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9:30 - 11:00

A Psychometric Analysis of the Rotterdam Renal Replacement Knowledge-Test (R3K-T) using Multidimensional Item Response Theory (MIRT)

Ismail, S.Y., Timmerman, L., Timman, R., Luchtenburg, A.E., Smak Gregoor, P.J.H., Nette, R.W., Dorpel, R.M.A. van den, Zuidema, W. C., Massey, E.K., Busschbach, J.J. V., Weimar, W. W.

Categorie(ën):

Objective Knowledge is one of the strongest motivators for promoting well-informed (shared) decision making. Nevertheless, there is no validated and standardized test of the level of knowledge among renal patients regarding kidney disease and all treatment options. Therefore, the objective of this study was to investigate the psychometric properties of a questionnaire that assesses patients’ knowledge on kidney disease and renal replacement therapies for use in research and practice.

 

Methods A 30-item list was validated in 187 patients on dialysis and in 83 patients who were undergoing living donor kidney transplantation the following day. Additionally, the test was administered to 2 representative reference groups from the general population of Dutch residents (n=515) and North American residents (n=550) using a web-based survey. The test is available in 9 languages. Firstly, using the 2PL model from Item Response Theory we assessed Differential Item Functioning (DIF) for all the groups. Secondly, we examined the difficulty and discriminative properties of the questionnaire by using Multidimensional IRT (MIRT). Thirdly, norm-references were calculated.

 

Results Almost all items showed good discrimination and threshold parameters based on the fitted 2PL model. DIF was found for 5 redundant items which would distort trait level estimates. MIRT analyses were subsequently employed for the remaining 25 items. Two stable dimensions with 21 items were retrieved for which norm-references for the dialysis and transplantation group were calculated. The first dimension ‘Dialysis and Transplantation’ contains 11 items and the second dimension ‘Living Donation’ contains 10 items.

 

Conclusions This study resulted in a questionnaire, the R3K-T, which enables reliable testing of patient’s knowledge on kidney disease and treatment options. Further validation of the R3K-T in more specific groups, such as living kidney donors, for which subscale scores may contain clinically relevant information would increase practical rigor of this test.