Effects of Education on Differential Item Functioning on the 15-Item Modified Korean Version of the Boston Naming Test.
OBJECTIVE
Education is expected to have an effect on differential item functioning (DIF) on the 15-item Modified Boston Naming Test in the Korean version of the Consortium to Establish a Registry for Alzheimer's Disease Assessment Packet (BNT-KC). However, no study has examined DIF in the BNT-KC.


METHODS
We used the item response theory to investigate the impact of education on the DIF in the BNT-KC among elderly individuals with or without dementia (n=720). A two-parameter item response model was used to determine the difficulty and discrimination parameters of each item. The Benjamini-Hochberg procedure was used to address the risk of Type I errors on multiple testing.


RESULTS
Four items, "mermaid," "acorn," "compass," and "pomegranate" continued to demonstrate DIF after controlling for multiple comparisons. Those with low education levels were more likely to error on "mermaid" and "compass," while those with high education levels were more likely to error on "acorn" and "pomegranate." "Hand" and "red pepper" were too easily identified to be used for detecting dementia patients. "Monk's hat" and "pomegranate" were less discriminating than other items, limiting their usefulness in clinical setting.


CONCLUSIONS
These findings may provide useful information for the development of a revised version of the BNT-KC to help clinicians make diagnostic decisions more accurately.
Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
Byung-Soo
BS
Kim
Department of Psychiatry, Inje University College of Medicine, Seoul, Republic of Korea.
Dong-Woo
DW
Lee
Department of Psychiatry, Inha University College of Medicine, Incheon, Republic of Korea.
Jae-Nam
JN
Bae
Department of Psychiatry, Inha University College of Medicine, Incheon, Republic of Korea.
Ji-Hyun
JH
Kim
Department of Psychiatry, Yangsan Mental Hospital, Yangsan, Republic of Korea.
Shinkyum
S
Kim
Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea.; Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.
Ki Woong
KW
Kim
Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
Jee-Eun
JE
Park
Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Republic of Korea.; Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea.
Maeng Je
MJ
Cho
Department of Psychiatry, Kyungpook National University School of Medicine, Daegu, Republic of Korea.
Sung Man
SM
Chang
Dementia; Diagnostic errors; Education; Language tests