. 2020 Jun 1;4:42. doi: 10.1186/s41687-020-00204-x

Table 3.

Crosswalks mapping raw (total) Emotional Exhaustion (EE), Depersonalization (DP), and Personal Accomplishment (PA) subscale scores to IRT-based scores and response profiles

Raw (total) scores and corresponding IRT-scores^a			Probability of a US physician endorsing each item at a frequency of “once a week” or more
EE raw score	EE IRT z-score (θ) (se)	EE IRT t-score (se)	*EE items*^b
EE raw score	EE IRT z-score (θ) (se)	EE IRT t-score (se)	EE1: emotionally drained from work $P_{4_{EE 1}}$ (θ)	EE2: used up at end of workday $P_{4_{EE 2}}$ (θ)	EE3: fatigued when get up $P_{4_{EE 3}}$ (θ)	EE5: burned out from work $P_{4_{EE 5}}$ (θ)	EE6: frustrated by job $P_{4_{EE 6}}$ (θ)	EE7: working too hard on job $P_{4_{EE 7}}$ (θ)	EE4EE8: working with people is a real strain and/or puts too much stress on me $P_{8_{EE 4 EE 8}}$ (θ)	EE9: at the end of my rope $P_{4_{EE 9}}$ (θ)
0	−2.51 (0.43)	24.92 (4.26)	0.000	0.000	0.000	0.000	0.002	0.003	0.002	0.000
1	−2.13 (0.32)	28.72 (3.21)	0.000	0.001	0.001	0.000	0.005	0.008	0.004	0.000
2	−1.91 (0.30)	30.92 (2.95)	0.000	0.002	0.001	0.000	0.009	0.014	0.005	0.001
3	−1.74 (0.28)	32.58 (2.82)	0.001	0.003	0.002	0.000	0.014	0.021	0.006	0.001
4	−1.60 (0.27)	33.96 (2.72)	0.001	0.005	0.003	0.000	0.020	0.030	0.008	0.002
5	−1.49 (0.27)	35.14 (2.67)	0.002	0.008	0.005	0.000	0.027	0.039	0.009	0.002
6	−1.38 (0.26)	36.20 (2.62)	0.003	0.012	0.007	0.001	0.036	0.050	0.011	0.003
7	−1.28 (0.26)	37.19 (2.58)	0.005	0.018	0.009	0.001	0.047	0.063	0.013	0.004
8	−1.19 (0.26)	38.10 (2.55)	0.008	0.026	0.012	0.002	0.059	0.077	0.015	0.005
9	−1.10 (0.25)	38.96 (2.53)	0.012	0.036	0.016	0.003	0.075	0.095	0.017	0.006
10	−1.02 (0.25)	39.78 (2.51)	0.016	0.049	0.021	0.004	0.091	0.113	0.019	0.007
11	−0.94 (0.25)	40.56 (2.49)	0.023	0.066	0.027	0.005	0.111	0.134	0.021	0.009
12	−0.87 (0.25)	41.30 (2.47)	0.031	0.084	0.033	0.007	0.131	0.155	0.024	0.010
13	−0.80 (0.25)	42.02 (2.45)	0.041	0.108	0.041	0.009	0.155	0.179	0.026	0.012
14	−0.73 (0.24)	42.71 (2.44)	0.055	0.138	0.051	0.012	0.181	0.205	0.029	0.015
15	−0.66 (0.24)	43.38 (2.43)	0.073	0.174	0.062	0.017	0.211	0.235	0.032	0.017
16	−0.60 (0.24)	44.04 (2.42)	0.121	0.259	0.091	0.029	0.277	0.296	0.035	0.024
17	−0.53 (0.24)	44.68 (2.41)	0.151	0.307	0.107	0.038	0.311	0.328	0.039	0.027
18	−0.47 (0.24)	45.30 (2.41)	0.187	0.359	0.127	0.048	0.347	0.361	0.043	0.031
19	−0.41 (0.24)	45.92 (2.40)	0.230	0.414	0.149	0.062	0.385	0.395	0.047	0.036
20	−0.35 (0.24)	46.53 (2.40)	0.279	0.472	0.175	0.079	0.424	0.431	0.051	0.042
21	−0.29 (0.24)	47.13 (2.40)	0.334	0.531	0.204	0.100	0.465	0.467	0.055	0.048
22	−0.23 (0.24)	47.73 (2.41)	0.344	0.541	0.209	0.104	0.471	0.473	0.060	0.049
23	−0.17 (0.24)	48.32 (2.41)	0.394	0.589	0.236	0.127	0.505	0.504	0.066	0.055
