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Inflexion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，ASI-MV可能是美国最广泛使用的成人药物使用问题评估，为所有临床和研究目的提供了一个可靠、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10万人接受治疗。尽管ASI-MV在商业上取得了巨大成功，但目前版本的ASI-MV存在ASI本身固有的一些心理测量问题。ASI在四分之一个多世纪前发展起来，人们越来越担心ASI的心理测量表现，特别是根据现代思维进行评估。此外，在过去的25年里，滥用物质的性质、患者群体和治疗方法都发生了深刻的变化。因此，ASI和ASI-MV并不能满足管理者、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中介的ASI给药的可行性。根据项目反应理论(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)派生分数的标度和维度，(2)客户问题严重性的间隔测量，(3)总体上遵守科学测量原则，因此，(4)测量数据对统计分析的适用性。CAT还允许快速进行ASI筛查或后续评估，这可能会将管理时间减少50%至80%。在第一阶段，利用ASI-MV连接评估的大型数据库(N=23,400)实现了具体目标。对所有ASI领域的现有ASI项目的心理测量学(经典测试理论-CTT和IRT)状况进行了全面的检查。虽然有些领域的项目比其他领域的表现更好，但每个领域都需要更新和改进。为就业和精神病学领域产生了两个潜在的新项目池。第二阶段将完成四个具体目标：(1)开发和定性评估ASI其余领域(医疗、酒精、药物、法律和家庭/社会)的新题库，(2)对治疗药物使用障碍的大量客户和社区非临床样本的整个题库进行全面的心理测量分析，(3)创建ASI-MV-CAT的全功能原型，以及(4)对ASI-MV-CAT的有效性和对变化的敏感性进行经验测试。这些步骤将产生一个新的、功能更强大的ASI版本，这将代表着这一重要工具的发展取得了重大进展。 公共卫生相关性：ASI是药物滥用治疗个人的黄金标准评估。自创建以来，滥用物质、患者群体、治疗和心理测量标准的变化表明有必要更新版本。拟议的ASI-MV-CAT将满足这一需求，并允许灵活和有效的管理选择、更新内容，并可迅速传播。ASI-MV-CAT将具有重大的公共卫生重要性和巨大的商业潜力。

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.