Original research| Volume 99, ISSUE 3, P521-528, March 2018

Download started.


Developing Item Response Theory–Based Short Forms to Measure the Social Impact of Burn Injuries

Published:September 06, 2017DOI:



      To develop self-reported short forms for the Life Impact Burn Recovery Evaluation (LIBRE) Profile.


      Short forms based on the item parameters of discrimination and average difficulty.


      A support network for burn survivors, peer support networks, social media, and mailings.


      Burn survivors (N=601) older than 18 years.


      Not applicable.

      Main Outcome Measures

      The LIBRE Profile.


      Ten-item short forms were developed to cover the 6 LIBRE Profile scales: Relationships with Family & Friends, Social Interactions, Social Activities, Work & Employment, Romantic Relationships, and Sexual Relationships. Ceiling effects were ≤15% for all scales; floor effects were <1% for all scales. The marginal reliability of the short forms ranged from .85 to .89.


      The LIBRE Profile-Short Forms demonstrated credible psychometric properties. The short form version provides a viable alternative to administering the LIBRE Profile when resources do not allow computer or Internet access. The full item bank, computerized adaptive test, and short forms are all scored along the same metric, and therefore scores are comparable regardless of the mode of administration.


      List of abbreviations:

      BOQ (Burn Outcomes Questionnaire), CAT (computerized adaptive testing), DIF (differential item functioning), IRT (item response theory), LIBRE (Life Impact Burn Recovery Evaluation), SF (Short Form), TIF (test information function)
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to Archives of Physical Medicine and Rehabilitation
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Schneider J.C.
        • Qu H.D.
        Neurologic and musculoskeletal complications of burn injuries.
        Phys Med Rehabil Clin N Am. 2011; 22 (vi): 261-275
        • Lawrence J.W.
        • Mason S.T.
        • Schomer K.
        • Klein M.B.
        Epidemiology and impact of scarring after burn injury: a systematic review of the literature.
        J Burn Care Res. 2012; 33: 136-146
        • Blakeney P.E.
        • Rosenberg L.
        • Rosenberg M.
        • Faber A.W.
        Psychosocial care of persons with severe burns.
        Burns. 2008; 34: 433-440
        • Madianos M.G.
        • Papaghelis M.
        • Ioannovich J.
        • Dafni R.
        Psychiatric disorders in burn patients: a follow-up study.
        Psychother Psychosom. 2001; 70: 30-37
        • Thombs B.D.
        • Notes L.D.
        • Lawrence J.W.
        • Magyar-Russell G.
        • Bresnick M.G.
        • Fauerbach J.A.
        From survival to socialization: a longitudinal study of body image in survivors of severe burn injury.
        J Psychosom Res. 2008; 64: 205-212
        • Esselman P.C.
        Community integration outcome after burn injury.
        Phys Med Rehabil Clin N Am. 2011; 22 (vii): 351-356
        • Mackey S.P.
        • Diba R.
        • McKeown D.
        • et al.
        Return to work after burns: a qualitative research study.
        Burns. 2009; 35: 338-342
        • Mason S.T.
        • Esselman P.
        • Fraser R.
        • Schomer K.
        • Truitt A.
        • Johnson K.
        Return to work after burn injury: a systematic review.
        J Burn Care Res. 2012; 33: 101-109
        • Bianchi T.L.
        Aspects of sexuality after burn injury: outcomes in men.
        J Burn Care Rehabil. 1997; 18 (discussion 182): 183-186
        • Kvannli L.
        • Finlay V.
        • Edgar D.W.
        • Wu A.
        • Wood F.M.
        Using the Burn Specific Health Scale-Brief as a measure of quality of life after a burn—what score should clinicians expect?.
        Burns. 2011; 37: 54-60
        • Ryan C.M.
        • Lee A.F.
        • Kazis L.E.
        • et al.
        Is real-time feedback of burn-specific patient-reported outcome measures in clinical settings practical and useful? A pilot study implementing the Young Adult Burn Outcome Questionnaire.
        J Burn Care Res. 2016; 37: 64-74
        • McDonough C.M.
        • Ni P.
        • Coster W.J.
        • Haley S.M.
        • Jette A.M.
        Development of an IRT-based short form to assess applied cognitive function in outpatient rehabilitation.
        Am J Phys Med Rehabil. 2016; 95: 62-71
        • Cella D.
        • Gershon R.
        • Lai J.S.
        • Choi S.
        The future of outcomes measurement: item banking, tailored short-forms, and computerized adaptive assessment.
        Qual Life Res. 2007; 16: 133-141
        • Willebrand M.
        • Kildal M.
        A simplified domain structure of the Burn-Specific Health Scale-Brief (BSHS-B): a tool to improve its value in routine clinical work.
        J Trauma. 2008; 64: 1581-1586
