Computerized Adaptive Assessment of Headache Impact

描述(由申请人提供)：我们建议使用计算机化自适应测试(CAT)来评估头痛的功能影响，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准确的评估。在之前的工作中，我们开发了头痛影响题库，提高了评分的精确度和有效性，并提供了更广泛的测量范围，我们还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)软件对项目进行管理，以减轻反应负担。在第一阶段，我们开发并试行了一个原型评估(头痛-CAT)，它结合了静态的通用健康相关生活质量(HRQOL)工具和利用扩展题库的增强的头痛影响CAT。对头痛CAT的初步测试结果表明，随着题库的增加，测量精度和效率都会提高。患者参与者对头痛CAT提供了积极的反馈，并提供了一个原型患者报告，该报告指导了对一般HRQOL和头痛影响结果的解释。第二阶段的目标是：(1)通过增强条目选择程序来提高头痛CAT的内容效度；(2)通过启发式评估和可用性测试来提高头痛CAT的实际有用性；(3)评估头痛CAT对临床状况随时间的变化的反应；(4)开发和评估语音激活的条目管理，以便于视觉或识字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；以及(5)最终确定单一的综合头痛-CAT评估系统，该系统：a)将题库用于通用的HRQOL和头痛影响领域，b)具有全面的用户指南，c)可以提供传统量表的衡量标准的分数，d)可以提供单个患者和临床医生的报告，以及提供者的聚合级别报告，以改进小组级别的评估和监测工作。本项目开发的头痛CAT评估工具将通过极大地降低数据收集成本和受访者负担，增加测量的广度和精度，使头痛患者的HRQOL筛查和常规结果监测成为可能。

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.