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

失范评估：利用项目反应理论提高效率和效用

• 批准号: 9147562
• 负责人: Gerasimos Fergadiotis
• 金额: $ 13.6万
• 依托单位: PORTLAND STATE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-09-22 至 2018-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9147562
• 关键词: Address; Affect; Agreement; Algorithms; Anomia; Aphasia; Archives; Binding; Chi-Square Tests; Classification; Cognitive deficits; Communication impairment; Computational algorithm; Computers; Data; Databases; Decision Making; Development; Diagnosis; Diagnostic; Disease; Electronics; Engineering; Evaluation; Generations; Goals; Health; Healthcare; Impairment; Individual; Logistics; Measurement; Measures; Modeling; Mosses; Names; National Institute on Deafness and Other Communication Disorders; Nature; Outcome; Participant; Patients; Performance; Persons; Philadelphia; Plant Roots; Policies; Property; Protocols documentation; Psycholinguistics; Psychometrics; Rehabilitation therapy; Research; Retrieval; Sampling; Severities; Strategic Planning; Symptoms; System; Testing; Theoretical model; Time; United States National Institutes of Health; base; handheld mobile device; health data; improved; improved outcome; novel therapeutics; prevent; prospective; response; simulation; theories; tool; trait

 DESCRIPTION (provided by applicant): Anomia is a core feature of aphasia, a disorder that affects approximately 80,000 people each year. Sensitive metrics of change are needed for the development and evaluation of new anomia treatments and to provide the basis for rehabilitation reimbursement and policy decisions. To be optimally useful, these metrics must (i) be validated within a modern framework, such as item response theory, to enhance their psychometric properties, (ii) yield information about severity and underlying cognitive deficits with low response burden, (iii) support repeated assessments without posing threats to internal validity, and (iv) predict functioning at the activity level of the ICF. The long-term goal of thisline of research is to maximize the precision, efficiency, and utility of word retrieval assessment for quantifying change, evaluating new therapeutic protocols, and diagnosing impairments in terms of current theoretical models. To achieve this goal, this proposal will focus on engineering a theoretically driven, computer-adaptive system using IRT for assessing anomia. IRT is a state-of-the-art psychometric framework with important theoretical and practical benefits. First, it transforms observed responses to test items into latent trait scores with interval properties. Second, it formalizes how measurement precision varies as a function of a person's ability. Third, it supports algorithms for computer adaptive testing (CAT), in which only the most informative items are selected and administered for a particular patient, thus reducing testing time. It also permits the generation of equivalent test forms for assessing the same person on multiple occasions with scores that are expressed on a single common scale. This proposal has the following Specific Aims. Specific Aim 1a is to validate a CAT version of the Philadelphia Naming Test (PNT-CAT) that is based on a 1-parameter logistic IRT model for quantifying overall severity. Specifically, this aim will determine the extent to which CAT-PNT scores are precise, unbiased, and correlated with performance on the full PNT. Specific Aim 1b is to determine the ability of an augmented CAT algorithm to predict error proportions on the full PNT. The goal of Specific Aim 2 is to verify the equivalence and precision of PNT-CAT alternate forms in order to determine stability when no change is expected. Specific Aim 3 will determine the relationship of the full PNT with discourse performance and assess any potential degradation of the strength of the relationship when CAT-PNT - instead of the full PNT - are used. Our overarching goal is consistent with the NIH Roadmap's recognition of the "pressing need to better quantify clinically important symptoms and outcomes". Further, it directly addresses goals identified in the NIDCD Strategic Plan for 2012-2016, including the development of effective and efficient diagnostic tools by using "electronic health data to inform the conscientious, explicit, and judicious use of current best evidence in making decisions about health care options to improve outcomes for individuals with communication disorders."

 描述(由申请人提供)：失语症是失语症的一个核心特征，失语症是一种每年影响大约8万人的疾病。为开发和评估新的失调症治疗方法，并为康复、补偿和政策决策提供依据，需要敏感的变化指标。为了达到最佳效果，这些测量必须(I)在现代框架内(如项目反应理论)进行验证，以增强其心理测量学特性；(Ii)以较低的反应负担产生关于严重程度和潜在认知缺陷的信息；(Iii)在不对内部效度构成威胁的情况下支持重复评估；以及(Iv)预测ICF活动水平的功能。这项研究的长期目标是根据当前的理论模型，最大限度地提高单词提取评估的精确度、效率和效用，以量化变化、评估新的治疗方案和诊断损伤。为了实现这一目标，本提案将侧重于设计一个理论驱动的、计算机自适应的系统，使用IRT来评估失范。IRT是一种最先进的心理测量学框架，具有重要的理论和实践意义。首先，它将对测试项目的观察反应转换为具有区间属性的潜在特质分数。其次，它将测量精度作为一个人的能力的函数而变化的方式正式化。第三，它支持计算机自适应测试(CAT)的算法，在该算法中，只为特定患者选择和管理信息最丰富的项目，从而减少测试时间。它还允许生成等同的测试表，用于在多个场合评估同一人，分数以单一的共同标尺表示。这项建议有以下具体目标。具体目标1a是验证费城命名测试(PNT-CAT)的CAT版本，该版本基于用于量化总体严重性的单参数Logistic IRT模型。具体地说，这一目标将决定CAT-PNT分数在多大程度上是准确、公正的，并与完整PNT的表现相关联。具体目标1b是确定扩展CAT算法预测全部PNT上的错误比例的能力。具体目标2的目标是验证PNT-CAT替代形式的等价性和精确度，以便在预期不会发生变化时确定稳定性。具体目标3将确定完整的PNT与语篇表现的关系，并评估当使用CAT-PNT而不是完整的PNT时，这种关系的强度是否有任何潜在的下降。我们的总体目标与NIH路线图对“更好地量化临床重要症状和结果的迫切需要”的认识是一致的。此外，它直接涉及2012-2016年NIDCD战略计划中确定的目标，包括开发有效和高效的诊断工具，方法是使用电子健康数据，向认真、明确和明智地使用当前最佳证据的人提供信息，以便就医疗保健选择作出决定，以改善患有沟通障碍的个人的预后。