title: Customized computer-based administration of the PCL-5 for the efficient assessment of PTSD: A proof-of-principle study.
abstract: To investigate the potential of customized computer-based testing procedures to reduce the mean test length of the Posttraumatic Stress Checklist for DSM-5 (PCL-5).
  
  
  
  A retrospective analysis was conducted using responses from 942 adults who had completed the full-length (20-item) PCL-5 in the aftermath of Hurricane Sandy. The abilities of 2 testing procedures, curtailment and stochastic curtailment, to lessen the instrument's mean test length while maintaining the same result as the full-length PCL-5 ("positive" or "negative") were evaluated in a post hoc simulation. Curtailment and stochastic curtailment track a respondent's answers as she takes the instrument and stop the test if future items are unable or unlikely to change the result. The performance of each procedure was recorded under 2 scoring methods: a total-score-based method and a cluster-based method. Each procedure's sensitivity, specificity, and overall agreement with the full-length PCL-5 were computed.
  
  
  
  Curtailment reduced the mean test length by 40% under the total-score-based method, and by more than 70% under the cluster-based method, while exhibiting 100% sensitivity, specificity, and overall agreement with the full-length PCL-5. Stochastic curtailment reduced the mean test length by up to 88% under the total-score-based method, and up to 84% under the cluster-based method, while always exhibiting at least 92% sensitivity and 99.8% overall agreement, as well as 100% specificity, for the full-length PCL-5.
  
  
  
  Curtailment and stochastic curtailment have potential to enhance the efficiency of the PCL-5 when this assessment is administered by computer. The 2 procedures should be evaluated in future prospective studies. (PsycINFO Database Record
authors.affiliation: School of Dental Medicine, Tufts University.
authors.forename: Matthew D
authors.initials: MD
authors.lastname: Finkelman
authors.affiliation: Department of Psychology, Montclair State University.
authors.forename: Sarah R
authors.initials: SR
authors.lastname: Lowe
authors.affiliation: Measured Progress, Inc.
authors.forename: Wonsuk
authors.initials: W
authors.lastname: Kim
authors.affiliation: T.H. Chan School of Public Health, Harvard University.
authors.forename: Oliver
authors.identifier: 0000-0001-9783-4770
authors.initials: O
authors.lastname: Gruebner
authors.affiliation: Research Institute of Child Development and Education, University of Amsterdam.
authors.forename: Niels
authors.initials: N
authors.lastname: Smits
authors.affiliation: School of Public Health, Boston University.
authors.forename: Sandro
authors.identifier: 0000-0002-7534-0945
authors.initials: S
authors.lastname: Galea
mesh_terms: D000328:Adult; D000368:Aged; D057189:Checklist; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis*