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Development of computer adaptive testing for measuring depression in patients with cancer.

ABSTRACT: The usefulness of depression scales for patients with cancer based on item response theory (IRT) and computer adaptive testing (CAT) has not yet been fully explored. This study thus aimed to develop an IRT-based tool for measuring depression in patients with cancer. We analyzed data from 393 patients with cancer from four tertiary centers in Japan who had not received psychiatric treatment. They answered 62 questions across five categories regarding their psychiatric status over the previous week. We selected 28 items that satisfied the assumptions of IRT, fitted a graded response model to these items, and performed CAT simulations. The CAT simulation used an average of 6.96 items and showed a Pearson's correlation coefficient of 0.916 (95% confidence interval, 0.899-0.931) between the degree of depression estimated by simulation and that estimated using all 28 items. The measurement precision of CAT with only four items was superior to that of the estimation using the calibrated Patient Health Questionnaire-9. These results imply that this scale is useful and accurate for measuring depression in patients with cancer.

SUBMITTER: Kurisu K

PROVIDER: S-EPMC9114408 | biostudies-literature | 2022 May

REPOSITORIES: biostudies-literature

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Development of computer adaptive testing for measuring depression in patients with cancer.

Kurisu Ken K Hashimoto Masayuki M Ishizawa Tetsuro T Shibayama Osamu O Inada Shuji S Fujisawa Daisuke D Inoguchi Hironobu H Shimoda Haruki H Inoue Shinichiro S Ogawa Asao A Akechi Tatsuo T Shimizu Ken K Uchitomi Yosuke Y Matsuyama Yutaka Y Yoshiuchi Kazuhiro K

Scientific reports 20220517 1

The usefulness of depression scales for patients with cancer based on item response theory (IRT) and computer adaptive testing (CAT) has not yet been fully explored. This study thus aimed to develop an IRT-based tool for measuring depression in patients with cancer. We analyzed data from 393 patients with cancer from four tertiary centers in Japan who had not received psychiatric treatment. They answered 62 questions across five categories regarding their psychiatric status over the previous wee ...[more]

PMID: 35581321

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Project description:ObjectivesTo build an item response theory-based computer adaptive test (CAT) for balance from 3 traditional, fixed-form balance measures: Berg Balance Scale (BBS), Performance-Oriented Mobility Assessment (POMA), and dynamic gait index (DGI); and to examine whether the CAT's psychometric performance exceeded that of individual measures.DesignSecondary analysis combining 2 existing datasets.SettingCommunity based.ParticipantsCommunity-dwelling older adults (N=187) who were aged ≥65 years (mean age, 75.2±6.8y, 69% women).InterventionsNot applicable.Main outcome measuresThe BBS, POMA, and DGI items were compiled into an initial 38-item bank. The Rasch partial credit model was used for final item bank calibration. CAT simulations were conducted to identify the ideal CAT. CAT score accuracy, reliability, floor and ceiling effects, and validity were examined. Floor and ceiling effects and validity of the CAT and individual measures were compared.ResultsA 23-item bank met model expectations. A 10-item CAT was selected, showing a very strong association with full item bank scores (r=.97) and good overall reliability (.78). Reliability was better in low- to midbalance ranges as a result of better item targeting to balance ability when compared with the highest balance ranges. No floor effect was noted. The CAT ceiling effect (11.2%) was significantly lower than the POMA (40.1%) and DGI (40.3%) ceiling effects (P<.001 per comparison). The CAT outperformed individual measures, being the only test to discriminate between fallers and nonfallers (P=.007), and being the strongest predictor of self-reported function.ConclusionsThe balance CAT showed excellent accuracy, good overall reliability, and excellent validity compared with individual measures, being the only measure to discriminate between fallers and nonfallers. Prospective examination, particularly in low-functioning older adults and clinical populations with balance deficits, is recommended. Development of an improved CAT based on an expanded item bank containing higher difficulty items is also recommended.

Project description:BACKGROUND:There is a need for shorter-length assessments that capture patient questionnaire data while attaining high data quality without an undue response burden on patients. Computerized adaptive testing (CAT) and classification and regression tree (CART) methods have the potential to meet these needs and can offer attractive options to shorten questionnaire lengths. OBJECTIVE:The objective of this study was to test whether CAT or CART was best suited to reduce the number of questionnaire items in multiple domains (eg, anxiety, depression, quality of life, and social support) used for a needs assessment procedure (NAP) within the field of cardiac rehabilitation (CR) without the loss of data quality. METHODS:NAP data of 2837 CR patients from a multicenter Cardiac Rehabilitation Decision Support System (CARDSS) Web-based program was used. Patients used a Web-based portal, MyCARDSS, to provide their data. CAT and CART were assessed based on their performances in shortening the NAP procedure and in terms of sensitivity and specificity. RESULTS:With CAT and CART, an overall reduction of 36% and 72% of NAP questionnaire length, respectively, was achieved, with a mean sensitivity and specificity of 0.765 and 0.817 for CAT, 0.777 and 0.877 for classification trees, and 0.743 and 0.40 for regression trees, respectively. CONCLUSIONS:Both CAT and CART can be used to shorten the questionnaires of the NAP used within the field of CR. CART, however, showed the best performance, with a twice as large overall decrease in the number of questionnaire items of the NAP compared to CAT and the highest sensitivity and specificity. To our knowledge, our study is the first to assess the differences in performance between CAT and CART for shortening questionnaire lengths. Future research should consider administering varied assessments of patients over time to monitor their progress in multiple domains. For CR professionals, CART integrated with MyCARDSS would provide a feedback loop that informs the rehabilitation progress of their patients by providing real-time patient measurements.

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Development of computer adaptive testing for measuring depression in patients with cancer.

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Development of computer adaptive testing for measuring depression in patients with cancer.

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