The correlation coefficients between item difficulties (in logit (log odds) units calibrated by WINSTEPS), observed and expected response summation scores across items and the skewness yielded by both observed and expected responses on items are reported. We will examine whether the skewness of expected responses can earn a higher correlation to other counterparts than the
skewness of observed scores. A graphical representation of the comparison of patient attitudes toward quality of life across the entirety of the questionnaire will be presented.