03228nas a2200397 4500008004100000020002700041245014200068210006900210250001500279260001100294300001200305490000700317520193600324653002702260653003002287653001002317653000902327653002202336653003602358653001602394653002402410653004402434653001102478653001602489653002602505653003002531653003002561653003102591100001302622700001402635700001502649700001402664700001702678700001502695856012002710 2008 eng d a1528-1159 (Electronic)00aLetting the CAT out of the bag: Comparing computer adaptive tests and an 11-item short form of the Roland-Morris Disability Questionnaire0 aLetting the CAT out of the bag Comparing computer adaptive tests a2008/05/23 cMay 20 a1378-830 v333 aSTUDY DESIGN: A post hoc simulation of a computer adaptive administration of the items of a modified version of the Roland-Morris Disability Questionnaire. OBJECTIVE: To evaluate the effectiveness of adaptive administration of back pain-related disability items compared with a fixed 11-item short form. SUMMARY OF BACKGROUND DATA: Short form versions of the Roland-Morris Disability Questionnaire have been developed. An alternative to paper-and-pencil short forms is to administer items adaptively so that items are presented based on a person's responses to previous items. Theoretically, this allows precise estimation of back pain disability with administration of only a few items. MATERIALS AND METHODS: Data were gathered from 2 previously conducted studies of persons with back pain. An item response theory model was used to calibrate scores based on all items, items of a paper-and-pencil short form, and several computer adaptive tests (CATs). RESULTS: Correlations between each CAT condition and scores based on a 23-item version of the Roland-Morris Disability Questionnaire ranged from 0.93 to 0.98. Compared with an 11-item short form, an 11-item CAT produced scores that were significantly more highly correlated with scores based on the 23-item scale. CATs with even fewer items also produced scores that were highly correlated with scores based on all items. For example, scores from a 5-item CAT had a correlation of 0.93 with full scale scores. Seven- and 9-item CATs correlated at 0.95 and 0.97, respectively. A CAT with a standard-error-based stopping rule produced scores that correlated at 0.95 with full scale scores. CONCLUSION: A CAT-based back pain-related disability measure may be a valuable tool for use in clinical and research contexts. Use of CAT for other common measures in back pain research, such as other functional scales or measures of psychological distress, may offer similar advantages.10a*Disability Evaluation10a*Health Status Indicators10aAdult10aAged10aAged, 80 and over10aBack Pain/*diagnosis/psychology10aCalibration10aComputer Simulation10aDiagnosis, Computer-Assisted/*standards10aHumans10aMiddle Aged10aModels, Psychological10aPredictive Value of Tests10aQuestionnaires/*standards10aReproducibility of Results1 aCook, KF1 aChoi, S W1 aCrane, P K1 aDeyo, R A1 aJohnson, K L1 aAmtmann, D uhttp://iacat.org/content/letting-cat-out-bag-comparing-computer-adaptive-tests-and-11-item-short-form-roland-morris03100nas a2200445 4500008004100000020002200041245007100063210006900134250001500203300001200218490000700230520183100237653003802068653001902106653002102125653002002146653001402166653001102180653003002191653001102221653000902232653002502241653004602266653001802312653002602330100001302356700001402369700001702383700001302400700001502413700001502428700001702443700001402460700001802474700002302492700001602515700001602531700001502547856009202562 2007 eng d a0962-9343 (Print)00aIRT health outcomes data analysis project: an overview and summary0 aIRT health outcomes data analysis project an overview and summar a2007/03/14 a121-1320 v163 aBACKGROUND: In June 2004, the National Cancer Institute and the Drug Information Association co-sponsored the conference, "Improving the Measurement of Health Outcomes through the Applications of Item Response Theory (IRT) Modeling: Exploration of Item Banks and Computer-Adaptive Assessment." A component of the conference was presentation of a psychometric and content analysis of a secondary dataset. OBJECTIVES: A thorough psychometric and content analysis was conducted of two primary domains within a cancer health-related quality of life (HRQOL) dataset. RESEARCH DESIGN: HRQOL scales were evaluated using factor analysis for categorical data, IRT modeling, and differential item functioning analyses. In addition, computerized adaptive administration of HRQOL item banks was simulated, and various IRT models were applied and compared. SUBJECTS: The original data were collected as part of the NCI-funded Quality of Life Evaluation in Oncology (Q-Score) Project. A total of 1,714 patients with cancer or HIV/AIDS were recruited from 5 clinical sites. MEASURES: Items from 4 HRQOL instruments were evaluated: Cancer Rehabilitation Evaluation System-Short Form, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Functional Assessment of Cancer Therapy and Medical Outcomes Study Short-Form Health Survey. RESULTS AND CONCLUSIONS: Four lessons learned from the project are discussed: the importance of good developmental item banks, the ambiguity of model fit results, the limits of our knowledge regarding the practical implications of model misfit, and the importance in the measurement of HRQOL of construct definition. With respect to these lessons, areas for future research are suggested. The feasibility of developing item banks for broad definitions of health is discussed.10a*Data Interpretation, Statistical10a*Health Status10a*Quality of Life10a*Questionnaires10a*Software10aFemale10aHIV Infections/psychology10aHumans10aMale10aNeoplasms/psychology10aOutcome Assessment (Health Care)/*methods10aPsychometrics10aStress, Psychological1 aCook, KF1 aTeal, C R1 aBjorner, J B1 aCella, D1 aChang, C-H1 aCrane, P K1 aGibbons, L E1 aHays, R D1 aMcHorney, C A1 aOcepek-Welikson, K1 aRaczek, A E1 aTeresi, J A1 aReeve, B B uhttp://iacat.org/content/irt-health-outcomes-data-analysis-project-overview-and-summary02740nas a2200541 