title: Measuring anxiety after spinal cord injury: Development and psychometric characteristics of the SCI-QOL Anxiety item bank and linkage with GAD-7.
abstract: OBJECTIVE
  To develop a calibrated item bank and computer adaptive test to assess anxiety symptoms in individuals with spinal cord injury (SCI), transform scores to the Patient Reported Outcomes Measurement Information System (PROMIS) metric, and create a statistical linkage with the Generalized Anxiety Disorder (GAD)-7, a widely used anxiety measure.
  
  
  METHODS
  Grounded-theory based qualitative item development methods; large-scale item calibration field testing; confirmatory factor analysis; graded response model item response theory analyses; statistical linking techniques to transform scores to a PROMIS metric; and linkage with the GAD-7. Setting Five SCI Model System centers and one Department of Veterans Affairs medical center in the United States. Participants Adults with traumatic SCI.
  
  
  METHODS
  Spinal Cord Injury-Quality of Life (SCI-QOL) Anxiety Item Bank
  
  
  RESULTS
  Seven hundred sixteen individuals with traumatic SCI completed 38 items assessing anxiety, 17 of which were PROMIS items. After 13 items (including 2 PROMIS items) were removed, factor analyses confirmed unidimensionality. Item response theory analyses were used to estimate slopes and thresholds for the final 25 items (15 from PROMIS). The observed Pearson correlation between the SCI-QOL Anxiety and GAD-7 scores was 0.67.
  
  
  CONCLUSIONS
  The SCI-QOL Anxiety item bank demonstrates excellent psychometric properties and is available as a computer adaptive test or short form for research and clinical applications. SCI-QOL Anxiety scores have been transformed to the PROMIS metric and we provide a method to link SCI-QOL Anxiety scores with those of the GAD-7.
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Kisala
authors.forename: David S
authors.initials: DS
authors.lastname: Tulsky
authors.forename: Claire Z
authors.initials: CZ
authors.lastname: Kalpakjian
authors.forename: Allen W
authors.initials: AW
authors.lastname: Heinemann
authors.forename: Ryan T
authors.initials: RT
authors.lastname: Pohlig
authors.forename: Adam
authors.initials: A
authors.lastname: Carle
authors.forename: Seung W
authors.initials: SW
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D001007:Anxiety / Q000145:classification / Q000175:diagnosis* / Q000209:etiology; D005260:Female; D006305:Health Status Indicators; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D013119:Spinal Cord Injuries / Q000150:complications / Q000523:psychology*; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: Anxiety; Health-Related Quality of Life; Outcomes Assessment (Healthcare); Patient Reported Outcomes; Spinal Cord Injuries