A Computerized Adaptive Testing Version of the ASI

描述（由申请人提供）：此第二阶段申请建议继续开发ASI-MV-CAT，这是Inflexxion流行的成瘾严重程度指数多媒体版本（ASI-MV）的计算机自适应测试版本。ASI-MV建立在ASI的基础上，可能是美国最广泛使用的成人物质使用问题评估，ASI-MV为所有临床和研究目的提供了可靠，有效和具有成本效益的版本。ASI-MV Connect的互联网连接允许以与临床和管理系统兼容的方式自动收集数据。ASI-MV目前在全国500多个地点使用，每年有近10万人接种。尽管ASI-MV在商业上取得了巨大的成功，但目前版本的ASI-MV仍存在ASI本身固有的一些心理测量问题。在超过四分之一世纪前发展起来的，人们对ASI的心理测量性能越来越关注，特别是根据现代思维进行评估。此外，在过去25年中，滥用药物的性质、患者群体和治疗方法都发生了深刻的变化。因此，ASI和扩展的ASI-MV不能满足管理员、研究人员和临床医生的所有关键评估和治疗需求。ASI-MV-CAT旨在更新ASI，并提供简短但最先进的评估选项。ASI-MV充分证明了使用计算机介导的ASI给药的可行性。基于项目反应理论（IRT）的原理，ASI-MV的计算机自适应测试（CAT）版本将允许改进几个相关的测量概念：（1）导出分数的标度和维度，（2）客户问题严重性的间隔测量，（3）全面遵守科学测量原则，因此，（4）测量数据对统计分析的适用性。CAT还允许快速的ASI筛查或随访评估，可能会减少50%至80%的给药时间。在第I阶段，使用ASI-MV Connect评估的大型数据库（N = 23，400）实现特定目标。对所有ASI领域现有ASI项目的心理测量（经典测试理论-CTT和IRT）状态进行了全面检查。虽然有些领域的项目表现优于其他领域，但每个领域都需要更新和改进。两个池的潜在的新项目产生的就业和精神领域。第二阶段将完成四个具体目标：（1）为剩余的ASI领域开发和定性评估新的项目库（医疗、酒精、毒品、法律的和家庭/社会），（2）对大量治疗物质使用障碍的客户和社区非临床样本的整个项目库的综合心理测量分析，（3）建立一个功能齐全的ASI-MV-CAT原型，（4）对ASI-MV-CAT的有效性和变化敏感性进行经验测试。这些步骤将产生一个新的、更强大的ASI版本，这将代表这一重要工具发展的一个重大进步。 公共卫生相关性：ASI是药物滥用治疗个人的黄金标准评估。自其创建以来，滥用物质，患者人群，治疗和心理测量标准的变化表明需要更新版本。拟议的ASI-MV-CAT将满足这一需要，允许灵活和有效的管理选择，更新内容，并可以迅速传播。ASI-MV-CAT将具有重大的公共卫生意义和巨大的商业潜力。

DESCRIPTION (provided by applicant): This Phase II application proposes to continue development of the ASI-MV-CAT, a Computer Adaptive Testing edition of Inflexxion's popular Addiction Severity Index-Multimedia Version (ASI-MV). Built on the ASI, probably the most widely used adult assessment for substance use problems in the US, the ASI-MV provides a reliable, valid and cost-effective version for all clinical and research purposes. The Internet connectivity of ASI-MV Connect allows automated collection of data in a manner that is compatible with clinical and administrative systems. The ASI-MV is currently used at more than 500 sites throughout the country and is administered nearly a hundred thousand individuals annually. Despite its substantial commercial success, the current version of the ASI-MV suffers from some of the psychometric problems inherent in the ASI itself. Developed more than quarter century ago, concerns have mounted about the psychometric performance of the ASI, particularly as evaluated in light of modern thinking. Furthermore, profound changes in the nature of the substances abused, patient populations, and treatments have occurred during the past 25 years. Thus, the ASI and, by extension, the ASI-MV do not meet all critical assessment and treatment needs of administrators, researchers, and clinicians. The ASI-MV-CAT is intended to update the ASI and to provide the option for brief, but state-of-the-art, assessment. The ASI-MV has amply demonstrated the feasibility of using computer- mediated administration of the ASI. Based on principles of Item Response Theory (IRT), a computer adaptive testing (CAT) version of the ASI-MV will permit improvement in several, related measurement concepts: (1) scaling and dimensionality of derived scores, (2) interval measurement of clients' problem severity, (3) overall adherence to scientific measurement principles and hence, (4) applicability of measurement data to statistical analyses. CAT also permits a quick ASI screening or follow-up assessment that could potentially reduce administration time 50% to 80%. In Phase I, the Specific Aims were accomplished utilizing a large database of ASI-MV Connect assessments (N = 23,400). A comprehensive examination of the psychometric (classical test theory-CTT and IRT) status of the existing ASI items for all ASI domains was conducted. While some domain items performed better than others, each domain was found to require updating and improvement. Two pools of potential new items were generated for the employment and psychiatric domains. Phase II will see the completion of four Specific Aims: (1) development and qualitative evaluation of new pools of items for the remaining ASI domains (medical, alcohol, drug, legal, and family/social), (2) comprehensive psychometric analyses of the entire item bank on a large number of clients in treatment for substance use disorders and a community, non-clinical sample, (3) creation of a fully functioning prototype of an ASI-MV-CAT, and (4) empirical tests of validity and sensitivity to change of the ASI-MV-CAT. These steps will result in a new and more powerful version of the ASI that will represent a significant advance in the evolution of this important tool. PUBLIC HEALTH RELEVANCE: The ASI is the gold standard assessment for individuals in substance abuse treatment. Since its creation, changes in the substances abused, patient populations, treatments, and psychometric standards suggest the need for an updated version. The proposed ASI-MV-CAT would address this need and permit flexible and efficient administration options, updated content, and could be rapidly disseminated. The ASI-MV-CAT will have major public health importance and significant commercial potential.