Evidence map›Paper›PMID 40844584›Full record

ArticleQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation2025

Tree-based item-response theory model for evaluating differential item functioning in patient-reported outcome measures: a web-based R Shiny implementation.

Olayinka I Arimoro, Lisa M Lix, Mark A Ferro, Matthew T James, Scott B Patten, Samuel Wiebe, Colin B Josephson, Tolulope T Sajobi

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Article in Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Enhancing Measurement Precision of Patient-Reported Outcomes Using Item Response Theory.Inquiry : a journal of medical care organization, provision and financing
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Olayinka I ArimoroDepartment of Community Health Sciences & O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
Lisa M LixDepartment of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada.
Mark A FerroSchool of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada.
Matthew T JamesDepartment of Community Health Sciences & O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
Scott B PattenDepartment of Community Health Sciences & O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
Samuel WiebeDepartment of Community Health Sciences & O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
Colin B JosephsonDepartment of Community Health Sciences & O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada.
Tolulope T SajobiDepartment of Community Health Sciences & O'Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada. ttsajobi@ucalgary.ca.ORCID http://orcid.org/0000-0002-5696-5552

Funding

CIHR 438908
6 · The paper itself

Abstract

purposeThe validity of inferences from patient-reported outcome measure (PROM) scores can be confounded by differential item functioning (DIF). DIF occurs when there is heterogeneity in how patients respond to and interpret questions about their health, despite having the same underlying health status. Ignoring the effects of DIF could lead to inaccurate interpretations and misinformed clinical decisions resulting in compromised healthcare delivery. Tree-based item response theory (IRT) models are recommended as an alternative class of methods for analyzing PROMs because they offer a robust approach for identifying DIF when covariates associated with DIF are unknown a priori.

methodsThis paper introduces a web application developed using R Shiny, which enables users to implement tree-based IRT models for DIF assessment in potentially heterogeneous populations. The app provides flexible model specifications, visualization tools, and customizable settings to accommodate various data types and research needs. A practical tutorial is included, guiding users through the application interface, data preparation, model selection, and interpretation of results.

resultsThe web application (https://ucalgary-pcma-lab.shinyapps.io/tree_based_dif_analysis/) offers interactive data upload in .CSV and .XLSX data formats. Recommendations are provided for selecting model parameters within the app based on the results of previous simulation studies. The web app tests for DIF on dichotomous- and polytomous-scored items. The coefficients, item parameters, and plots provide insights into potential sources of DIF.

conclusionThis web application provides a user-friendly, interactive, innovative, easily accessible, and valuable tool for clinicians, applied health researchers, and analysts seeking to understand sample heterogeneity due to DIF in PROM data.

Indexed as

InternetPatient Reported Outcome MeasuresSoftwareHumansModels, StatisticalPsychometricsQuality of LifeSurveys and QuestionnairesDifferential item functioningItem response theoryPatient-reported outcome measureRecursive partitioningR shiny

Identifiers

PMID40844584

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.