Interpretation of differential item functioning analyses using external review

Neil W Scott, Peter Fayers, Neil K Aaronson, Andrew Bottomley, Alexander de Graeff, Mogens Groenvold, Chad Gundy, Michael Koller, Morten A Petersen, Mirjam A G Sprangers, on behalf of the EORTC Quality of Life Group and the Quality of Life Cross-Cultural Meta-Analysis Group

Research output: Contribution to journalArticlepeer-review

7 Citations (Scopus)


Differential item functioning (DIF) analyses are used to determine whether certain groups respond differently to a particular item of a test or questionnaire; however, these do not explain the reasons for observed response differences. Many studies have used external reviews of items, sometimes using blinded reviewers, to help interpret these results. The authors conducted a literature review of this topic to describe the current usage of external reviews alongside DIF analyses. It concentrated on studies of health-related quality of life instruments, but studies in other fields were also considered. Relatively few examples of blinded item reviews were identified, and these were mostly from educational studies. A case study using blinded bilingual reviewers alongside translation DIF analyses of a health-related quality of life instrument is described. Future researchers should consider conducting external item reviews alongside DIF analyses.
Original languageEnglish
Pages (from-to)253-258
Number of pages6
JournalExpert Review of Pharmacoeconomics & Outcomes Research
Issue number3
Publication statusPublished - Jun 2010


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