24	−0.11 (0.24)	48.91 (2.42)	0.457	0.644	0.271	0.158	0.546	0.540	0.072	0.063
25	−0.05 (0.24)	49.51 (2.44)	0.522	0.696	0.310	0.196	0.587	0.576	0.078	0.072
26	0.01 (0.25)	50.10 (2.45)	0.565	0.728	0.338	0.225	0.613	0.600	0.082	0.079
27	0.07 (0.25)	50.70 (2.48)	0.647	0.786	0.396	0.292	0.663	0.646	0.092	0.094
28	0.13 (0.25)	51.30 (2.50)	0.704	0.823	0.442	0.349	0.699	0.679	0.100	0.107
29	0.19 (0.25)	51.90 (2.53)	0.755	0.854	0.489	0.411	0.732	0.710	0.109	0.122
30	0.25 (0.26)	52.51 (2.57)	0.800	0.881	0.536	0.475	0.763	0.739	0.118	0.139
31	0.31 (0.26)	53.13 (2.61)	0.838	0.904	0.582	0.540	0.791	0.766	0.128	0.157
32	0.37 (0.26)	53.75 (2.65)	0.870	0.922	0.627	0.604	0.817	0.792	0.138	0.177
33	0.44 (0.27)	54.38 (2.69)	0.901	0.940	0.677	0.674	0.844	0.818	0.151	0.204
34	0.50 (0.27)	55.01 (2.74)	0.922	0.952	0.717	0.729	0.864	0.839	0.163	0.228
35	0.57 (0.28)	55.65 (2.80)	0.941	0.963	0.759	0.785	0.885	0.861	0.178	0.260
36	0.63 (0.29)	56.30 (2.85)	0.954	0.971	0.792	0.826	0.901	0.878	0.192	0.289
37	0.70 (0.29)	56.96 (2.92)	0.965	0.977	0.826	0.866	0.917	0.895	0.209	0.325
38	0.76 (0.30)	57.64 (2.99)	0.973	0.982	0.851	0.893	0.928	0.908	0.225	0.358
39	0.83 (0.31)	58.34 (3.07)	0.980	0.986	0.877	0.919	0.940	0.921	0.244	0.398
40	0.91 (0.32)	59.06 (3.17)	0.986	0.990	0.902	0.942	0.951	0.934	0.267	0.445
41	0.98 (0.33)	59.82 (3.30)	0.989	0.992	0.919	0.956	0.959	0.944	0.288	0.487
42	1.06 (0.34)	60.61 (3.45)	0.993	0.994	0.936	0.969	0.967	0.953	0.314	0.536
43	1.14 (0.35)	61.39 (3.54)	0.995	0.996	0.950	0.978	0.973	0.961	0.341	0.584
44	1.22 (0.37)	62.22 (3.66)	0.996	0.997	0.960	0.984	0.979	0.968	0.369	0.630
45	1.30 (0.37)	63.04 (3.74)	0.997	0.998	0.969	0.989	0.983	0.974	0.397	0.674
46	1.39 (0.38)	63.89 (3.81)	0.998	0.998	0.976	0.992	0.986	0.979	0.431	0.720
47	1.48 (0.39)	64.79 (3.90)	0.999	0.999	0.983	0.995	0.990	0.983	0.465	0.767
48	1.57 (0.40)	65.69 (3.99)	0.999	0.999	0.986	0.997	0.992	0.986	0.499	0.800
49	1.66 (0.40)	66.57 (3.97)	0.999	0.999	0.990	0.998	0.993	0.989	0.533	0.832
50	1.77 (0.41)	67.70 (4.08)	1.000	1.000	0.993	0.999	0.995	0.991	0.574	0.866
51	1.89 (0.41)	68.88 (4.14)	1.000	1.000	0.995	0.999	0.996	0.994	0.618	0.897
52	2.05 (0.44)	70.55 (4.42)	1.000	1.000	0.997	1.000	0.998	0.996	0.674	0.928
53	2.21 (0.46)	72.13 (4.63)	1.000	1.000	0.998	1.000	0.999	0.997	0.725	0.950
54	2.51 (0.52)	75.14 (5.25)	1.000	1.000	0.999	1.000	0.999	0.999	0.806	0.975
DP raw score	DP IRT z-score (θ) (se)	DP IRT t-score (se)	*DP items*^c
DP raw score	DP IRT z-score (θ) (se)	DP IRT t-score (se)	DP1: treat patients as impersonal objects $P_{4_{DP 1}}$ (θ)	DP2: more callous toward people $P_{4_{DP 2}}$ (θ)		DP3: worry job hardening me emotionally $P_{4_{DP 3}}$ (θ)	DP4: don’t really care what happens to some patients $P_{4_{DP 4}}$ (θ)		DP5: patients blame me for some problems $P_{4_{DP 5}}$ (θ)