4500008004100000020002200041245017000063210006900233250001500302260000800317300001100325490000700336520116200343653001901505653002501524653002101549653002101570653001501591653001001606653000901616653001601625653002301641653003201664653001101696653001101707653000901718653001601727653004601743653001801789653002901807653001801836100001501854700001401869700001701883700001301900700001501913700001601928700001501944700001701959700001401976700001801990700001102008700001602019700001502035700001302050700001302063856012202076 2007 eng d a0025-7079 (Print)00aPsychometric evaluation and calibration of health-related quality of life item banks: plans for the Patient-Reported Outcomes Measurement Information System (PROMIS)0 aPsychometric evaluation and calibration of healthrelated quality a2007/04/20 cMay aS22-310 v453 aBACKGROUND: The construction and evaluation of item banks to measure unidimensional constructs of health-related quality of life (HRQOL) is a fundamental objective of the Patient-Reported Outcomes Measurement Information System (PROMIS) project. OBJECTIVES: Item banks will be used as the foundation for developing short-form instruments and enabling computerized adaptive testing. The PROMIS Steering Committee selected 5 HRQOL domains for initial focus: physical functioning, fatigue, pain, emotional distress, and social role participation. This report provides an overview of the methods used in the PROMIS item analyses and proposed calibration of item banks. ANALYSES: Analyses include evaluation of data quality (eg, logic and range checking, spread of response distribution within an item), descriptive statistics (eg, frequencies, means), item response theory model assumptions (unidimensionality, local independence, monotonicity), model fit, differential item functioning, and item calibration for banking. RECOMMENDATIONS: Summarized are key analytic issues; recommendations are provided for future evaluations of item banks in HRQOL assessment.10a*Health Status10a*Information Systems10a*Quality of Life10a*Self Disclosure10aAdolescent10aAdult10aAged10aCalibration10aDatabases as Topic10aEvaluation Studies as Topic10aFemale10aHumans10aMale10aMiddle Aged10aOutcome Assessment (Health Care)/*methods10aPsychometrics10aQuestionnaires/standards10aUnited States1 aReeve, B B1 aHays, R D1 aBjorner, J B1 aCook, KF1 aCrane, P K1 aTeresi, J A1 aThissen, D1 aRevicki, D A1 aWeiss, DJ1 aHambleton, RK1 aLiu, H1 aGershon, RC1 aReise, S P1 aLai, J S1 aCella, D uhttp://iacat.org/content/psychometric-evaluation-and-calibration-health-related-quality-life-item-banks-plans-patient02156nas a2200289 4500008004100000245010000041210006900141260000800210300001200218490000700230520127700237653003401514653002101548653000901569653001201578653002201590653001101612653001101623653000901634653001601643653002901659653001901688100001301707700001501720700001301735856011801748 2006 eng d00aFactor analysis techniques for assessing sufficient unidimensionality of cancer related fatigue0 aFactor analysis techniques for assessing sufficient unidimension cSep a1179-900 v153 aBACKGROUND: Fatigue is the most common unrelieved symptom experienced by people with cancer. The purpose of this study was to examine whether cancer-related fatigue (CRF) can be summarized using a single score, that is, whether CRF is sufficiently unidimensional for measurement approaches that require or assume unidimensionality. We evaluated this question using factor analysis techniques including the theory-driven bi-factor model. METHODS: Five hundred and fifty five cancer patients from the Chicago metropolitan area completed a 72-item fatigue item bank, covering a range of fatigue-related concerns including intensity, frequency and interference with physical, mental, and social activities. Dimensionality was assessed using exploratory and confirmatory factor analysis (CFA) techniques. RESULTS: Exploratory factor analysis (EFA) techniques identified from 1 to 17 factors. The bi-factor model suggested that CRF was sufficiently unidimensional. CONCLUSIONS: CRF can be considered sufficiently unidimensional for applications that require unidimensionality. One such application, item response theory (IRT), will facilitate the development of short-form and computer-adaptive testing. This may further enable practical and accurate clinical assessment of CRF.10a*Factor Analysis, Statistical10a*Quality of Life10aAged10aChicago10aFatigue/*etiology10aFemale10aHumans10aMale10aMiddle Aged10aNeoplasms/*complications10aQuestionnaires1 aLai, J-S1 aCrane, P K1 aCella, D uhttp://iacat.org/content/factor-analysis-techniques-assessing-sufficient-unidimensionality-cancer-related-fatigue02068nas a2200217 4500008004500000245013400045210006900179300001200248490000700260520127300267653003401540653004201574653002501616653001901641100001401660700001301674700001801687700001401705700001501719856011601734 2006 Engldsh 00aSimulated computerized adaptive test for patients with shoulder impairments was efficient and produced valid measures of function0 aSimulated computerized adaptive test for patients with shoulder a290-2980 v593 a
Background and Objective: To test unidimensionality and local independence of a set of shoulder functional status (SFS) items,
develop a computerized adaptive test (CAT) of the items using a rating scale item response theory model (RSM), and compare discriminant validity of measures generated using all items (qIRT) and measures generated using the simulated CAT (qCAT).
Study Design and Setting: We performed a secondary analysis of data collected prospectively during rehabilitation of 400 patients
with shoulder impairments who completed 60 SFS items.
Results: Factor analytic techniques supported that the 42 SFS items formed a unidimensional scale and were locally independent. Except for five items, which were deleted, the RSM fit the data well. The remaining 37 SFS items were used to generate the CAT. On average, 6 items on were needed to estimate precise measures of function using the SFS CAT, compared with all 37 SFS items. The qIRT and qCAT measures were highly correlated (r 5 .96) and resulted in similar classifications of patients.
Conclusion: The simulated SFS CAT was efficient and produced precise, clinically relevant measures of functional status with good
discriminating ability.