Rasch model of the child perceptions questionnaire in multi-country data

Stamm TA 1 , Omara M 2 , Bakerc SR 3 , Foster Page L 4 , Thomson WM 4 , Benson PE 3 Show all authors , Broomhead T 3 , Aguilar-Diaz F 5 , Do L 6 , Gibson BJ 3 , Hirsch C 7 , Marshman Z 3 , McGrath C 8 , Mohamed A 9 , Robinson PG 10 , Traebert J 11 , Turton B 12 , Salzberger T 13 , Bekes K 14

Affiliations 

  • 1 Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria. Electronic address: tanja.stamm@meduniwien.ac.at
  • 2 Section for Outcomes Research, Center for Medical Statistics, Informatics, and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria; Ludwig Boltzmann Cluster Arthritis and Rehabilitation, Nußdorfer Strasse 64, 1090, Vienna, Austria
  • 3 Unit of Oral Health, Dentistry and Society, School of Clinical Dentistry, Claremont Crescent, University of Sheffield, Western Bank, Sheffield, S10 2TN, UK
  • 4 Department of Oral Sciences, Sir John Walsh Research Institute, Faculty of Dentistry, University of Otago, 362 Leith St, North Dunedin, Dunedin, 9016, Otago, New Zealand
  • 5 Department of Public Health, National Autonomous University of Mexico León Unit, León, Guanajuato, Mexico
  • 6 Australian Research Centre for Population Oral Health, The University of Adelaide, Adelaide, SA, 5005, Australia
  • 7 Department of Paediatric Dentistry, Department of Head Medicine and Oral Health, University of Leipzig, Liebigstrasse 12, 04103, Leipzig, Germany
  • 8 Periodontology & Public Health, Faculty of Dentistry, University of Hong Kong, Pok Fu Lam, Hong Kong
  • 9 Department of Dental Services, Ministry of Health, Bandar Seri Begawan BB3913, Brunei Darussalam
  • 10 Bristol Dental School, The University of Bristol, Senate House, Tyndall Ave, Bristol, BS8 1TH, UK
  • 11 Postgraduate Program in Health Sciences, University of Southern Santa Catarina, Av. José Acácio Moreira, 787 - Dehon, Tubarão, Santa Catarina, 88704-900, Brazil
  • 12 Faculty of Dentistry, University of Puthisastra, 55 180 Phnom Penh, 12211, Cambodia
  • 13 Institute for Statistics and Mathematics, Vienna University of Economics and Business, Welthandelsplatz 1, 1020, Vienna, Austria
  • 14 Department of Paediatric Dentistry, School of Dentistry, Medical University of Vienna, Sensengasse 2a, 1090, Vienna, Austria
J Dent, 2020 02;93:103267.
PMID: 31866414 DOI: 10.1016/j.jdent.2019.103267

Abstract

OBJECTIVE: To be fit-for-purpose, oral health-related quality of life instruments must possess a range of psychometric properties which had not been fully examined in the 16-item Short Form Child Perceptions Questionnaire for children aged 11 to 14 years (CPQ11-14 ISF-16). We used advanced statistical approaches to determine the CPQ's measurement accuracy, precision, invariance and dimensionality and analyzed whether age range could be extended from 8 to 15 years.

METHODS: Fit to the Rasch model was examined in 6648 8-to-15-year-olds from Australia, New Zealand, Brunei, Cambodia, Hong Kong, Malaysia, Thailand, Germany, United Kingdom, Brazil and Mexico.

RESULTS: In all but two items, the initial five answer options were reduced to three or four, to increase precision of the children's selection. Items 10 (Shy/embarrassed) and 11 (Concerned what others think) showed an 'extra' dependency between item scores beyond the relationship related to the underlying latent construct represented by the instrument, and so were deleted. Without these two items, the CPQ was unidimensional. The three oral symptoms items (4 Food stuck in teeth, 3 Bad breath and 1 Pain) were required for a sufficient person-item coverage. In three out of 14 items (21 %), Europe and South America showed regional differences in the patterns of how the answer options were selected. No differential item functioning was detected for age.

CONCLUSION: Except for a few modifications, the present analysis supports the combination of items, the cross-cultural validity of the CPQ with 14 items and the extension of the age range from 8 to 15 years.

CLINICAL SIGNIFICANCE: The valid, reliable, shortened and age-extended version of the CPQ resulting from this study should be used in routine care and clinical research. Less items and a wider age range increase its usability. Symptoms items are needed to precisely differentiate between children with higher and lower quality of life.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.

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