Research in Vestibular Science

Original Article

Rasch Analysis of the Clinimetric Properties of the Korean Dizziness Handicap Inventory in Patients with Parkinson Disease: Da-Young Lee, Hui-Jun Yang, Dong-Seok Yang, Jin-Hyuk Choi, Byoung-Soo Park, Ji-Yun Park; Res Vestib Sci. 2018;17(4):152-159. Published online December 21, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.4.152

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Objectives
The Korean Dizziness Handicap Inventory (KDHI), which includes 25 patient-reported items, has been used to assess self-reported dizziness in Korean patients with Parkinson disease (PD). Nevertheless, few studies have examined the KDHI based on item-response theory within this population. The aim of our study was to address the feasibility and clinimetric properties of the KDHI instrument using polytomous Rasch measurement analysis.
Methods
The unidimensionality, scale targeting, separation reliability, item difficulty (severity), and response category utility of the KDHI were statistically assessed based on the Andrich rating scale model. The utilities of the orderedresponse categories of the 3-point Likert scale were analyzed with reference to the probability curves of the response categories. The separation reliability of the KDHI was assessed based on person separation reliability (PSR), which is used to measure the capacity to discriminate among groups of patients with different levels of balance deficits.
Results
Principal component analyses of residuals revealed that the KDHI had unidimensionality. The KHDI had satisfactory PSR and there were no disordered thresholds in the 3-point rating scale. However, the KDHI showed several issues for inappropriate scale targeting and misfit items (items 1 and 2) for Rasch model. Conclusions: The KDHI provide unidimensional measures of imbalance symptoms in patients with PD with adequate separation reliability. There was no statistical evidence of disorder in polytomous rating scales. The Rasch analysis results suggest that the KDHI is a reliable scale for measuring the imbalance symptoms in PD patients, and identified parts for possible amendments in order to further improve the linear metric scale.

Citations

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Validation and Reliability of the Cataract-related Visual Function Questionnaire (CVFQ)
Eun Jin Koh, Jong Min Lee, Dong Hui Lim, Danbee Kang, Juhee Cho, Min Kyung Song, In Kwon Chung, Hun Jin Choi, Ji Woong Chang, Jong Hyun Lee, Tae Young Chung, Young Sub Eom, Yeoun Sook Chun, So Hyang Chung, Eun Chul Kim, Joon Young Hyon, Do Hyung Lee
Journal of the Korean Ophthalmological Society.2023; 64(11): 1030. CrossRef
Dizziness in patients with early stages of Parkinson's disease: Prevalence, clinical characteristics and implications
Kyum‐Yil Kwon, Suyeon Park, Mina Lee, Hyunjin Ju, Kayeong Im, Byung‐Euk Joo, Kyung Bok Lee, Hakjae Roh, Moo‐Young Ahn
Geriatrics & Gerontology International.2020; 20(5): 443. CrossRef

Rasch analysis of the clinimetric properties of the Korean Dizziness Handicap Inventory in patients with Parkinson's disease: Da-Young Lee, Hui-Jun Yang, Ji-Yun Park, Dong-Seok Yang, Jin-Hyuk Choi, Byoung-Soo Park; Received November 30, 2018 Accepted December 3, 2018 Published online December 3, 2018; [Accepted]

