Construct validity of the Trunk Aesthetic Clinical Evaluation (TRACE) in young people with idiopathic scoliosis.
Adolescent
Braces
Child
Disability Evaluation
Esthetics
/ psychology
Female
Humans
Male
Outcome Assessment, Health Care
Patient Acceptance of Health Care
/ psychology
Principal Component Analysis
Psychiatric Status Rating Scales
/ standards
Psychometrics
Reproducibility of Results
Scoliosis
/ psychology
Severity of Illness Index
Torso
Aesthetics
Evaluation
Idiopathic scoliosis
Rasch analysis
Rehabilitation
Journal
Annals of physical and rehabilitation medicine
ISSN: 1877-0665
Titre abrégé: Ann Phys Rehabil Med
Pays: Netherlands
ID NLM: 101502773
Informations de publication
Date de publication:
May 2020
May 2020
Historique:
received:
20
02
2019
revised:
29
10
2019
accepted:
30
10
2019
pubmed:
10
12
2019
medline:
27
3
2021
entrez:
10
12
2019
Statut:
ppublish
Résumé
Aesthetics is recognized as a main outcome in idiopathic scoliosis (IS) treatment, but to date, there is no criterion standard for physicians' evaluation. Trunk Aesthetic Clinical Evaluation (TRACE) is a simple 12-point ordinal scale to quantify symmetry as a proxy of aesthetics. TRACE is already diffused worldwide and has been used in clinical research. We aimed to validate TRACE and improve it with Rasch analysis. This study involved an observational Rasch analysis validation of an evaluation tool in outpatient rehabilitation centres. From a clinical database, we randomly selected patients who had IS, were age 10 to 18, had brace prescription at first evaluation, and had at least 2 consultations. Rasch analysis (partial credit model) was used. Differential item functioning (DIF) was assessed for age, sex, disease severity, bracing and treatment. The median was chosen to dichotomize disease severity and bracing. We removed 64 outlier participants (4%). We included 1553 participants (1334 females; mean [SD] age 13 [1.7] years old). TRACE items showed ordered thresholds and proper fit to the Rasch model. The score-to-measure conversion table showed proper length (range -4.55 to 4.79 logit) with a mean (SE) measure of -0.52 (0.04) logit. The principal component analysis supported the TRACE unidimensionality. The TRACE was free from DIF for age, sex and bracing. The TRACE ordinal scale has been converted into a Rasch-consistent, interval-level measure of trunk aesthetics in IS patients and can be used to compare different populations. Its main flaw is low reliability, likely because of the small number of items. TRACE can be used as an outcome measure and in everyday clinical evaluation of IS, even if new developments of the scale are advised.
Sections du résumé
BACKGROUND
BACKGROUND
Aesthetics is recognized as a main outcome in idiopathic scoliosis (IS) treatment, but to date, there is no criterion standard for physicians' evaluation. Trunk Aesthetic Clinical Evaluation (TRACE) is a simple 12-point ordinal scale to quantify symmetry as a proxy of aesthetics. TRACE is already diffused worldwide and has been used in clinical research.
OBJECTIVE
OBJECTIVE
We aimed to validate TRACE and improve it with Rasch analysis.
MATERIAL AND METHODS
METHODS
This study involved an observational Rasch analysis validation of an evaluation tool in outpatient rehabilitation centres. From a clinical database, we randomly selected patients who had IS, were age 10 to 18, had brace prescription at first evaluation, and had at least 2 consultations. Rasch analysis (partial credit model) was used. Differential item functioning (DIF) was assessed for age, sex, disease severity, bracing and treatment. The median was chosen to dichotomize disease severity and bracing. We removed 64 outlier participants (4%).
RESULTS
RESULTS
We included 1553 participants (1334 females; mean [SD] age 13 [1.7] years old). TRACE items showed ordered thresholds and proper fit to the Rasch model. The score-to-measure conversion table showed proper length (range -4.55 to 4.79 logit) with a mean (SE) measure of -0.52 (0.04) logit. The principal component analysis supported the TRACE unidimensionality. The TRACE was free from DIF for age, sex and bracing.
CONCLUSIONS
CONCLUSIONS
The TRACE ordinal scale has been converted into a Rasch-consistent, interval-level measure of trunk aesthetics in IS patients and can be used to compare different populations. Its main flaw is low reliability, likely because of the small number of items. TRACE can be used as an outcome measure and in everyday clinical evaluation of IS, even if new developments of the scale are advised.
Identifiants
pubmed: 31816447
pii: S1877-0657(19)30186-1
doi: 10.1016/j.rehab.2019.10.008
pii:
doi:
Types de publication
Journal Article
Observational Study
Validation Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
216-221Informations de copyright
Copyright © 2019 Elsevier Masson SAS. All rights reserved.