A Comparison of Psychometric Properties Between Internet and Paper Versions of Two Depression Instruments (BDI-II and MADRS-S) Administered to Clinic Patients
A Comparison of Psychometric Properties Between Internet and Paper Versions of Two Depression Instruments (BDI-II and MADRS-S) Administered to Clinic Patients
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DOI：
10.2196/jmir.1392
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发表时间：
2010-01-01
影响因子：
7.4
通讯作者：
Engstrom, Ingemar
中科院分区：
文献类型：
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作者：
Hollandare, Fredrik;Andersson, Gerhard;Engstrom, Ingemar
背景：自我报告措施可以指导临床决策，在评估治疗结果时很有用。然而，许多临床医生在临床实践中并没有系统地使用自我报告措施。基于互联网的问卷可以帮助管理，但在实施之前应该探索在线版本的工具的心理测量学特性。国际测试委员会的建议是分别测试每一份问卷的心理测量学特性。目的：我们的目标是比较两份测量抑郁症状的问卷的纸笔版和网络版的心理测量学特性。方法：87名参与调查的患者来自瑞典公共卫生保健系统的初级保健和精神护理。参与者完成了贝克抑郁量表(BDI-II)和蒙哥马利-阿斯伯格抑郁量表-自评(MADRS-S)，包括纸质版和互联网版。为了考虑顺序效应，将顺序随机设置为对照。样本中症状严重程度从轻度到重度抑郁症状不等。结果：两种给药方式的心理测量学特性基本相同。网络版和纸质版的内部一致性相似，S版(r=0.84)和BDI-II(r=0.89)之间存在显著的相关性。当单独分析时，纸质和互联网总分在两份问卷和涉及自杀的MADRS-S问题(第9项)上的差异均不具有统计学意义。BDI-II中有关自杀倾向的问题(第9项)在互联网上的得分显著低于纸质得分，但差异不大(效应大小，Cohen‘s[d]=0.14)。管理顺序在两份问卷上均存在显著的主效应，格式与顺序之间存在显著的交互作用。然而，只要重复测量时不改变给药形式，这在临床上应该不会造成问题。结论：MADRS-S可以在不影响心理测量学特性的情况下转移到网上使用，具有临床意义。完整的BDI-II在转移时似乎也保留了它的性质；然而，互联网版本中衡量自杀行为的项目需要进一步调查，因为它与本研究中的较低分数有关。在线问卷的使用为临床医生提供了一种更实用的测量抑郁症状的方法，并有可能节省资源。
Background: Self-report measures can guide clinical decisions and are useful when evaluating treatment outcomes. However, many clinicians do not use self-report measures systematically in their clinical practice. Internet-based questionnaires could facilitate administration, but the psychometric properties of the online version of an instrument should be explored before implementation. The recommendation from the International Test Commission is to test the psychometric properties of each questionnaire separately.Objective: Our objective was to compare the psychometric properties of paper-and-pencil versions and Internet versions of two questionnaires measuring depressive symptoms.Methods: The 87 participating patients were recruited from primary care and psychiatric care within the public health care system in Sweden. Participants completed the Beck Depression Inventory (BDI-II) and the Montgomery-Asberg Depression Rating Scale-Self-rated (MADRS-S), both on paper and on the Internet. The order was randomized to control for order effects. Symptom severity in the sample ranged from mild to severe depressive symptoms.Results: Psychometric properties of the two administration formats were mostly equivalent. The internal consistency was similar for the Internet and paper versions, and significant correlations were found between the formats for both MADRS-S (r = .84) and the BDI-II (r = .89). Differences between paper and Internet total scores were not statistically significant for either questionnaire nor for the MADRS-S question dealing with suicidality (item 9) when analyzed separately. The score on the BDI-II question about suicidality (item 9) was significantly lower when administered via the Internet compared with the paper score, but the difference was small (effect size, Cohen's [d] = 0.14). There were significant main effects for order of administration on both questionnaires and significant interaction effects between format and order. This should not, however, pose a problem in clinical use as long as the administration format is not changed when repeated measurements are made.Conclusions: The MADRS-S can be transferred to online use without affecting the psychometric properties in a clinically meaningful way. The full BDI-II also seems to retain its properties when transferred; however, the item measuring suicidality in the Internet version needs further investigation since it was associated with a lower score in this study. The use of online questionnaires offers clinicians a more practical way of measuring depressive symptoms and has the potential to save resources.