Using PHQ-9 item parameters of a common metric resulted in similar depression scores compared to independent IRT model reestimation

Abstract

Objectives To investigate the validity of a common depression metric in independent samples. Study Design and Setting We applied a common metrics approach based on item-response theory for measuring depression to four German-speaking samples that completed the Patient Health Questionnaire (PHQ-9). We compared the PHQ item parameters reported for this common metric to reestimated item parameters that derived from fitting a generalized partial credit model solely to the PHQ-9 items. We calibrated the new model on the same scale as the common metric using two approaches (estimation with shifted prior and Stocking–Lord linking). By fitting a mixed-effects model and using Bland–Altman plots, we investigated the agreement between latent depression scores resulting from the different estimation models. Results We found different item parameters across samples and estimation methods. Although differences in latent depression scores between different estimation methods were statistically significant, these were clinically irrelevant. Conclusion Our findings provide evidence that it is possible to estimate latent depression scores by using the item parameters from a common metric instead of reestimating and linking a model. The use of common metric parameters is simple, for example, using a Web application (http://www.common-metrics.org) and offers a long-term perspective to improve the comparability of patient-reported outcome measures.