0	−1.52 (0.60)	34.81 (6.03)	0.004	0.000		0.002	0.003		0.059
1	−1.13 (0.53)	38.71 (5.32)	0.007	0.000		0.006	0.005		0.087
2	−0.78 (0.49)	42.19 (4.87)	0.014	0.001		0.015	0.009		0.122
3	−0.57 (0.48)	44.26 (4.85)	0.020	0.003		0.026	0.012		0.148
4	−0.41 (0.48)	45.91 (4.80)	0.026	0.005		0.039	0.015		0.171
5	−0.29 (0.49)	47.10 (4.93)	0.032	0.008		0.054	0.018		0.190
6	−0.15 (0.47)	48.54 (4.68)	0.041	0.014		0.076	0.022		0.214
7	0.01 (0.43)	50.06 (4.27)	0.053	0.026		0.112	0.029		0.244
8	0.14 (0.41)	51.39 (4.10)	0.066	0.043		0.152	0.035		0.270
9	0.26 (0.40)	52.61 (4.01)	0.080	0.068		0.198	0.042		0.296
10	0.38 (0.39)	53.76 (3.95)	0.097	0.105		0.253	0.050		0.324
11	0.49 (0.39)	54.86 (3.90)	0.116	0.154		0.313	0.059		0.350
12	0.59 (0.39)	55.94 (3.87)	0.135	0.214		0.373	0.068		0.375
13	0.70 (0.38)	57.00 (3.85)	0.159	0.296		0.444	0.079		0.403
14	0.80 (0.38)	58.04 (3.84)	0.184	0.385		0.511	0.092		0.428
15	0.91 (0.38)	59.08 (3.84)	0.215	0.493		0.583	0.107		0.457
16	1.01 (0.39)	60.11 (3.86)	0.247	0.591		0.647	0.123		0.484
17	1.12 (0.39)	61.15 (3.90)	0.284	0.692		0.711	0.142		0.514
18	1.22 (0.39)	62.19 (3.94)	0.322	0.770		0.762	0.162		0.540
19	1.32 (0.40)	63.23 (3.99)	0.361	0.833		0.807	0.185		0.567
20	1.43 (0.40)	64.29 (4.04)	0.407	0.885		0.849	0.212		0.595
21	1.54 (0.41)	65.38 (4.10)	0.454	0.923		0.883	0.242		0.623
22	1.65 (0.42)	66.53 (4.19)	0.503	0.949		0.910	0.274		0.650
23	1.77 (0.43)	67.73 (4.31)	0.555	0.968		0.933	0.313		0.679
24	1.89 (0.44)	68.94 (4.42)	0.607	0.980		0.951	0.355		0.706
25	2.01 (0.45)	70.13 (4.49)	0.656	0.987		0.964	0.399		0.732
26	2.14 (0.45)	71.42 (4.53)	0.706	0.992		0.974	0.448		0.758
27	2.30 (0.46)	72.97 (4.58)	0.761	0.996		0.983	0.510		0.788
28	2.49 (0.47)	74.93 (4.67)	0.816	0.998		0.990	0.583		0.820
29	2.73 (0.49)	77.32 (4.94)	0.871	0.999		0.995	0.670		0.855
30	3.05 (0.55)	80.49 (5.51)	0.923	1.000		0.998	0.770		0.893
PA raw score	PA IRT z-score (θ) (se)	PA IRT t-score (se)	*PA items*^d
PA raw score	PA IRT z-score (θ) (se)	PA IRT t-score (se)	PA1: Easily understand how patients feel $P_{4_{PA 1}}$ (θ)	PA2: deal very effectively with problems of patients $P_{4_{PA 2}}$ (θ)	PA3: positively influencing other people’s lives through work $P_{4_{PA 3}}$ (θ)	PA4: feel very energetic $P_{4_{PA 4}}$ (θ)	PA5: can easily create relaxed atmosphere with patients $P_{4_{PA 5}}$ (θ)	PA6: exhilarated after working closely with patients $P_{4_{PA 6}}$ (θ)	PA7: accomplished many worthwhile things in job $P_{4_{PA 7}} (θ)$	PA8: deal with emotional problems very calmly $P_{4_{PA 8}}$ (θ)
0	−3.91 (0.48)	10.91 (4.83)	0.217	0.083	0.002	0.013	0.019	0.002	0.001	0.110
1	−3.71 (0.45)	12.85 (4.54)	0.256	0.111	0.004	0.018	0.027	0.003	0.002	0.137
2	−3.56 (0.44)	14.36 (4.40)	0.288	0.138	0.006	0.022	0.035	0.004	0.003	0.159
