Calibration of the Nasal Obstruction Symptom Evaluation Questionnaire Using Rasch Analysis

Year 2023, Volume: 6 Issue: 2, 61 - 68, 28.08.2023

Frank Declau Laura Pingnet Valérie Verkest

Abstract

Objective: The objective of the study was to establish a Rasch-calibrated table to convert the raw ordinal score of the Nasal Obstruction Symptom Evaluation questionnaire into linear interval-level data. The Nasal Obstruction Symptom Evaluation scale was developed by Stewart et al in 2004 as the first validated questionnaire for the assessment of subjective nasal obstruction. The use of questionnaires typically involves a process of summing individual item scores into total scores that are treated as measures of the variable that the instrument intends to represent. However, raw total scores are ordinal and not linear scaled. Therefore, measurement equivalence may be problematic, which in turn prohibits sound comparisons across different sample groups of individuals.

Methods: The psychometric properties of the Dutch version of the Nasal Obstruction Symptom Evaluation scale were evaluated on pre- and postoperative data from a prospective consecutive cohort of 219 Dutch-speaking septorhinoplasty patients.

Results: Analysis with the Rasch measurement model demonstrated that the Nasal Obstruction Symptom Evaluation questionnaire adequately met the requirement of measurement invariance in rhinoplasty patients. The Nasal Obstruction Symptom Evaluation scale was also found to be unidimensional and without local item dependencies. Within an acceptable range, item and person fit were adequate, as well as differential item functioning. The construction of a Rasch-calibrated table allowed us to convert raw ordinal scores of the Nasal Obstruction Symptom Evaluation questionnaire into linear interval-level data within the original 0-100 range.

Conclusion: The Nasal Obstruction Symptom Evaluation scale satisfies the expectations of the unidimensional Rasch model. A conversion table was successfully created. Although the clinical benefits of interval-transformed scores require further evaluation, they can facilitate comparisons of outcome measures in multicentered research.

