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...

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Publicado en:Journal of the American Medical Informatics Association Vol. 24; no. 5; pp. 897 - 903
Autores principales: Morris, Scott, Bass, Mike, Lee, Mirinae, Neapolitan, Richard E.
Formato: research Journal Article
Publicado: Oxford University Press / USA Sep2017
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Sep2017
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      pub: Oxford University Press / USA
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        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
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