3	−3.45 (0.43)	15.51 (4.33)	0.313	0.161	0.008	0.026	0.043	0.005	0.004	0.178
4	−3.34 (0.42)	16.65 (4.22)	0.340	0.187	0.010	0.030	0.052	0.006	0.005	0.199
5	−3.23 (0.42)	17.67 (4.16)	0.367	0.215	0.013	0.035	0.063	0.008	0.006	0.221
6	−3.14 (0.41)	18.64 (4.09)	0.390	0.241	0.017	0.040	0.074	0.010	0.008	0.240
7	−3.04 (0.40)	19.61 (4.01)	0.417	0.272	0.021	0.046	0.088	0.012	0.010	0.263
8	−2.95 (0.39)	20.52 (3.95)	0.441	0.302	0.027	0.052	0.102	0.014	0.013	0.285
9	−2.86 (0.39)	21.42 (3.89)	0.465	0.334	0.033	0.059	0.119	0.016	0.016	0.307
10	−2.77 (0.38)	22.28 (3.84)	0.489	0.367	0.042	0.066	0.138	0.019	0.020	0.331
11	−2.69 (0.38)	23.12 (3.79)	0.511	0.398	0.050	0.074	0.157	0.023	0.024	0.353
12	−2.61 (0.38)	23.94 (3.75)	0.533	0.430	0.061	0.082	0.178	0.026	0.029	0.375
13	−2.53 (0.37)	24.74 (3.72)	0.554	0.462	0.074	0.091	0.201	0.031	0.036	0.398
14	−2.45 (0.37)	25.52 (3.69)	0.576	0.495	0.089	0.101	0.226	0.036	0.043	0.422
15	−2.37 (0.37)	26.30 (3.66)	0.597	0.527	0.107	0.112	0.253	0.041	0.052	0.446
16	−2.29 (0.36)	27.07 (3.64)	0.618	0.560	0.129	0.124	0.283	0.048	0.063	0.470
17	−2.22 (0.36)	27.83 (3.62)	0.636	0.588	0.150	0.136	0.310	0.055	0.075	0.491
18	−2.14 (0.36)	28.58 (3.60)	0.656	0.619	0.178	0.150	0.343	0.063	0.090	0.515
19	−2.07 (0.36)	29.33 (3.59)	0.673	0.645	0.206	0.163	0.373	0.072	0.106	0.537
20	−1.99 (0.36)	30.08 (3.59)	0.692	0.675	0.241	0.180	0.409	0.083	0.126	0.561
21	−1.92 (0.36)	30.82 (3.58)	0.708	0.699	0.275	0.195	0.441	0.094	0.147	0.581
22	−1.84 (0.36)	31.57 (3.58)	0.725	0.726	0.318	0.214	0.478	0.108	0.174	0.605
23	−1.77 (0.36)	32.32 (3.58)	0.740	0.748	0.358	0.231	0.511	0.122	0.201	0.625
24	−1.69 (0.36)	33.07 (3.58)	0.757	0.772	0.406	0.253	0.548	0.139	0.236	0.647
25	−1.62 (0.36)	33.83 (3.59)	0.770	0.791	0.450	0.272	0.581	0.157	0.269	0.667
26	−1.54 (0.36)	34.60 (3.60)	0.785	0.812	0.501	0.296	0.617	0.178	0.311	0.688
27	−1.46 (0.36)	35.38 (3.61)	0.800	0.831	0.552	0.320	0.651	0.202	0.355	0.708
28	−1.38 (0.36)	36.17 (3.62)	0.813	0.849	0.601	0.346	0.685	0.229	0.403	0.728
29	−1.30 (0.36)	36.98 (3.64)	0.826	0.865	0.649	0.373	0.716	0.257	0.453	0.747
30	−1.22 (0.37)	37.80 (3.66)	0.838	0.879	0.694	0.400	0.746	0.288	0.503	0.765
31	−1.14 (0.37)	38.64 (3.68)	0.850	0.892	0.736	0.428	0.773	0.321	0.553	0.782
32	−1.05 (0.37)	39.50 (3.71)	0.862	0.906	0.778	0.460	0.801	0.361	0.609	0.800
33	−0.96 (0.37)	40.39 (3.74)	0.873	0.917	0.815	0.493	0.827	0.402	0.661	0.817
34	−0.87 (0.38)	41.30 (3.78)	0.884	0.928	0.847	0.525	0.850	0.445	0.710	0.832
35	−0.78 (0.38)	42.25 (3.82)	0.893	0.937	0.875	0.558	0.870	0.488	0.755	0.847
36	−0.68 (0.39)	43.23 (3.87)	0.903	0.946	0.900	0.593	0.890	0.537	0.799	0.862
37	−0.57 (0.39)	44.26 (3.92)	0.913	0.955	0.923	0.631	0.908	0.590	0.840	0.877
38	−0.47 (0.40)	45.33 (3.99)	0.922	0.961	0.939	0.664	0.923	0.636	0.871	0.890