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Abstract: Objectives
The Korean Dizziness Handicap Inventory (KDHI), which includes 25 patient-reported items, has been used to assess self-reported dizziness in Korean patients with Parkinson's disease (PD). Nevertheless, few studies have examined the KDHI based on item-response theory within this population. The aim of the present study was to assess the feasibility and clinimetric properties of the KDHI instrument using polytomous Rasch measurement analysis.
Methods
The unidimensionality, local independence, scale precision, item difficulty (severity), and response category utility of the KDHI were statistically assessed using WINSTEPS version 4.0.1 (Winsteps Inc.; Chicago, IL, USA) based on the Andrich rating scale model. The utilities of the ordered response categories of the three-point Likert scale were analyzed with reference to the probability curves of the response categories. The separation reliability of the KDHI was assessed based on person separation reliability, which is used to measure the capacity to discriminate among groups of patients with different levels of balance deficits.
Results
Principal component analyses of residuals revealed that the KDHI had unidimensionality. The KHDI had satisfactory PSR and there were no disordered thresholds in the three-point rating scale. However, the KDHI showed several issues for inappropriate scale targeting and misfit items (item 1 and 2) for Rasch model.
Conclusions
The KDHI provide unidimensional measures of imbalance symptoms in patients with PD with adequate separation reliability. There was no statistical evidence of disorder in polytomous rating scales. The Rasch analysis results suggest that the KDHI is a reliable scale for measuring the imbalance symptoms in PD patients, and identified

Original Article

Classification of Chronic Dizziness in Elderly People and Relation with Falls: Dong-Suk Yang, Da-Young Lee, Sun-Young Oh, Ji-Yun Park; Res Vestib Sci. 2018;17(1):13-17. Published online March 15, 2018; DOI: https://doi.org/10.21790/rvs.2018.17.1.13

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Abstract PDF: Objectives
Fall is a major cause of morbidity and mortality among older adults. Falls result from many various causes, and dizziness is important risk for falls, especially in the elderly. Research on the relationship between chronic dizziness and falls in elderly people has been rarely performed and these were no studies that analyzed the risk of falls according to subtypes of chronic dizziness.
Methods
We conducted a prospective study of the association between subtypes of chronic dizziness and falls in the elderly between 65 to 75 years. We divided dizzy patients into 5 groups according to the results of symptom, vestibular and autonomic function test. Falls and new events (acute dizziness or other medical conditions) were checked monthly by telephone or out patient department follow-up for 6 months.
Results
Thirty-four patients were enrolled and all completed follow-up for 6 months. Nine patients classified as the falling groups and 34 patients as nonfalling group. Whereas the frequencies of orthostatic hypotension (n=6, 67%) and vestibular dysfunction (n=1, 11%) were higher in fall group, psychogenic dizziness (n=12, 35%), and vestibular migraine (n=3, 9%) were more frequent in nonfall group.
Conclusions
The presence of dizziness in the elderly is a strong predictor of fall, especially orthostatic hypotension is an important predictor of fall. In order to lower the risk of falls in the elderly, an approach based on the cause of dizziness is needed.

Classification of chronic dizziness in elderly people and relation with falls: Dong-Suk Yang, Da-Young Lee, Sun-Young Oh, Ji-Yun Park; Received February 26, 2018 Accepted March 8, 2018 Published online March 8, 2018; [Accepted]

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Abstract: Purpose
Fall is a major cause of morbidity and mortality among older adults. Falls result from many various causes, and dizziness is important risk for falls, especially in the elderly. Research on the relationship between chronic dizziness and falls in elderly people has been rarely performed and these were no studies that analyzed the risk of falls according to subtypes of chronic dizziness.
Methods
We conducted a prospective study of the association between subtypes of chronic dizziness and falls in the elderly between 65 to 75 years. We divided dizzy patients into 5 groups according to the results of symptom, vestibular and autonomic function test.. Falls and new events (acute dizziness or other medical conditions) were checked monthly by telephone or OPD follow-up for 6 months.
Results
34 patients were enrolled and all completed follow-up for 6 months. Nine patients in the fall group and 34 patients in the non - fall group. Whereas the frequencies of orthostatic hypotension (n=6, 67%) and vestibular dysfunction (n=1, 11%) were higher in fall group, psychogenic dizziness (n=12, 35%) and vestibular migraine (n=3, 9%) were more frequent in non-fall group.
Conclusion
The presence of dizziness in the elderly is a strong predictor of falls, especially orthostatic hypotension is an important predictor of fall. In order to lower the risk of falls in the elderly, an approach based on the cause of dizziness is needed.

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