Rasch-Transformed Total Neuropathy Score clinical version (RT-TNSc©) in patients with chemotherapy-induced peripheral neuropathy

Davide Binda; Guido Cavaletti; David R. Cornblath; Ingemar S J Merkies

doi:10.1111/jns.12140

Rasch-Transformed Total Neuropathy Score clinical version (RT-TNSc^©) in patients with chemotherapy-induced peripheral neuropathy

Davide Binda, Guido Cavaletti, David R. Cornblath, Ingemar S J Merkies^*

^*Corresponding author for this work

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Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Composite scales such as the Total Neuropathy Score clinical version (TNSc(©) ) have been widely used to measure neurological impairment in a standardized manner but they have been criticized due to their ordinal setting having no fixed unit. This study aims to improve impairment assessment in patients with chemotherapy-induced peripheral neuropathy (CIPN) by subjecting TNSc(©) records to Rasch analyses. In particular, we wanted to investigate the influence of factors affecting the use of the TNSc(©) in clinical practice. TNSc(©) has 7 domains (sensory, motor, autonomic, pin-prick, vibration, strength, and deep tendon reflexes [DTR]) each being scored 0-4. Data obtained in 281 patients with stable CIPN were subjected to Rasch analyses to determine the fit to the model. The TNSc(©) did not meet Rasch model's expectations primarily because of misfit statistics in autonomic and DTR domains. Removing these two, acceptable model fit and uni-dimensionality were obtained. However, disordered thresholds (vibration and strength) and item bias (mainly cultural) were still seen, but these findings were kept to balance the assessment range of the Rasch-Transformed TNSc(©) (RT-TNSc(©) ). Acceptable reliability findings were also obtained. A 5-domains RT-TNSc(©) may be a more proper assessment tool in patients with CIPN. Future studies are needed to examine its responsive properties.

Original language	English
Pages (from-to)	328-332
Number of pages	5
Journal	Journal of the Peripheral Nervous System
Volume	20
Issue number	3
DOIs	https://doi.org/10.1111/jns.12140
Publication status	Published - 1 Sept 2015

Keywords

Rasch analysis
chemotherapy
peripheral neuropathy
psychometrics
total neuropathy score

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10.1111/jns.12140

http://www.mendeley.com/research/raschtransformed-total-neuropathy-score-clinical-version-rttnscsupsup-patients-chemotherapyinduced-p

Cite this

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title = "Rasch-Transformed Total Neuropathy Score clinical version (RT-TNSc{\textcopyright}) in patients with chemotherapy-induced peripheral neuropathy",

abstract = "Composite scales such as the Total Neuropathy Score clinical version (TNSc({\textcopyright}) ) have been widely used to measure neurological impairment in a standardized manner but they have been criticized due to their ordinal setting having no fixed unit. This study aims to improve impairment assessment in patients with chemotherapy-induced peripheral neuropathy (CIPN) by subjecting TNSc({\textcopyright}) records to Rasch analyses. In particular, we wanted to investigate the influence of factors affecting the use of the TNSc({\textcopyright}) in clinical practice. TNSc({\textcopyright}) has 7 domains (sensory, motor, autonomic, pin-prick, vibration, strength, and deep tendon reflexes [DTR]) each being scored 0-4. Data obtained in 281 patients with stable CIPN were subjected to Rasch analyses to determine the fit to the model. The TNSc({\textcopyright}) did not meet Rasch model's expectations primarily because of misfit statistics in autonomic and DTR domains. Removing these two, acceptable model fit and uni-dimensionality were obtained. However, disordered thresholds (vibration and strength) and item bias (mainly cultural) were still seen, but these findings were kept to balance the assessment range of the Rasch-Transformed TNSc({\textcopyright}) (RT-TNSc({\textcopyright}) ). Acceptable reliability findings were also obtained. A 5-domains RT-TNSc({\textcopyright}) may be a more proper assessment tool in patients with CIPN. Future studies are needed to examine its responsive properties.",

keywords = "Rasch analysis, chemotherapy, peripheral neuropathy, psychometrics, total neuropathy score",

author = "Davide Binda and Guido Cavaletti and Cornblath, {David R.} and Merkies, {Ingemar S J}",

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T1 - Rasch-Transformed Total Neuropathy Score clinical version (RT-TNSc©) in patients with chemotherapy-induced peripheral neuropathy

AU - Binda, Davide

AU - Cavaletti, Guido

AU - Cornblath, David R.

AU - Merkies, Ingemar S J

PY - 2015/9/1

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N2 - Composite scales such as the Total Neuropathy Score clinical version (TNSc(©) ) have been widely used to measure neurological impairment in a standardized manner but they have been criticized due to their ordinal setting having no fixed unit. This study aims to improve impairment assessment in patients with chemotherapy-induced peripheral neuropathy (CIPN) by subjecting TNSc(©) records to Rasch analyses. In particular, we wanted to investigate the influence of factors affecting the use of the TNSc(©) in clinical practice. TNSc(©) has 7 domains (sensory, motor, autonomic, pin-prick, vibration, strength, and deep tendon reflexes [DTR]) each being scored 0-4. Data obtained in 281 patients with stable CIPN were subjected to Rasch analyses to determine the fit to the model. The TNSc(©) did not meet Rasch model's expectations primarily because of misfit statistics in autonomic and DTR domains. Removing these two, acceptable model fit and uni-dimensionality were obtained. However, disordered thresholds (vibration and strength) and item bias (mainly cultural) were still seen, but these findings were kept to balance the assessment range of the Rasch-Transformed TNSc(©) (RT-TNSc(©) ). Acceptable reliability findings were also obtained. A 5-domains RT-TNSc(©) may be a more proper assessment tool in patients with CIPN. Future studies are needed to examine its responsive properties.

AB - Composite scales such as the Total Neuropathy Score clinical version (TNSc(©) ) have been widely used to measure neurological impairment in a standardized manner but they have been criticized due to their ordinal setting having no fixed unit. This study aims to improve impairment assessment in patients with chemotherapy-induced peripheral neuropathy (CIPN) by subjecting TNSc(©) records to Rasch analyses. In particular, we wanted to investigate the influence of factors affecting the use of the TNSc(©) in clinical practice. TNSc(©) has 7 domains (sensory, motor, autonomic, pin-prick, vibration, strength, and deep tendon reflexes [DTR]) each being scored 0-4. Data obtained in 281 patients with stable CIPN were subjected to Rasch analyses to determine the fit to the model. The TNSc(©) did not meet Rasch model's expectations primarily because of misfit statistics in autonomic and DTR domains. Removing these two, acceptable model fit and uni-dimensionality were obtained. However, disordered thresholds (vibration and strength) and item bias (mainly cultural) were still seen, but these findings were kept to balance the assessment range of the Rasch-Transformed TNSc(©) (RT-TNSc(©) ). Acceptable reliability findings were also obtained. A 5-domains RT-TNSc(©) may be a more proper assessment tool in patients with CIPN. Future studies are needed to examine its responsive properties.

KW - Rasch analysis

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KW - psychometrics

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