High-dimensional item response theory analysis of patient-reported outcomes in total knee arthroplasty
Abstract This study introduces a Bayesian multidimensional hierarchical item response theory (MHIRT) model to improve patient-reported outcome (PRO) assessments in total knee arthroplasty (TKA). Traditional unidimensional scoring fails to capture the multifaceted nature of recovery. Our model uncove...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2025-07-01
|
| Series: | npj Digital Medicine |
| Online Access: | https://doi.org/10.1038/s41746-025-01783-z |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Abstract This study introduces a Bayesian multidimensional hierarchical item response theory (MHIRT) model to improve patient-reported outcome (PRO) assessments in total knee arthroplasty (TKA). Traditional unidimensional scoring fails to capture the multifaceted nature of recovery. Our model uncovers latent traits and inter-item relationships directly from PROMs such as the OKS and the EQ-5D-3L, without relying on predefined subscales. MHIRT flexibly decomposes PROMs into clinically meaningful traits like pain, mobility, self-care, and confidence. These traits captured more domain-specific variation, showed stronger sensitivity to temporal changes, and better reflected demographic factors than traditional total scores. The model was trained on a large NHS dataset and externally validated on PROMs from the moveUP digital platform. In predictive modeling of postoperative outcomes, MHIRT-derived features consistently outperformed unidimensional scores and conventional multidimensional IRT models. These findings suggest that MHIRT offers a potentially interpretable framework for tracking recovery and predicting health outcomes. |
|---|---|
| ISSN: | 2398-6352 |