Computerized Adaptive Testing - Depression Inventory

描述（由申请人提供）：本研究的目的是开发和评估用于评估抑郁症的计算机自适应测试程序和算法。在最初的研究中，我们证明了项目反应理论（IRT）和计算机自适应测试（CAT）在开发和管理大型（626个项目）的心理健康评定量表的可行性。使用626个情绪和焦虑障碍症状项目的项目库，我们发现：（a）项目库中的大多数项目（90%）可区分情绪障碍的高水平和低水平，（B）双因素IRT模型在解释症状领域内项目的聚类方面做得很好，（c）平均而言，测试的CAT管理导致对个体受试者管理的项目数量减少95%（626个项目中的24个使用模拟CAT，31个用于现场CAT测试），（4）CAT损伤评定与626个项目的得分之间的相关系数r=0.93。基于这些非常令人鼓舞的初步结果，这个竞争性的更新建议使用IRT和CAT开发CAT抑郁量表（CAT-DI）。更新的具体目标是：（1）通过对约100个现有抑郁量表和以前作为PROMIS网络一部分识别的抑郁条目进行回顾，创建抑郁条目库，（2）使用各种IRT模型校准抑郁条目库（一维，双因素，多维）使用平衡不完全区组（BIB）设计，给予800名抑郁症患者和200名非抑郁症对照，（3）获得300名受试者的新样本（200例抑郁，100例非抑郁），取样本库中的所有项目，进行模拟CAT，并优化CAT的调谐参数（200例抑郁，100例非抑郁）用于活CAT测试，（5）将最终的CAT-DI应用于700名患者的社区样本（约200例符合重度抑郁症- MOD标准），以测试有效性（比较有和没有MOD的患者的损伤估计），预测MOD，并建立患者筛查的标准范围，和（6）对来自行为健康诊所的患者进行20次认知访谈，这些患者将CAT-DI作为β-测试仪器。

DESCRIPTION (provided by applicant): The aim of this investigation is to develop and evaluate computerized adaptive testing programs and algorithms for the assessment of depression. In the original study we demonstrated the feasibility of item response theory (IRT), and computerized adaptive testing (CAT) in the development and administration of a large (626 item) mental health rating scale. Using an item bank of 626 mood and anxiety disorder symptom items, we found that (a) the majority of the items in the item bank (90%) were discriminating of high and low levels of mood disorders, (b) the bi-factor IRT model did an excellent job of accounting for the clustering of items within symptom domains, (c) on average, CAT administration of the test resulted in a 95% reduction in the number of items administered to an individual subject (24 out of 626 items using simulated CAT and 31 items for live CAT testing), and (d) the correlation between the CAT based impairment rating and the score based on all 626 items was r=0.93. Based on these very encouraging preliminary results, this competitive renewal proposes to use IRT and CAT to develop a CAT Depression Inventory (CAT-DI). The specific objectives of the renewal are (1) create a depression item bank by collecting items from a review of approximately 100 existing depression scales and depression items previously identified as a part of the PROMIS network, (2) calibrate the depression item bank using a variety of IRT models (unidimensional, bi-factor, multidimensional) using a balanced incomplete blocks (BIB) design administered to 800 depressed patients and 200 non-depressed controls, (3) obtain a new sample of 300 subjects (200 depressed, 100 non-depressed) that take all of the items in the bank, perform a simulated CAT, and optimize the tuning parameters of the CAT, (4) obtain a new sample 300 subjects (200 depressed, 100 non- depressed) for live CAT testing, (5) apply the final CAT-DI to a community sample of 700 patients (approximately 200 meeting criteria for major depressive disorder - MOD) to test validity (comparison of impairment estimates in patients with and without MOD), predicting MOD, and establishing normative ranges for patient screening, and (6) conduct 20 cognitive interviews of patients from a behavioral health clinic who have taken the CAT-DI as a qualitative research approach to beta-testing of the instrument.