Development of a computerized adaptive test for depression.
Development of a computerized adaptive test for depression.
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DOI：
10.1001/archgenpsychiatry.2012.14
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发表时间：
2012-11
影响因子：
--
通讯作者：
Kupfer DJ
中科院分区：
文献类型：
--
作者：
Gibbons RD;Weiss DJ;Pilkonis PA;Frank E;Moore T;Kim JB;Kupfer DJ
与其他医学领域不同，精神病学几乎完全依赖于病人的报告来评估疾病的存在和严重程度；因此，特别重要的是，我们必须找到更准确和有效的方法来取得该报告。开发抑郁症计算机化适应测试（CAT），称为计算机化适应测试-抑郁量表（CAT- di），以减轻患者和临床医生的负担，提高测量精度。病例对照研究。精神科诊所和社区精神卫生中心。共招募了1614名患有或不患有轻度和重度抑郁症的个体进行研究。本研究的重点是CAT-DI的发展。采用汉密尔顿抑郁症24项评定量表、患者健康问卷9和美国流行病学研究中心抑郁量表研究新量表的收敛效度，并采用DSM-IV的结构化临床访谈获得轻度和重度抑郁症的诊断分类。每个研究参与者平均需要12个项目才能在抑郁严重程度估计中达到0.3的SE，并与389个项目的测试总分保持r=0.95的相关性。使用基于混合正态分布的经验推导阈值，我们发现在由抑郁症患者和健康对照组成的样本中，对重度抑郁症进行分类的灵敏度为0.92，特异性为0.88。与其他临床医师及自评量表得分呈r=0.8的相关。CAT-DI在整个抑郁严重程度连续体（轻度和重度抑郁）中提供了很好的区分，而传统量表主要在极端情况下（如重度抑郁）提供了很好的区分。传统的测量固定了管理项目的数量，并允许测量不确定度变化。相比之下，CAT固定了测量的不确定度，并允许项目的数量变化。结果是显著减少了测量抑郁所需的项目数量，提高了测量精度。
Unlike other areas of medicine, psychiatry is almost entirely dependent on patient report to assess the presence and severity of disease; therefore, it is particularly crucial that we find both more accurate and efficient means of obtaining that report. To develop a computerized adaptive test (CAT) for depression, called the Computerized Adaptive Test–Depression Inventory (CAT-DI), that decreases patient and clinician burden and increases measurement precision. Case-control study. A psychiatric clinic and community mental health center. A total of 1614 individuals with and without minor and major depression were recruited for study. The focus of this study was the development of the CAT-DI. The 24-item Hamilton Rating Scale for Depression, Patient Health Questionnaire 9, and the Center for Epidemiologic Studies Depression Scale were used to study the convergent validity of the new measure, and the Structured Clinical Interview for DSM-IV was used to obtain diagnostic classifications of minor and major depressive disorder. A mean of 12 items per study participant was required to achieve a 0.3 SE in the depression severity estimate and maintain a correlation of r=0.95 with the total 389-item test score. Using empirically derived thresholds based on a mixture of normal distributions, we found a sensitivity of 0.92 and a specificity of 0.88 for the classification of major depressive disorder in a sample consisting of depressed patients and healthy controls. Correlations on the order of r=0.8 were found with the other clinician and self-rating scale scores. The CAT-DI provided excellent discrimination throughout the entire depressive severity continuum (minor and major depression), whereas the traditional scales did so primarily at the extremes (eg, major depression). Traditional measurement fixes the number of items administered and allows measurement uncertainty to vary. In contrast, a CAT fixes measurement uncertainty and allows the number of items to vary. The result is a significant reduction in the number of items needed to measure depression and increased precision of measurement.
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影响因子：
3
作者：
BOCK, RD;AITKIN, M
通讯作者：
AITKIN, M
DOI：
10.1207/s15366359mea0403_1
发表时间：
2006-01-01
影响因子：
1
作者：
Santor, Darcy;Gregus, Michelle;Welch, Andrew
通讯作者：
Welch, Andrew
影响因子：
7.4
作者：
Simms, Leonard J;Gros, Daniel F;O'Hara, Michael W
通讯作者：
O'Hara, Michael W
影响因子：
3
作者：
GIBBONS, RD;HEDEKER, DR
通讯作者：
HEDEKER, DR
影响因子：
1.2
作者：
RADLOFF L S
通讯作者：
RADLOFF L S