Computer Adaptive Test for Patients with Heart Failure

心力衰竭患者的计算机自适应测试

• 批准号: 7053896
• 负责人: MATTHIAS ROSE
• 金额: $ 13.75万
• 依托单位: QUALITYMETRIC, INC.
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-04-15 至 2008-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7053896
• 关键词: Internet; cardiovascular disorder risk; clinical research; computer assisted medical decision making; computer program /software; computer simulation; computer system design /evaluation; data collection methodology /evaluation; dyspneas; fatigue; functional ability; heart failure; human subject; hypertrophic myocardiopathy; outpatient care; psychometrics; questionnaires

DESCRIPTION (provided by applicant): Our objective is to achieve a major advance in the technology used to assess patient reported outcomes in heart failure (HF). Numerous questionnaires currently are being used to measure outcomes of HF patients, but scores from these instruments can not be directly compared. In addition, no single fixed-length form can achieve the breath and precision of measurement needed to monitor individual patients, and yet still be practical for clinical use. To address these deficiencies, the Aims of Phase I are: (1) to develop a prototype Computer Adaptive Test (HF-CAT) to measure the cardinal subjective symptoms of heart failure (dyspnea, fatigue and physical function); (2) to develop a cross-calibration-approach to explore the possibility of comparing disease-specific static questionnaires (Chronic Heart Failure, Minnesota Living with Heart Failure, and Kansas City Cardiomyopathy Questionnaire); and (3) to evaluate the feasibility of a HF-CAT. We will collect data via the internet from 1,500 HF patients, who will answer the instruments mentioned above, two dyspnea questionnaires, and the vitality and physical functioning scale from the SF- 36. Item Response Theory methods will be applied to estimate item parameters to extend existing item banks for fatigue and physical functioning and to build a new item bank for dyspnea. These item banks will serve as a basis for the HF-CAT and will enable us to explore the possibility of comparing results between questionnaires. We will evaluate measurement precision and respondent burden in two simulation studies, and evaluate the feasibility of the HF-CAT in a study with 100 HF patients at the Montefiore Medical Center. Phase I will produce a prototype version of the HF-CAT with preliminary evidence of its acceptance by patients and a better understanding of the shared concepts of widely-used HF questionnaires. We expect the HF-CAT will provide enhanced measurement precision over a wide scale range without added respondent burden. Enhanced measurement precision is a desired feature for psychometric instruments, to improve response detection and risk prediction. In Phase II, we will include additional items, examine the responsiveness of the HF-CAT, and conduct clinical field studies to evaluate the tool's ability to predict deterioration of HF and health care utilization. The final goal will be to have a comprehensive practical tool available to improve patient centered care and life expectancy of patients with heart failure. Public Heath Relevance: Within this project we will develop a computer adaptive test which will measure the subjective symptoms of heart failure more precisely and with less respondent burden. This may help high risk heart failure patients get appropriate treatment earlier to prevent deterioration and hospitalization.

描述（由申请人提供）：我们的目标是在用于评估心力衰竭（HF）患者报告结果的技术方面取得重大进展。目前，许多问卷被用于测量心衰患者的预后，但这些工具的得分不能直接进行比较。此外，没有任何一种固定长度的形式可以达到监测单个患者所需的呼吸和测量精度，但仍然适用于临床使用。为了解决这些缺陷，第一阶段的目标是：(1)开发一个原型计算机适应测试（HF-CAT）来测量心力衰竭的主要主观症状（呼吸困难、疲劳和身体功能）；(2)建立一种交叉校准方法，探讨比较疾病特异性静态问卷（慢性心力衰竭、明尼苏达生活与心力衰竭和堪萨斯城心肌病问卷）的可能性；(3)评估HF-CAT的可行性。我们将通过互联网收集1500名心衰患者的数据，这些患者将回答上述仪器、两份呼吸困难问卷以及SF- 36的活力和身体功能量表。项目反应理论方法将应用于估计项目参数，以扩展现有的疲劳和身体功能的题库，并建立一个新的呼吸困难的题库。这些题库将作为HF-CAT的基础，并将使我们能够探索比较问卷结果的可能性。我们将在两项模拟研究中评估测量精度和被调查者负担，并在Montefiore医疗中心的100例心衰患者中评估HF- cat的可行性。第一阶段将制作HF- cat的原型版本，初步证明患者接受该版本，并更好地理解广泛使用的HF问卷的共同概念。我们期望HF-CAT将在不增加应答者负担的情况下，在大范围内提供更高的测量精度。提高测量精度是心理测量仪器的理想特征，以提高反应检测和风险预测。在第二阶段，我们将纳入其他项目，检查HF- cat的响应性，并进行临床实地研究，以评估该工具预测心衰恶化和医疗保健利用的能力。最终目标将是有一个全面的实用工具，可用于改善以患者为中心的护理和预期寿命的心力衰竭患者。公共卫生相关性：在这个项目中，我们将开发一种计算机适应性测试，它将更精确地测量心力衰竭的主观症状，并减少应答者的负担。这可能有助于高危心力衰竭患者尽早得到适当的治疗，以防止病情恶化和住院。