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From the Department of Clinical Neurosciences (Drs. Cano and Warner), Royal Free & University College Medical School, UK; MESA (Dr. Linacre), University of Chicago, IL; Sobell Department of Motor Neuroscience and Movement Disorders (Dr. Bhatia) and Neurological Outcome Measures Unit (Drs. Cano, Thompson, and Hobart), Institute of Neurology, University College London, UK; Department of Public Health (Dr. Fitzpatrick), University of Oxford, UK; and Department of Clinical Neurosciences (Dr. Hobart), Peninsula Medical School, Plymouth, UK.
Address correspondence and reprint requests to Dr. Jeremy Hobart, Department of Clinical Neurosciences, Peninsula Medical School, Derriford Hospital, Plymouth, PL6 8DH, UK; e-mail: jeremy.hobart{at}pms.ac.uk
Objectives: To develop a new rating scale for measuring the health impact of cervical dystonia (CD) that includes patients’ perceptions and complements existing observer dependent clinician rating scales.
Methods: Scale development was in three stages. In Stage 1, a large pool of items was generated from patient interviews (n = 25), expert opinion, and literature review. In Stage 2, these items were administered by postal survey to people with CD. The resulting data were analyzed using Rasch item analysis to construct, from the item pool, a rating scale that satisfied criteria for rigorous measurement. In Stage 3, the measurement properties of this rating scale were examined in an independent sample of people with CD.
Results: In Stage 1, 150 items concerning the health impact of CD were generated. In Stage 2, 556 people completed questionnaires (87% response rate) and a 58-item rating scale measuring the health impact of CD in eight areas was constructed (CD Impact Profile, CDIP-58). In Stage 3, CDIP-58 data from 391 people (87% response rate) were received. Analyses supported the measurement of eight unidimensional constructs (infit mean square range 0.62 to 1.50), item calibration (33.37 to 67.56), and patient separation statistics (2.59 to 3.38). Items demonstrated stable calibrations in subgroups of people with CD supporting the stability of the CDIP-58.
Conclusions: The CDIP-58 is a reliable and valid patient-based rating scale measuring the health impact of CD in eight health dimensions.
Received April 29, 2004. Accepted in final form June 25, 2004.
Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the November 9 issue to find the title link for this article.
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