New resilience instrument for family caregivers in cancer: a multidimensional item response theory analysis

Objective Resilience instruments specific to family caregivers (FCs) in cancer are limited. This study was designed to validate the 10-item Resilience Scale Specific to Cancer (RS-SC-10) in FCs using multidimensional item response theory (MIRT) analysis. Methods 382 FCs were enrolled from Be Resilient to Cancer Program (BRCP) and administered with RS-SC-10 and 36-item Short Form Health Survey (SF-36). MIRT was performed to evaluate item parameters while Generalized Additive Model (GAM) and Latent Profile Analysis (LPA) were performed to test the non-linear relationship between resilience (RS-SC-10) and Quality of Life (QoL, SF-36). Results RS-SC-10 retained 10 items with high multidimensional discrimination, monotonous thresholds and its original two-factor structure (Generic and Shift-Persist). Four latent resilience subgroups were identified and a non-linear dose–response pattern between resilience and QoL was confirmed (per-SD increase OR = 1.62, 95% CI 1.16–2.13, p = 0.0019). Conclusion RS-SC-10 is a brief and suitable resilience instrument for FCs in cancer. The resilience screening of patients and FCs can be performed simultaneously in clinical practice.

New Resilience Instrument for Family Caregivers in Cancer: A Multidimensional Item Response Theory Analysis

Objective: Resilience instruments specific to family caregivers (FCs) in cancer are limited. This study was designed to validate the 10-item Resilience Scale Specific to Cancer (RS-SC-10) in FCs using multidimensional item response theory (MIRT) analysis.Methods: 382 FCs were enrolled from Be Resilient to Cancer Program (BRCP) and administered with RS-SC-10 and 36-item Short Form Health Survey (SF-36). MIRT was performed to evaluate item parameters while Generalized Additive Model (GAM) and Latent Profile Analysis (LPA) were performed to test the non-linear relationship between resilience (RS-SC-10) and Quality of Life (QoL, SF-36).Results: RS-SC-10 retained 10 items with high multidimensional discrimination, monotonous thresholds and its original two-factor structure (Generic and Shift-Persist). Four latent resilience subgroups were identified and a non-linear dose-response pattern between resilience and QoL was confirmed (per-SD increase OR= 1.62, 95%CI, 1.16-2.13, p=0.0019).Conclusion: RS-SC-10 is a brief and suitable resilience instrument for FCs in cancer. The resilience screening of patients and FCs can be performed simultaneously in clinical practice.

Development of a Computerized Adaptive Test for Quantifying Chinese Medicine Syndrome of Myasthenia Gravis on Basis of Multidimensional Item Response Theory

Background. Making comprehensive management of myasthenia gravis (MG) is a challenge in clinical practice due to heterogeneity and multiple comorbidities among patients. Aim. To develop an end-to-end instrument for individualized assessment of MG in the perspective of Chinese medicine (TCM) with the application of multidisciplinary quantification approaches. Methods. A self-administrated questionnaire was developed integrating typical symptoms of MG and spleen-kidney deficiency syndrome on basis of the conceptual framework of TCM. With data collected in a multicenter cross-sectional study, confirmatory factor analysis together with multidimensional item response theory (MIRT) was used for evaluating the psychometric property of the questionnaire. A computerized adaptive test was developed based on the MIRT model, and scores of syndrome factors were calculated in simulation. A logistics regression model was also estimated for evaluating the consistency between the quantitative result and the clinical diagnosis of syndrome from clinical practitioners. Result. With 337 patients enrolled and assessed, the 14-item questionnaire was evaluated to be with adequate validity and reliability (Cronbach’s alpha indices = 0.87, AIC = 195.827, BIC = 348.631, CFI = 0.921, RMR = 0.006, GFI = 0.954, RMSEA = 0.048, and χ2/df = 1.782). With adequate factor loadings of symptoms on related syndrome factor, the instrument was evaluated with preliminary interpretation and was suitable for evaluating patients with moderate severity of the spleen and kidney deficiency syndrome. Conclusion. Setting typical symptoms of MG together with systemic discomforts in a computerized adaptive test on the basis of MIRT, this study proposed an innovative research paradigm for quantifying individual condition in the perspective of TCM with application of interdisciplinary approaches.

Boltzmann Machines as Multidimensional Item Response Theory Models

We show that Boltzmann machines can formally be represented as multidimensional item response theory models. This relationship inspired a new learning principle and new ways to regularize Boltzmann machines to make them more interpretable. The core results carry over to a broader class of models including Gaussian-Bernoulli restricted Boltzmann machines.