Development of symptom assessments utilising item response theory and computer-adaptive testing--a practical method based on a systematic review.
Assessment of individual patients' distress is a cornerstone of clinical care for advanced cancer. Patients' ability to fill out lengthy questionnaires is compromised by many factors. Computer-adaptive tests (CAT) offer a promising approach to developing tailored instruments, that administer only items relevant to the individual patient. A systematic review of the literature about CATs in medical databases was conducted. Based on the results, a method for developing a CAT was designed that requires nine steps: (1) build an item pool; (2) administer the items to a predefined sample in a calibration study; (3) eliminate inappropriate items; (4) examine whether all items are influenced by a single dominant trait; (5) calibrate the items to the best-fitting item response theory (IRT) model; (6) evaluate items' parameter equivalence across subgroups; (7) build an item bank with the calibrated items; (8) develop the CAT; and (9) pilot test the developed CAT. CAT offers the chance to extend the usefulness of patient-reported outcome (PRO) measurements from clinical studies to daily clinical practice.
Oncological Palliative Medicine, Section Oncology/Haematology, Department of Internal Medicine and Palliative Care Center, Cantonal Hospital, Rorschacherstrasse 95, 9007 St. Gallen, Switzerland.
Jochen
J
Walker
Jan R
JR
Böhnke
Thomas
T
Cerny
Florian
F
Strasser
D002138:Calibration; D003627:Data Interpretation, Statistical; D003936:Diagnosis, Computer-Assisted / Q000379:methods*; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010358:Patient Participation / Q000379:methods*; D012984:Software