Using Item Response Theory to Improve Children's Quality of Life Assessment

描述（由申请人提供）：作为对PA 05-143的回应，本指导患者导向研究职业奖（K23）的目标是允许来自佛罗里达大学的l-Chan Huang博士成为儿童健康相关生活质量（HRQOL）评估领域的独立研究员，该评估测量身体和心理社会功能及其临床应用。该培训计划通过课程学习、指导研究培训和在儿科诊所的直接观察相结合，为黄医生提供了提高他在项目反应理论（IRT）和计算机适应测试（CAT）方面的技能的机会。2)了解亲子-医师互动及在儿科诊所使用HRQOL措施的障碍；3)与HRQOL测量相关的儿童健康和发展知识。佛罗里达大学流行病学和卫生政策研究系的资源以及与导师的密切联系将为黄博士实现目标提供理想的环境。家长报告说，在与孩子的医生讨论治疗方案和决策过程中，HRQOL是他们最重要的考虑因素之一。然而，目前的传统测量方法需要针对每种疾病（或使用不能解决特定疾病问题的通用仪器）和发育阶段定制仪器，并且需要对每个孩子管理整个项目集。IRT与CAT技术相结合，有助于调整和定制项目，更有效和准确地测量儿童的HRQOL，并允许比较儿童在发育和疾病轨迹中的HRQOL。在本次K23奖中，黄博士将使用IRT和模拟CAT技术来开发儿童HRQOL测量方法，重点是创建可用于临床环境的HRQOL项目库和简短形式的工具。他还将探讨家长、儿童和医生在临床环境中使用HRQOL的态度和障碍。研究对象将包括5至18岁儿童的父母（N=2,000）， 8至18岁儿童（N=800），他们参加了佛罗里达儿童护理计划（FKP），以及来自三家儿科诊所的8至18岁儿童样本（N=240）。

DESCRIPTION (provided by applicant): The goal of this Mentored Patient-Oriented Research Career Award (K23), in response to PA 05-143, is to allow Dr. l-Chan Huang from the U. of Florida to become an independent researcher in the area of children's health-related quality of life (HRQOL) assessment, which measures physical and psychosocial functioning, and its clinical application. This training plan, through a combination of coursework, mentored research training and direct observation in pediatric clinics, provides Dr. Huang with the opportunity to enhance his 1) skills in item response theory (IRT) and computerized adaptive test (CAT) for HRQOL measurement; 2) understanding of parent-child-physician interactions and barriers to using HRQOL measures in pediatric clinics; and, 3) knowledge of child health and development associated with HRQOL measurement. The resources at the University of Florida Department of Epidemiology and Health Policy Research and close contact with mentors will provide Dr. Huang with the ideal environment to achieve his goals. Parents report that HRQOL is one of their most important considerations in discussing treatment options with their children's physicians and in their decision making process. However, current conventional measurement methods require customized instruments for each illness (or the use of generic instruments that do not address disease-specific issues) and developmental stage and require administering the entire item set to each child. The use of IRT, combined with CAT technology, help adapt and tailor items to measure children's HRQOL more efficiently and precisely, and allows for comparison of children's HRQOL across developmental and illness trajectories. In this K23 award, Dr. Huang will use IRT and simulated CAT technology to develop children's HRQOL measures, focusing on creating HRQOL item pools and short-forms of the instruments that can be used in clinical settings. He will also explore the parents', children's and physicians' attitudes and barriers to using HRQOL in clinical settings. Study subjects will consist of parents of children 5 through 18 years old (N=2,000), children 8 through 18 years old (N=800) who are enrolled in the Florida KidCare Program (FKP) and a pediatric sample 8 through 18 years old (N=240) from three pediatric clinics. PUBLIC HEALTH RELEVANCE: IRT/CAT holds the promise of developing feasible, precise and affordable HRQOL tools for children. This K23 project will help Dr. Huang develop advanced children's HRQOL tools that can be used to measure children's health and functional status and to facilitate treatment planning and shared decision-making between parents, children and physicians