Item Response Theory in Health Services Research: Reasons for Extending Common Models
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P. J. Veazie , Department of Public Health Sciences, University of Rochester, Rochester, USA.
Item Response Theory (IRT) has enjoyed increased interest in recent years as a method for scaling health-related constructs. However, the context of this application is different from the context of IRT’s development. The shift in context has important implications for proper model specification. This paper reviews the common one, two, and three parameter IRT models, discusses their limitations as used in healthcare research, and argues for the four parameter hierarchical model as an alternative. The use of IRT as a pragmatic means to test item bias has merit, but the general use of IRT in healthcare research without consideration of underlying assumptions may lead to a less appropriate application. Healthcare research would benefit from development of models such as the 4-parameter IRT to account for plausible underlying assumptions.
Item Response Theory, Health Measurement Scales
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