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Discussion of Issues and Approaches Presented by Templin and Teresi

Discussions on using familiar and sophisticated methods to identify and address problems in patient satisfaction and communication, including the use of item-scale correlation matrices, logistic regression, and person fit analysis.

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Discussion of Issues and Approaches Presented by Templin and Teresi

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  1. Discussion of Issues and Approaches Presented by Templin and Teresi drhays@ucla.edu http://twitter.com/RonDHays http://gim.med.ucla.edu/FacultyPages/Hays/

  2. Discussion Points • Always use familiar along with unfamiliar (“more sophisticated”) methods • Sophisticated approaches often may not lead to different conclusions but they could and you can often learn something unique • All “quantitative” methods identify problems but supplemental approaches (“qualitative”) needed to find out why

  3. Item-Scale Correlation Matrix-- Patient Satisfaction Questionnaire Technical Interpersonal Communication Financial Communication 1 0.58† 0.59† 0.61* 0.26 2 0.47† 0.50† 0.50* 0.25 3 0.58† 0.66† 0.63* 0.23 4 0.66† 0.66† 0.67* 0.25 5 0.66† 0.71† 0.70* 0.25 Financial 1 0.35 0.35 0.35 0.72* 2 0.17 0.14 0.15 0.65* 3 0.25 0.23 0.23 0.61* 4 0.18 0.15 0.16 0.67* 5 0.31 0.27 0.29 0.70* 6 0.24 0.23 0.22 0.73* 7 0.25 0.23 0.25 0.55* 8 0.34 0.31 0.31 0.64* Cronbach's alpha 0.80 0.82 0.82 0.88 Note – Standard error of correlation is 0.03. Technical = satisfaction with technical quality. Interpersonal = satisfaction with the interpersonal aspects. Communication = satisfaction with communication. Financial = satisfaction with financial arrangements. *Item-scale correlations for hypothesized scales (corrected for item overlap). †Correlation within two standard errors of the correlation of the item with its hypothesized scale.

  4. DIF • Logistic (ordinal) regression • Item response regressed on • Total scale score • Group • Interaction between total scale score and group

  5. Hard time speaking with or understanding child’s dentist because you spoke different languages • Complex item? • Insufficient number of individuals in sample for which these item applies • Something else?

  6. Person Fit • Large negative ZL values indicate misfit. • Person responded to 14 items in physical functioning bank (ZL = -3.13) • For 13 items the person could do the activity (including running 5 miles) without any difficulty. • However, this person reported a little difficulty being out of bed for most of the day.

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