Keywords

Nasal congestion , nasal obstruction , PROM , rhinology

References

• Giotakis AI, Tomazic PV, Riechelmann H, Vent J. Objective assessment of nasal patency. Facial Plast Surg. 2017;33(4):378-387.
• Nathan RA, Eccles R, Howarth PH, Steinsvåg SK, Togias A. Objective monitoring of nasal patency and nasal physiology in rhinitis. J Allergy Clin Immunol. 2005;115(3)(suppl 1):S442-S459.
• Ta NH, Gao J, Philpott C. A systematic review to examine the relationship between objective and patient-reported outcome measures in sinonasal disorders: recommendations for use in research and clinical practice. Int Forum Allergy Rhinol. 2021;11(5):910-923.
• Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT. Development and validation of the nasal obstruction symptom evaluation (NOSE) scale. Otolaryngol Head Neck Surg. 2004;130(2):157-163.
• van Zijl FVWJ, Timman R, Datema FR. Adaptation and validation of the Dutch version of the nasal obstruction symptom evaluation (NOSE) scale. Eur Arch Otorhinolaryngol. 2017;274(6):2469-2476.
• Onerci Celebi O, Araz Server E, Yigit O, Longur ES. Adaptation and validation of the Turkish version of the Nasal Obstruction Symptom Evaluation scale. Int Forum Allergy Rhinol. 2018;8(1):72-76.
• Ekstrand J, Westergren A, Årestedt K, Hellström A, Hagell P. Transformation of Rasch model logits for enhanced interpretability. BMC Med Res Methodol. 2022;22(1):332.
• Tennant A, McKenna SP, Hagell P. Application of Rasch analysis in the development and application of quality of life instruments. Value Health. 2004;7(suppl1):S22-S26.
• Pingnet L, Verkest V, Fransen E, Declau F. Dutch translation and validation of the FACE-Q rhinoplasty module. Facial Plast Surg. 2021;37(3):296-301.
• Declau F, Pingnet L, Verkest V, Hansen T. Cross-cultural evaluation of the Dutch FACE-Q rhinoplasty questionnaires using Rasch analysis. Aesthet Surg J. 2021;41(12):NP1916-NP1930.
• Rasch G. Probabilistic Models for Some Intelligence and Attainment Tests. Chicago, IL: The University of Chicago Press; 1960.
• Boone W, Staver JR, Yale MS. Rasch Analysis in the Human Sciences. Berlin: Springer; 2014.
• Linacre JM. A User’s Guide to WINSTEPS/MINISTEPS Rasch Model Computer Programs. Available at: http://www.winsteps.com/index.htm; 2021.
• Bond T, Fox C. Applying the Rasch Model: Fundamental Measurement in the Human Sciences. New Jersy: Lawrence Erlbaum Associates; 2001.
• Allen J, Walsh JA. A construct-based approach to equivalence: methodologies for cross-cultural/ multicultural personality assessment research. In: Dana RH, ed. Handbook of Cross-Cultural and Multicultural Personality Assessment Personality in Clinical Psychology Series. New York: Lawrence Erlbaum Associates; 2000:63-85.
• Aryadoust V. Differential item functioning in while-listening performance tests: the case of the international English language testing system (IELTS) listening module. Int J Listening. 2012;26(1):40-60.
• Holland P, Wainer H. Differential Item Functioning. New Jersy: Lawrence Erlbaum Associates; 1993.
• Hagquist C, Andrich D. Is the sense of coherence-instrument applicable on adolescents? A latent trait analysis using Rasch-modelling. Pers Individ Dif. 2004;36(4):955-968.
• Bravo M. Instrument development: cultural adaptations for ethnic minority research. In: Bernal G, Trimble JE, Burlew AK, Leong FTL, eds. Handbook of Racial & Ethnic Minority Psychology. New Jersy: Thousand Oaks; 2003:220-236.
• Verkest V, Pİngnet L, Fransen E, Declau F. Analysis of functional and aesthetic outcomes in external septorhinoplasty: study protocol. B-ENT. 2020;16(1): 45-50.
• Pallant JF, Miller RL, Tennant A. Evaluation of the Edinburgh Post Natal Depression Scale using Rasch analysis. BMC Psychiatry. 2006;6:28.
• Saleh AM, Younes A, Friedman O. Cosmetics and function: quality-of-life changes after rhinoplasty surgery. Laryngoscope. 2012;122(2):254-259.
• Kahveci OK, Miman MC, Yucel A, Yucedag F, Okur E, Altuntas A. The efficiency of nose obstruction symptom evaluation (NOSE) scale on patients with nasal septal deviation. Auris Nasus Larynx. 2012;39(3):275-279.
• Shukla RH, Nemade SV, Shinde KJ. Comparison of visual analogue scale (VAS) and the nasal obstruction symptom evaluation (NOSE) score in evaluation of post septoplasty patients. World J Otorhinolaryngol Head Neck Surg. 2020; 6(1):53-58.
• Linacre JM. Sample size and item calibration stability. Available at: http://www.rasch.org/rmt/rmt74m.htm . Accessed June 4, 2021.
• Hagell P, Westergren A. Sample size and statistical conclusions from tests of fit to the Rasch model according to the Rasch unidimensional measurement model (Rumm) program in health outcome measurement. J Appl Meas. 2016;17(4):416-431.
• Hays JR, Reas DL, Shaw JB. Concurrent validity of the Wechsler Abbreviated Scale of Intelligence and the Kaufman Brief Intelligence Test among psychiatric inpatients. Psychol Rep. 2002;90(2):355-359.
• Arima LM, Velasco LC, Tiago RS. Influence of age on rhinoplasty outcomes evaluation: a preliminary study. Aesthet Plast Surg. 2012;36(2):248-253.
• Buil I, de Chernatony L, Martínez E. Methodological issues in cross-cultural research: an overview and recommendations. J Target Meas Anal Mark. 2012/09/01;20(3-4):223-234.
• Klassen AF, Cano SJ, Schwitzer JA, Scott AM, Pusic AL. FACE-Q scales for healthrelated quality of life, early life impact, satisfaction with outcomes, and decision to have treatment: development and validation. Plast Reconstr Surg. 2015;135(2):375-386.