A longitudinal evaluation of the Center for Epidemiologic Studies-Depression scale (CES-D) in a rheumatiod arthritis population using Rasch Analysis

Tanya Covic, Julie F. Pallant, Philip G. Conaghan, Alan Tennant

    Research output: Contribution to journalArticle

    Abstract

    Background: The aim of this study was to test the internal validity of the total Center for Epidemiologic Studies-Depression (CES-D) scale using Rasch analysis in a rheumatoid arthritis (RA) population. Methods: CES-D was administered to 157 patients with RA over three time points within a 12 month period. Rasch analysis was applied using RUMM2020 software to assess the overall fit of the model, the response scale used, individual item fit, differential item functioning (DIF) and person separation. Results: Pooled data across three time points was shown to fit the Rasch model with removal of seven items from the original 20-item CES-D scale. It was necessary to rescore the response format from four to three categories in order to improve the scale's fit. Two items demonstrated some DIF for age and gender but were retained within the 13-item CES-D scale. A new cut point for depression score of 9 was found to correspond to the original cut point score of 16 in the full CES-D scale. Conclusion: This Rasch analysis of the CES-D in a longstanding RA cohort resulted in the construction of a modified 13-item scale with good internal validity. Further validation of the modified scale is recommended particularly in relation to the new cut point for depression.
    Original languageEnglish
    Number of pages28
    JournalHealth and Quality of Life Outcomes
    Publication statusPublished - 2007

    Open Access - Access Right Statement

    © 2007 Covic et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

    Keywords

    • Center for Epidemiologic Studies-Depression scale
    • Rasch analysis
    • depression
    • rheumatoid arthritis

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