Computerized Adaptive Assessment of Headache Impact

描述（由申请人提供）：我们提出了一种用于评估头痛的功能影响的工具，该工具使用计算机化自适应测试（CAT），通过将问题与每个患者的头痛严重程度相匹配来实现更实用和更精确的评估。在以前的工作中，我们开发了一个头痛影响项目库，提高了评分的精度和有效性，并提供了更广泛的测量范围，我们开发了交叉校准程序，使我们能够直接比较CAT和现有头痛量表的结果。使用动态健康评估（DYNHA）软件管理项目，以减少回答负担。在第一阶段，我们开发并试行了一种原型评估（HEADACHE-CAT），该评估将静态通用健康相关生活质量（HRQOL）工具与增强型头痛影响CAT相结合，该工具利用了扩展的项目库。对HEADACHE-CAT的初步测试结果表明，随着试题库的扩大，测量精度和效率都有所提高。患者参与者对HEADACHE-CAT和原型患者报告提供了积极的反馈，该原型患者报告指导了通用HRQOL和头痛影响结果的解释。II期的目标是：（1）通过增强项目选择程序提高HEADACHE-CAT的内容效度;（2）通过启发式评价和可用性测试提高HEADACHE-CAT的实际有用性;（3）评价HEADACHE-CAT对临床状况随时间变化的响应性;（4）开发和评估带有语音激活的项目管理，以使视力或读写障碍患者更容易获得，并评估调查长度对患者满意度的影响;（5）最后确定一个单一的综合HEADACHE-CAT评估系统，该系统：a）使用通用HRQOL和头痛影响领域的项目库，B）具有全面的用户指南，c）可以提供传统量表的度量中的分数，d）可以提供个体患者和临床医生报告，以及提供者的汇总级报告，以改进团体级评估和监测工作。本项目开发的HEADACHE-CAT评估工具将通过大大降低数据收集成本、受访者负担、增加测量的广度和精度，使头痛患者的HRQOL筛查和常规结局监测成为可能。

DESCRIPTION (provided by applicant): We propose a tool for evaluating the functional impact of headaches that uses computerized adaptive testing (CAT) to achieve more practical and more precise assessments by matching the questions to each patient's headache severity level. In previous work, we developed a headache impact item bank that improved score precision and validity and provided measurement over a wider range, and we developed cross-calibration procedures that allowed us to directly compare results from CAT and existing headache scales. Items were administered using Dynamic Health Assessment (DYNHA¿) software to reduce response burden. In Phase I, we developed and piloted a prototype assessment (HEADACHE-CAT) that combines a static generic health- related quality of life (HRQOL) tool with an enhanced headache impact CAT which draws upon an expanded item bank. Results from a pilot test of the HEADACHE-CAT showed that measurement precision and efficiency increased with the larger item bank. Patient participants provided positive feedback on the HEADACHE-CAT and a prototype patient report that guides interpretation of generic HRQOL and headache impact results. The aims for Phase II are to: (1) improve the content validity of the HEADACHE-CAT by enhanced item selection procedures; (2) improve practical usefulness of the HEADACHE-CAT by heuristic evaluation and usability testing; (3) evaluate the responsiveness of the HEADACHE-CAT to changes in the clinical condition over time; (4) develop and evaluate item administation with voice activation for greater accessibility to patients with visual or literacy impairments and evaluate the effects of survey length on patient satisfaction; and (5) finalize a single comprehensive HEADACHE-CAT assessment system that: a) uses item banks for generic HRQOL and headache impact domains, b) has a comprehensive user guide, c) can provide scores in the metric of traditional scales, d) can deliver individual patient and clinician reports, and aggregate-level reports for providers to improve group-level assessment and monitoring efforts. The HEADACHE-CAT assessment tool developed by this project will make screening and routine outcomes monitoring of HRQOL feasible for headache sufferers by greatly lowering data collection costs, respondent burden, and increasing the breadth and precision of measurement.