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

描述(申请人提供)：为响应PA 05-143，这个以患者为导向的研究生涯指导奖(K23)的目标是允许来自佛罗里达大学的L-黄陈博士成为儿童健康相关生活质量评估领域的独立研究员，该评估衡量身体和心理社会功能及其临床应用。这一培训计划结合了课程作业、指导研究培训和在儿科诊所的直接观察，为黄医生提供了机会来增强他在1)项目反应理论(IRT)和用于HRQOL测量的计算机化自适应测试(CAT)方面的技能；2)了解父母、孩子和医生之间的互动以及在儿科诊所使用HRQOL测量的障碍；以及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部的资源以及与导师的密切联系将为黄博士提供实现他的目标的理想环境。父母报告说，在与孩子的医生讨论治疗方案时，以及在他们的决策过程中，HRQOL是他们最重要的考虑因素之一。然而，目前的常规测量方法需要为每种疾病定制仪器(或使用不解决疾病具体问题的通用仪器)和发育阶段，并需要为每个儿童管理整套项目。IRT结合CAT技术的使用，有助于调整和定制项目，以更有效和更准确地测量儿童的HRQOL，并允许比较儿童的HRQOL在发育和疾病轨迹上的差异。在本次K23奖项中，黄博士将使用IRT和模拟CAT技术来开发儿童HRQOL测量，重点创建可用于临床设置的HRQOL题库和工具的缩写。他还将探讨父母、孩子和医生对在临床环境中使用HRQOL的态度和障碍。研究对象将包括参加佛罗里达州儿童护理计划(FKP)的5至18岁儿童的父母(N=2000)、8至18岁儿童(N=800)以及来自三家儿科诊所的8至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、精确和负担得起的HRQOL工具。K23项目将帮助黄博士开发先进的儿童HRQOL工具，这些工具可以用来测量儿童的健康和功能状况，并促进治疗计划和父母、儿童和医生之间的共享决策

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