Assessment of anomia: Improving efficiency and utility using item response theory

项目总结/摘要 失名症是失语症的核心特征，失语症是一种影响至少250万美国人的疾病。命名评估 能力是失语症研究和临床实践的基础，但目前可用的命名测试 在过去的50年里，他们在很大程度上未能利用心理测量理论和实践的重要进展。 年需要敏感的指标来支持对失名症背后的认知机制的调查， 临床决策和治疗研究。为了达到最佳效果，这些指标必须在 一个严格的心理测量框架，以（i）有效地提供有关整体严重程度和 在一个统一的框架内的基本认知缺陷，（ii）支持重复评估，而不威胁 内部有效性或测量精度，（iii）目标对象和动作命名，以及（iv）易于集成 转化为计算机化的适应性测试平台。目前所有的失名症测试都缺乏这些特征中的至少一个。到 为了弥补这一差距，该项目追求三个目标。 首先，简化诊所和实验室之间的信息共享，并增强进行稳健评估的能力。 元分析研究，五个物体图片命名测试将等同于项目反应理论 框架，他们的分数将以相同的指标表示。此外，为了满足大型 样本在未来的项目开发，预测模型的困难，最形象的名词将细化 交叉验证正如长度的测量不取决于使用哪把尺子一样， 命名障碍的严重程度不需要依赖于所给予的命名测试。 其次，为了量化失名症的潜在认知缺陷，一个认知心理测量模型， 将对失名症进行细化和评估，以产生一个衡量模型， 与当前理论的契合度和忠实度。 第三，鉴于动作命名的重要性日益得到认可， 命名测验将使用项目反应理论，通过建模动作命名反应;回归 动词项目难度参数对相关目标属性;以及，进行真实数据模拟，以评估 计算机自适应测试引擎的精度。 这项工作将产生一个功能强大，灵活的失范评估工具，用于研究和 临床实践根据用户的规格，它将最大限度地提高诊断信息和测量 精确度，同时最大限度地减少响应负担。该项目的目标直接涉及 2017-2021年NIDCD战略计划，包括开发和完善技术，技术和 用于改进诊断的仪器，以帮助治疗和改善临床结果。

Project Summary/Abstract Anomia is a core feature of aphasia, a disorder affecting at least 2.5 million Americans. Assessment of naming ability is foundational to both research and clinical practice in aphasiology, but currently available naming tests have largely failed to capitalize on important advances in psychometric theory and practice over the past 50 years. Sensitive metrics are needed to support investigations of the cognitive mechanisms underlying anomia, clinical decision making, and treatment research. To be optimally useful, these metrics must be validated within a rigorous psychometric framework to (i) efficiently provide information about both overall severity and the underlying cognitive deficits in a unified framework, (ii) support repeated assessments without threatening internal validity or measurement precision, (iii) target both object and action naming, and (iv) easily integrate into computerized adaptive testing platforms. All current anomia tests lack at least one of these features. To remedy this gap, this project pursues three aims. First, to ease sharing of information across clinics and labs, and enhance the ability to conduct robust meta-analytic studies, five object picture-naming tests will be equated within an item response theory framework, and their scores will be expressed on the same metric. Further, to obviate the need for large samples in future item development, a model for predicting the difficulty of most picturable nouns will be refined and cross-validated. Just as the measurement of length does not depend on which ruler is used, measurement of anomia severity need not depend on which naming test is given. Second, to quantify the underlying cognitive deficits of anomia, a cognitive-psychometric model of anomia will be refined and evaluated to produce a measurement model that balances clinical utility, model-data fit, and fidelity to current theory. Third, given the increasingly recognized importance of action naming, a computer adaptive action naming test will be developed using item response theory by modeling action naming responses; regressing verb item difficulty parameters on relevant target properties; and, conducting real-data simulations to assess the precision of the computer adaptive test engine. This work will produce a powerful and flexible anomia assessment tool with utility for both research and clinical practice. Depending on user specifications, it will maximize diagnostic information and measurement precision while minimizing response burden. The aims of this project directly address goals identified in the NIDCD Strategic Plan for 2017-2021, including developing and refining techniques, technology, and instrumentation for improved diagnosis to aid in treatment and improve clinical outcomes.