        • Kazis L.E.
        • Liang M.H.
        • Lee A.
        • et al.
        The development, validation, and testing of a health outcomes burn questionnaire for infants and children 5 years of age and younger: American Burn Association/Shriners Hospitals for Children.
        J Burn Care Rehabil. 2002; 23: 196-207
        • Daltroy L.H.
        • Liang M.H.
        • Phillips C.B.
        • et al.
        American Burn Association/Shriners Hospitals for Children burn outcomes questionnaire: construction and psychometric properties.
        J Burn Care Rehabil. 2000; 21: 29-39
        • Meyer W.J.
        • Lee A.F.
        • Kazis L.E.
        • et al.
        Adolescent survivors of burn injuries and their parents' perceptions of recovery outcomes: do they agree or disagree?.
        J Trauma Acute Care Surg. 2012; 73: S213-S220
        • Ryan C.M.
        • Schneider J.C.
        • Kazis L.E.
        • et al.
        Benchmarks for multidimensional recovery after burn injury in young adults: the development, validation, and testing of the American Burn Association/Shriners Hospitals for Children Young Adult Burn Outcome Questionnaire.
        J Burn Care Res. 2013; 34: e121-e142
        • Kazis L.E.
        • Marino M.
        • Ni P.
        • et al.
        Development of the Life Impact Burn Recovery Evaluation (LIBRE) profile: assessing burn survivors' social participation.
        Qual Life Res. 2017; 26: 2851
        • Marino M.
        • Soley-Bori M.
        • Jette A.M.
        • et al.
        Measuring the social impact of burns on survivors.
        J Burn Care Res. 2017; 38: e377-e383
        • Marino M.
        • Soley-Bori M.
        • Jette A.M.
        • et al.
        Development of a conceptual framework to measure the social impact of burns.
        J Burn Care Res. 2016; 37: e569-e578
        • Gibbons R.D.
        • Bock R.D.
        • Hedeker D.
        • et al.
        Full-information item bifactor analysis of graded response data.
        Appl Psychol Meas. 2007; 31: 4-19
        • Edelen M.O.
        • Reeve B.B.
        Applying item response theory (IRT) modeling to questionnaire development, evaluation, and refinement.
        Qual Life Res. 2007; 16: 5-18
        • Orlando M.
        • Thissen D.
        Further investigation of the performance of S - X2: an item fit index for use with dichotomous item response theory models.
        Appl Psychol Meas. 2003; 27: 289-298
        • Langer M.
        A reexamination of Lord's Wald test for differential item functioning using item response theory and modern error estimation.
        ([dissertation]) Univ of North Carolina, Chapel Hill2008
        • Woods C.M.
        • Cai L.
        • Wang M.
        The Langer-improved Wald test for DIF testing with multiple groups evaluation and comparison to two-group IRT.
        Educ Psychol Meas. 2013; 73: 532-547
        • Edelen M.O.
        • Stucky B.D.
        • Chandra A.
        Quantifying “problematic” DIF within an IRT framework: application to a cancer stigma index.
        Qual Life Res. 2015; 24: 95-103
        • Choi S.W.
        • Reise S.P.
        • Pilkonis P.A.
        • Hays R.D.
        • Cella D.
        Efficiency of static and computer adaptive short forms compared to full-length measures of depressive symptoms.
        Qual Life Res. 2010; 19: 125-136
        • Heinemann A.W.
        • Dijkers M.P.
        • Ni P.
        • Tulsky D.S.
        • Jette A.
        Measurement properties of the Spinal Cord Injury-Functional Index (SCI-FI) short forms.
        Arch Phys Med Rehabil. 2014; 95: 1289-1297.e5
        • Hays R.D.
        • Morales L.S.
        • Reise S.P.
        Item response theory and health outcomes measurement in the 21st century.
        Med Care. 2000; 38: II28-II42
        • Revicki D.A.
        • Cella D.F.
        Health status assessment for the twenty-first century: item response theory, item banking and computer adaptive testing.
        Qual Life Res. 1997; 6: 595-600
        • Thissen D.
        • Nelson L.
        • Rosa K.
        • McLeod L.
        Item response theory for items scored in more than two categories.
        in: Thissen D. Wainer H. Test scoring. Lawrence Erlbaum Associates, Mahwah2001: 141-186
        • Kolen M.J.
        • Brennan R.L.
        Test equating, scaling, and linking—methods and practices.
        2nd ed. Springer, New York2004
      1. Thissen D. Wainer H. Test scoring. Lawrence Erlbaum Associates, Mahwah2001
        • Varni J.W.
        • Stucky B.D.
        • Thissen D.
        • et al.
        PROMIS Pediatric Pain Interference Scale: an item response theory analysis of the pediatric pain item bank.
        J Pain. 2010; 11: 1109-1119
        • Cella D.
        • Riley W.
        • Stone A.
        • et al.
        The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008.
        J Clin Epidemiol. 2010; 63: 1179-1194