Grant: Travel Awards - Institute Community Support

Patient-reported outcome measures (PROMs) are powerful evidence-informed multi-item scales used as tools to ensure our healthcare services are responsive to the unique needs of older adults and continue to provide high quality care. PROMs are used by patients to describe how they feel about their health and quality of life. As medical innovations transform the delivery and type of health services available, PROMs are increasingly needed. Despite tremendous interest to integrate PROMs into health services evaluations and comparative effectiveness research, little work has examined gender-based differences using differential item functioning (DIF). DIF arises when patients with the same underlying health status do not interpret the scale items in the same way, which is a major threat to the validity of PROMs. Previous research suggests females are more likely to endorse items that describe emotions of vulnerability while males were more likely to endorse items of physical activity. Thus, items of different endorsements may inflate negative scores at the scale level for women compared to men, which can lead to inaccurate evaluations, ultimately leading PROMs to produce irrelevant evidence for tailored decision-making. Our study remedies this gap by examining the extent to which group membership of gender affect item responses in PROMs. Using innovative item response theory models that test for DIF, data from the 2010 Health Outcomes Survey (pertaining to Medicare beneficiaries) will be analyzed. PROMs will be assessed using the Veterans Rand 12 Health Survey. There are plans to use this survey to assess population health across Canada. The findings of this study will contribute to valid, comparable PROMs data to ensure that healthcare services lead to better outcomes and are equally beneficial to all Canadians.