Computerized Adaptive Testing - Depression Inventory

描述（由申请人提供）：抑郁症每年花费美国400亿美元（Rice &米勒，1998）。2000年，在男女和所有年龄组的残疾调整生命年中，单是单相抑郁症就排在第四位（卫生组织，2001年）。此外，精神疾病往往是慢性的，对其他慢性疾病有深远的影响。2002年，美国预防服务工作组认可在一般医疗实践中进行抑郁症筛查，但没有推荐特定的筛查工具（Pignone，Gaynes，Rushton et al.，2002年）。社区诊所在检测和治疗抑郁症方面发挥着关键作用。然而，社区或初级保健诊所的抑郁症筛查人员通常很简短，一些研究只使用医生口头询问的2个问题（Arroll，Khin和Kerse，2005）。拟议的补充（修订）研究将通过调查在计算机化自适应测试（CAT）环境中管理的抑郁量表项目对重度抑郁症（MDD）诊断分类的有效性来扩大当前补助金的性质，该诊断分类基于精神疾病诊断和统计手册- IV（DSM-IV;美国精神病学协会，1994年）。这项奋进建立在正在进行的研究基础上，通过（a）开发一个专门设计的患者报告量表项目库（约100个），以符合MDD诊断的DSM-IV标准，（B）开发和评估四个统计模型，以识别患有MDD的个体和未患有MDD的个体，以及（c）将基于CAT的MDD诊断与传统DSM诊断进行比较。还将研究该方法区分轻度抑郁症和重度抑郁症的能力。这项研究代表了使用患者报告的结果来诊断抑郁症的重大进展。公共卫生相关性：抑郁症每年给美国造成400亿美元的损失（Rice &米勒，1998）。2002年，美国预防服务工作组认可在一般医疗实践中进行抑郁症筛查，但没有推荐特定的筛查工具（Pignone，Gaynes，Rushton et al.，2002年）。拟议的研究响应这一重要的建议，开发一个新的模式，用于快速诊断重性抑郁症（MDD）的基础上，一个新的应用程序的计算机自适应测试（CAT）和项目反应理论。由此产生的CAT为基础的MDD诊断系统提供了一个筛选工具，可用于精神病和初级保健设置，并根据患者报告的结果。

DESCRIPTION (provided by applicant): Depression costs the United States $40 billion annually (Rice & Miller, 1998). Unipolar depression alone ranked fourth among the leading causes of disability-adjusted life years (DALYs) in both sexes and all age groups in 2000 (WHO, 2001). In addition, psychiatric disorders are often chronic and have a profound impact on other chronic medical illnesses. In 2002, the U.S. Preventive Services Task Force endorsed depression screening in general medical practice but did not recommend a specific screening tool (Pignone, Gaynes, Rushton et al., 2002). Community clinics play a pivotal role in the detection and treatment of depressive disorders. However, depression screeners in community or primary care clinics are usually brief with some studies using as few as 2 questions orally asked by the physician (Arroll, Khin, & Kerse, 2005). The proposed supplemental (revision) research will expand the nature of the current grant by investigating the efficacy of depression scale items administered in a computerized adaptive testing (CAT) environment for the diagnostic classification of Major Depressive Disorder (MDD), based on the Diagnostic and Statistical Manual of Mental Disorders - IV (DSM-IV; American Psychiatric Association, 1994). This endeavor builds on the ongoing research by (a) developing a bank of patient reported scale items (approximately 100) designed specifically to correspond to the DSM-IV criteria for MDD diagnosis, (b) developing and evaluating four statistical models to identify individuals experiencing MDD from those who are not, and (c) comparing MDD diagnosis based on CAT to traditional DSM diagnosis. The ability of the methodology to differentiate minor from major depression will also be investigated. This research represents a major advance in the use of patient reported outcomes to diagnose depression. PUBLIC HEALTH RELEVANCE: Depression costs the United States $40 billion annually (Rice & Miller, 1998). In 2002, the U.S. Preventive Services Task Force endorsed depression screening in general medical practice but did not recommend a specific screening tool (Pignone, Gaynes, Rushton et al., 2002). The proposed research responds to this important recommendation by developing a new paradigm for the rapid diagnosis of major depressive disorder (MDD) based on a novel application of computer adaptive testing (CAT) and item response theory. The resulting CAT-based MDD diagnostic system provides a screening tool that can be used in both psychiatric and primary care settings, and is based on patient reported outcomes.