An evaluation of patient-reported outcomes found computerized adaptive testing was efficient in assessing stress perception.
OBJECTIVE
This study aimed to develop and evaluate a first computerized adaptive test (CAT) for the measurement of stress perception (Stress-CAT), in terms of the two dimensions: exposure to stress and stress reaction.


METHODS
Item response theory modeling was performed using a two-parameter model (Generalized Partial Credit Model). The evaluation of the Stress-CAT comprised a simulation study and real clinical application. A total of 1,092 psychosomatic patients (N1) were studied. Two hundred simulees (N2) were generated for a simulated response data set. Then the Stress-CAT was given to n=116 inpatients, (N3) together with established stress questionnaires as validity criteria.


RESULTS
The final banks included n=38 stress exposure items and n=31 stress reaction items. In the first simulation study, CAT scores could be estimated with a high measurement precision (SE<0.32; rho>0.90) using 7.0+/-2.3 (M+/-SD) stress reaction items and 11.6+/-1.7 stress exposure items. The second simulation study reanalyzed real patients data (N1) and showed an average use of items of 5.6+/-2.1 for the dimension stress reaction and 10.0+/-4.9 for the dimension stress exposure. Convergent validity showed significantly high correlations.


CONCLUSIONS
The Stress-CAT is short and precise, potentially lowering the response burden of patients in clinical decision making.
Kocalevent
Rüya-Daniela
RD
Clinic for Internal Medicine, Department of Psychosomatic Medicine and Psychotherapy, Charité University Medicine Berlin, Berlin, Germany. rueya.kocalevent@fu-berlin.de
Rose
Matthias
M
Becker
Janine
J
Walter
Otto B
OB
Fliege
Herbert
H
Bjorner
Jakob B
JB
Kleiber
Dieter
D
Klapp
Burghard F
BF
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016001:Confidence Intervals; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010465:Perception; D011787:Quality of Health Care / Q000592:standards*; D015203:Reproducibility of Results; D018434:Sickness Impact Profile; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires; D016896:Treatment Outcome