Measurement Characteristics of the Knowledge Assessment of Renal Transplantation (KART)

Background Kidney transplant is the best treatment for most end-stage renal disease (ESRD) patients, but proportionally few ESRD patients receive kidney transplant. To make an informed choice about whether to pursue kidney transplant, patients must be knowledgeable of its risks and benefits. To reliably and validly measure ESRD patients' kidney transplant knowledge, rigorously tested measures are required. This paper describes the development and psychometric testing of the Knowledge Assessment of Renal Transplantation (KART). Methods We administered 17 transplant knowledge items to a sample of 1,294 ESRD patients. Item characteristics and scale scores were estimated using an item response theory (IRT) graded response model. Construct validity was tested by examining differences in scale scores between patients who had spent 1 hour receiving various types of transplant education. Results IRT modelling suggested that 15 items should be retained for the KART. This scale had a marginal reliability of 0.75 and evidenced acceptable reliability (>0.70) across most of its range. Construct validity was supported by the KART's ability to distinguish patients who had spent 1 hour receiving different types of kidney transplant education, including talking to doctors/medical staff [effect size (ES) = 0.61; p

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