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

描述（由申请人提供）：这个指导病人为导向的研究职业奖（K23）的目标，在回应PA 05-143，是让博士l陈黄从美国。成为一个独立的研究人员在该地区的儿童健康相关的生活质量（HRQOL）的评估，衡量身体和心理社会功能，及其临床应用。本培训计划通过课程作业、指导性研究培训和儿科诊所的直接观察相结合，为黄博士提供了机会，以提高他的1）项目反应理论（IRT）和用于HRQOL测量的计算机自适应测试（CAT）技能; 2）理解父母-儿童-医生的互动和在儿科诊所使用HRQOL测量的障碍;（3）与HRQOL测量相关的儿童健康和发育知识。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提供实现目标的理想环境。父母报告说，HRQOL是他们与孩子的医生讨论治疗方案和决策过程中最重要的考虑因素之一。然而，目前的常规测量方法需要针对每种疾病（或使用不解决疾病特异性问题的通用仪器）和发育阶段的定制仪器，并且需要向每个儿童施用整个项目集。IRT的使用，结合CAT技术，有助于调整和定制项目，以更有效，更精确地测量儿童的HRQOL，并允许儿童的HRQOL跨发展和疾病轨迹的比较。在此次K23项目中，黄博士将利用IRT和模拟CAT技术开发儿童HRQOL测量工具，重点是创建HRQOL项目库和可用于临床环境的工具简式。他还将探讨父母，儿童和医生的态度和障碍，在临床环境中使用HRQOL。研究受试者将包括5 - 18岁儿童的父母（N= 2，000）、入组佛罗里达儿童护理项目（FKP）的8 - 18岁儿童（N=800）和来自三家儿科诊所的8 - 18岁儿童样本（N=240）。 公共卫生相关性：IRT/CAT承诺为儿童开发可行、准确和负担得起的HRQOL工具。这个K23项目将帮助黄博士开发先进的儿童HRQOL工具，可用于测量儿童的健康和功能状态，并促进治疗计划和父母，儿童和医生之间的共同决策

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