Advancing the efficiency and efficacy of patient reported outcomes with multivariate computer adaptive testing.
Objective: The Patient Reported Outcomes Measurement Information System (PROMIS) initiative developed an array of patient reported outcome (PRO) measures. To reduce the number of questions administered, PROMIS utilizes unidimensional item response theory and unidimensional computer adaptive testing...
| Publicado en: | Journal of the American Medical Informatics Association Vol. 24; no. 5; pp. 897 - 903 |
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| Autores principales: | , , , |
| Formato: | research Journal Article |
| Publicado: |
Oxford University Press / USA
Sep2017
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=124641439&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 124641439 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 10675027 FZ9 jtl: Journal of the American Medical Informatics Association issn: 10675027 maglogo: N pubinfo: dt: Sep2017 vid: 24 iid: 5 pid: 622 pub: Oxford University Press / USA artinfo: ui: 124641439 124641439 NLM28444397 124641439 10.1093/jamia/ocx003 NLM28444397 124641439 ppf: 897 ppct: 6 formats: tig: atl: Advancing the efficiency and efficacy of patient reported outcomes with multivariate computer adaptive testing. aug: au: Morris, Scott Bass, Mike Lee, Mirinae Neapolitan, Richard E. affil: Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA sug: subj: Computers and Computerization Patient-Reported Outcomes Methods Information Systems Models, Psychological Funding Source Human ab: Objective: The Patient Reported Outcomes Measurement Information System (PROMIS) initiative developed an array of patient reported outcome (PRO) measures. To reduce the number of questions administered, PROMIS utilizes unidimensional item response theory and unidimensional computer adaptive testing (UCAT), which means a separate set of questions is administered for each measured trait. Multidimensional item response theory (MIRT) and multidimensional computer adaptive testing (MCAT) simultaneously assess correlated traits. The objective was to investigate the extent to which MCAT reduces patient burden relative to UCAT in the case of PROs.Methods: One MIRT and 3 unidimensional item response theory models were developed using the related traits anxiety, depression, and anger. Using these models, MCAT and UCAT performance was compared with simulated individuals.Results: Surprisingly, the root mean squared error for both methods increased with the number of items. These results were driven by large errors for individuals with low trait levels. A second analysis focused on individuals aligned with item content. For these individuals, both MCAT and UCAT accuracies improved with additional items. Furthermore, MCAT reduced the test length by 50%.Discussion: For the PROMIS Emotional Distress banks, neither UCAT nor MCAT provided accurate estimates for individuals at low trait levels. Because the items in these banks were designed to detect clinical levels of distress, there is little information for individuals with low trait values. However, trait estimates for individuals targeted by the banks were accurate and MCAT asked substantially fewer questions.Conclusion: By reducing the number of items administered, MCAT can allow clinicians and researchers to assess a wider range of PROs with less patient burden. pubtype: Academic Journal doctype: research Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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