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Seventeen (53%) clearly described identical care programmes other than the trial options (Item G).
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For the structure items the third distractors were more successful than the fourth distractor present only in the 5-option items, although for the reading items, the fourth distractors were rather more successful than the third.
After the reduction of response options, items whose curves remained disordered were deleted from NutriQoL®.
There was some support for this tendency from the comparison of individual item facility values in the reading section where the 5-option items were noted to have been consistently more difficult than the 3-option items, although this was not found to be statistically significant.
The 3-option items produced the highest number of AENO values between k-0.5 and k, 15 among the structure items and five among the reading items, with the 4- and 5-option items producing only five and three respectively for the structure items and one each for the reading items.
A one-way ANOVA on the reading item facility index values also produced no indications of significant differences (F = 0.258, p > 0.05 df = 2, 21) although it was notable that the facility index values for all eight of the 3-option reading items exceeded those of the 5-option items indicating a tendency for the 3-option reading items to be easier than their 5-option counterparts.
'Prune Strategy' removes one incorrect option and turns the original 4-option item into a 3-option one.
A clear pattern emerges, with more positive findings overall for the first and second distractors present in all three option format tests with the 3-option items producing more positive findings than the 4- and 5-option tests among the common distractors.