39	−0.35 (0.41)	46.48 (4.07)	0.931	0.968	0.954	0.701	0.938	0.688	0.901	0.903
40	−0.23 (0.42)	47.69 (4.16)	0.939	0.973	0.966	0.736	0.949	0.736	0.925	0.915
41	−0.10 (0.43)	48.99 (4.27)	0.946	0.978	0.975	0.771	0.960	0.782	0.945	0.927
42	0.04 (0.44)	50.38 (4.37)	0.953	0.983	0.983	0.805	0.969	0.825	0.961	0.937
43	0.19 (0.44)	51.89 (4.42)	0.960	0.986	0.988	0.837	0.976	0.863	0.973	0.947
44	0.36 (0.45)	53.61 (4.52)	0.967	0.990	0.992	0.868	0.983	0.898	0.982	0.957
45	0.56 (0.46)	55.58 (4.62)	0.973	0.993	0.995	0.897	0.988	0.929	0.989	0.966
46	0.80 (0.47)	58.03 (4.73)	0.979	0.995	0.997	0.925	0.992	0.954	0.994	0.974
47	1.15 (0.52)	61.47 (5.21)	0.986	0.997	0.999	0.954	0.996	0.976	0.998	0.983
48	1.62 (0.61)	66.22 (6.07)	0.991	0.999	1.000	0.976	0.998	0.990	0.999	0.990

The burnout symptom burden represented by subscale scores in this table can be interpreted based on the profile of likely item endorsements (i.e., a content-referenced score interpretation) as well as how far above or below the scores are relative to the mean score in a 2014 reference population of US physicians (i.e., a norm-referenced score interpretation). ^a A raw score on each subscale refers to the total (or sum) score on each subscale. Bolded rows correspond to IRT scores and response profiles that are at or closest to the mean for each subscale. ^b Items EE4 and EE8 were combined into one item (EE4EE8) to meet local independence assumptions. The probabilities shown for the combined EE4EE8 item represent the probability of a physician endorsing that working with people puts too much stress on him/her and/or is a real strain at a frequency of once a week or more at a particular score (i.e., a score of at least 8 on the combined EE4EE8 item). Higher scores on the EE subscale indicate more emotional exhaustion (and a higher burnout symptom burden). An EE item with > 0.50 probability of endorsement indicates a physician is likely to endorse feeling that particular EE symptom at a frequency of once a week or more at a particular score. ^c Higher scores on the DP subscale indicate more depersonalization (and a higher burnout symptom burden). A DP item with > 0.50 probability of endorsement indicates a physician is likely to endorse feeling that particular DP symptom at a frequency of once a week or more at a particular score. ^d Higher scores on the PA subscale indicate more personal accomplishment (and a lower symptom burden); whereas, lower scores on the PA subscale indicate a lower sense of personal accomplishment (and higher burnout symptom burden). A PA item with < 0.50 probability of endorsement indicates a physician is unlikely to endorse feeling that particular PA indicator at a frequency of once a week or more at a particular score