS
  Rasch analysis showed overall support for the psychometric properties of the two MSIS-29 subscales, however it was necessary to reduce the response format of the MSIS-29-PHYS to a 3-point response scale. Both subscales were unidimensional, had good internal consistency, and were free from item bias for sex and age. Dimensionality testing indicated it was not appropriate to combine the two subscales to form a total MSIS score.
  
  
  CONCLUSIONS
  In this first study to use Rasch analysis to fully assess the psychometric properties of the MSIS-29 support was found for the two subscales but not for the use of the total scale. Further use of Rasch analysis on the MSIS-29 in larger and broader samples is recommended to confirm these findings.
authors: Department of General Practice, University of Melbourne, Carlton 3053, Victoria, Australia. m.ramp@unimelb.edu.au
authors: Melina
authors: M
authors: Ramp
authors: Fary
authors: F
authors: Khan
authors: Rose Anne
authors: RA
authors: Misajon
authors: Julie F
authors: JF
authors: Pallant
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D009483:Neuropsychological Tests / Q000592:standards; D017063:Outcome Assessment, Health Care / Q000592:standards*; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires / Q000592:standards