title: Development and calibration of an item bank for the assessment of activities of daily living in cardiovascular patients using Rasch analysis.
abstract: BACKGROUND
  To develop and calibrate the activities of daily living item bank (ADLib-cardio) as a prerequisite for a Computer-adaptive test (CAT) for the assessment of ADL in patients with cardiovascular diseases (CVD).
  
  
  METHODS
  After pre-testing for relevance and comprehension a pool of 181 ADL items were answered on a five-point Likert scale by 720 CVD patients, who were recruited in fourteen German cardiac rehabilitation centers. To verify that the relationship between the items is due to one factor, a confirmatory factor analysis (CFA) was conducted. A Mokken analysis was computed to examine the double monotonicity (i.e. every item generates an equivalent order of person traits, and every person generates an equivalent order of item difficulties). Finally, a Rasch analysis based on the partial credit model was conducted to test for unidimensionality and to calibrate the item bank.
  
  
  RESULTS
  Results of CFA and Mokken analysis confirmed a one factor structure and double monotonicity. In Rasch analysis, merging response categories and removing items with misfit, differential item functioning or local response dependency reduced the ADLib-cardio to 33 items. The ADLib-cardio fitted to the Rasch model with a nonsignificant item-trait interaction (chi-square = 105.42, df = 99; p = 0.31). Person-separation reliability was 0.81 and unidimensionality could be verified.
  
  
  CONCLUSIONS
  The ADLib-cardio is the first calibrated, unidimensional item bank that allows for the assessment of ADL in rehabilitation patients with CVD. As such, it provides the basis for the development of a CAT for the assessment of ADL in patients with cardiovascular diseases. Calibrating the ADLib-cardio in other than rehabilitation cardiovascular patient settings would further increase its generalizability.
authors.affiliation: Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Engelbergerstraße 41, Freiburg D-79085, Germany. baumeister@psychologie.uni-freiburg.de.
authors.forename: Harald
authors.initials: H
authors.lastname: Baumeister
authors.forename: Birgit
authors.initials: B
authors.lastname: Abberger
authors.forename: Anne
authors.initials: A
authors.lastname: Haschke
authors.forename: Maren
authors.initials: M
authors.lastname: Boecker
authors.forename: Juergen
authors.initials: J
authors.lastname: Bengel
authors.forename: Markus
authors.initials: M
authors.lastname: Wirtz
mesh_terms: D000203:Activities of Daily Living; D002138:Calibration; D000072038:Cardiac Rehabilitation; D004185:Disability Evaluation; D005163:Factor Analysis, Statistical; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D011594:Psychometrics; D011795:Surveys and Questionnaires
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