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Evaluation & the Health Professions
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Data Pooling and Analysis to Build a Preliminary Item Bank

An Example Using Bowel Function in Prostate Cancer

David T. Eton

Northwestern University School of Medicine, d-eton{at}northwestern.edu

Jin-Shei Lai

Northwestern University School of Medicine

David Cella

Northwestern University School of Medicine

Bryce B. Reeve

National Cancer Institute

James A. Talcott

Massachusetts General Hospital

Jack A. Clark

Boston University, School of Public Health

Carol P. McPherson

H. Lee Moffitt Cancer Center

Mark S. Litwin

University of California Schools of Medicine and Public Health, Los Angeles

Carol M. Moinpour

Fred Hutchinson Cancer Research Center

Assessing bowel function (BF) in prostate cancer can help determine therapeutic trade-offs. We determined the components of BF commonly assessed in prostate cancer studies as an initial step in creating an item bank for clinical and research application. We analyzed six archived data sets representing 4,246 men with prostate cancer. Thirty-one items from validated instruments were available for analysis. Items were classified into domains (diarrhea, rectal urgency, pain, bleeding, bother/distress, and other) then subjected to conventional psychometric and item response theory (IRT) analyses. Items fit the IRT model if the ratio between observed and expected item variance was between 0.60 and 1.40. Four of 31 items had inadequate fit in at least one analysis. Poorly fitting items included bleeding (2), rectal urgency (1), and bother/distress (1). A fifth item assessing hemorrhoids was poorly correlated with other items. Our analyses supported four related components of BF: diarrhea, rectal urgency, pain, and bother/distress.

Key Words: bowel function • prostate cancer • quality of life • item response theory • self-report

Evaluation & the Health Professions, Vol. 28, No. 2, 142-159 (2005)
DOI: 10.1177/0163278705275338
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