BACKGROUND The provision of psychometrically valid patient reported outcomes (PROs) improves patient outcomes and reflects their quality of life. Consequently, ad hoc clinician-generated questionnaires of the past are being replaced by more rigorous instruments. This change, while beneficial, risks the loss/orphaning of decades-long information on difficult to capture/chronically ill populations. The goal of this study was to assess to the quality of data retrieved from these legacy questionnaires. METHODS Participants included 8563 patients who generated a total of 12,626 hospital admissions over the 2004-2014 study period. Items used to screen for issues related to function, mood, symptoms, and social support among patients with chronic disease were identified in our medical center's patient information questionnaire. Cluster and exploratory factor analyses (EFA) followed by multidimensional item response theory (MIRT) analyses were used to select items that defined factors. Scores were derived with summation and MIRT approaches; inter-factor relationships and relationships of factor scores to assigned diagnostic codes were assessed. Rasch analyses assessed the constructs' measurement properties. RESULTS Literature review and clinician interviews yielded four hypothesized constructs: psychological distress/wellbeing, symptom burden, social support, and physical function. Rasch analyses showed that, while all had good measurement properties, only one, function, separated individuals well. In exploratory factor analyses (EFA), 11 factors representing depression, respiratory symptoms, musculoskeletal pain, family support, mobility, activities of daily living, alcohol consumption, weight loss, fatigue, neurological disorders, and fear at home were identified. Based on the agreement between EFA and cluster analyses as well as Cronbach's alpha, six domains were retained for analyses. Correlations were strong between activities of daily living and mobility (.84), and moderate between pain and mobility (.37) and psychological distress (.59) Known-group validity was supported from the relationships between factor scores and the relevant diagnostic code assignments (.12 to .20). CONCLUSIONS AND DISCUSSION Items from ad hoc clinician-generated patient information questionnaires can be aggregated into valid factors that assess supportive care domains among chronically ill patients. However, the binary response options offered by many screening items limit their information content and consequently, as highlighted by Rasch analyses, their ability to meaningfully discriminate trait levels in these populations.

中文翻译：

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评估临时的临床医生生成的患者调查表是否提供心理上有效的信息。

背景技术心理上有效的患者报告结果（PRO）的提供改善了患者结果并反映了他们的生活质量。因此，过去的临时临床医生生成的调查表已被更严格的工具所取代。这种变化虽然是有益的，但是却可能使数十年之久的有关难以捕获/长期患病人口的信息丢失/孤立。这项研究的目的是评估从这些传统调查表中检索到的数据的质量。方法参与者包括8563名患者，在2004年至2014年的研究期间，共计入院12626例入院。在我们医疗中心的患者信息调查表中，确定了用于筛选与慢性病患者的功能，情绪，症状和社会支持有关的问题的项目。使用聚类和探索性因素分析（EFA），然后进行多维项目响应理论（MIRT）分析，以选择定义因素的项目。分数是通过求和和MIRT方法得出的；评估了因素间的关系以及因素评分与分配的诊断代码的关系。Rasch分析评估了构建体的测量属性。结果文献综述和临床医生访谈得出了四个假设的构想：心理困扰/福祉，症状负担，社会支持和身体机能。Rasch分析表明，尽管所有这些都具有良好的测量属性，但只有一个功能可以很好地分离个体。在探索性因素分析（EFA）中，有11个因素分别代表抑郁症，呼吸道症状，肌肉骨骼疼痛，家庭支持，活动能力，日常生活活动，确定了饮酒，体重减轻，疲劳，神经系统疾病和家庭恐惧感。根据EFA和聚类分析之间的协议以及Cronbach的alpha，保留了六个域进行分析。日常生活活动与活动能力之间的相关性很强（.84），疼痛与活动能力之间的相关性很强（.37）与心理困扰之间的相关性（.59）因子得分与相关诊断代码分配之间的关系支持了已知组的有效性。 （.12至.20）。结论与讨论可将临时临床医生生成的患者信息调查表中的项目汇总为有效因素，以评估慢性病患者的支持性护理领域。但是，许多筛查项目提供的二进制响应选项限制了其信息内容，因此，