@article {7,
	title = {Development and preliminary testing of a computerized adaptive assessment of chronic pain},
	journal = {Journal of Pain},
	volume = {10},
	number = {9},
	year = {2009},
	note = {Anatchkova, Milena DSaris-Baglama, Renee NKosinski, MarkBjorner, Jakob B1R43AR052251-01A1/AR/NIAMS NIH HHS/United StatesEvaluation StudiesResearch Support, N.I.H., ExtramuralUnited StatesThe journal of pain : official journal of the American Pain SocietyJ Pain. 2009 Sep;10(9):932-43.},
	month = {Sep},
	pages = {932-943},
	edition = {2009/07/15},
	abstract = {The aim of this article is to report the development and preliminary testing of a prototype computerized adaptive test of chronic pain (CHRONIC PAIN-CAT) conducted in 2 stages: (1) evaluation of various item selection and stopping rules through real data-simulated administrations of CHRONIC PAIN-CAT; (2) a feasibility study of the actual prototype CHRONIC PAIN-CAT assessment system conducted in a pilot sample. Item calibrations developed from a US general population sample (N = 782) were used to program a pain severity and impact item bank (kappa = 45), and real data simulations were conducted to determine a CAT stopping rule. The CHRONIC PAIN-CAT was programmed on a tablet PC using QualityMetric{\textquoteright}s Dynamic Health Assessment (DYHNA) software and administered to a clinical sample of pain sufferers (n = 100). The CAT was completed in significantly less time than the static (full item bank) assessment (P < .001). On average, 5.6 items were dynamically administered by CAT to achieve a precise score. Scores estimated from the 2 assessments were highly correlated (r = .89), and both assessments discriminated across pain severity levels (P < .001, RV = .95). Patients{\textquoteright} evaluations of the CHRONIC PAIN-CAT were favorable. PERSPECTIVE: This report demonstrates that the CHRONIC PAIN-CAT is feasible for administration in a clinic. The application has the potential to improve pain assessment and help clinicians manage chronic pain.},
	keywords = {*Computers, *Questionnaires, Activities of Daily Living, Adaptation, Psychological, Chronic Disease, Cohort Studies, Disability Evaluation, Female, Humans, Male, Middle Aged, Models, Psychological, Outcome Assessment (Health Care), Pain Measurement/*methods, Pain, Intractable/*diagnosis/psychology, Psychometrics, Quality of Life, User-Computer Interface},
	isbn = {1528-8447 (Electronic)1526-5900 (Linking)},
	author = {Anatchkova, M. D. and Saris-Baglama, R. N. and Kosinski, M. and Bjorner, J. B.}
}
@article {227,
	title = {An evaluation of patient-reported outcomes found computerized adaptive testing was efficient in assessing stress perception},
	journal = {Journal of Clinical Epidemiology},
	volume = {62},
	number = {3},
	year = {2009},
	note = {Kocalevent, Ruya-DanielaRose, MatthiasBecker, JanineWalter, Otto BFliege, HerbertBjorner, Jakob BKleiber, DieterKlapp, Burghard FEvaluation StudiesUnited StatesJournal of clinical epidemiologyJ Clin Epidemiol. 2009 Mar;62(3):278-87, 287.e1-3. Epub 2008 Jul 18.},
	pages = {278-287},
	edition = {2008/07/22},
	abstract = {OBJECTIVES: 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. STUDY DESIGN AND SETTING: 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.},
	keywords = {*Diagnosis, Computer-Assisted, Adolescent, Adult, Aged, Aged, 80 and over, Confidence Intervals, Female, Humans, Male, Middle Aged, Perception, Quality of Health Care/*standards, Questionnaires, Reproducibility of Results, Sickness Impact Profile, Stress, Psychological/*diagnosis/psychology, Treatment Outcome},
	isbn = {1878-5921 (Electronic)0895-4356 (Linking)},
	author = {Kocalevent, R. D. and Rose, M. and Becker, J. and Walter, O. B. and Fliege, H. and Bjorner, J. B. and Kleiber, D. and Klapp, B. F.}
}
@article {29,
	title = {Developing tailored instruments: item banking and computerized adaptive assessment},
	journal = {Quality of Life Research},
	volume = {16},
	number = {Suppl 1},
	year = {2007},
	note = {Bjorner, Jakob BueChang, Chih-HungThissen, DavidReeve, Bryce B1R43NS047763-01/NS/United States NINDSAG015815/AG/United States NIAResearch Support, N.I.H., ExtramuralNetherlandsQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitationQual Life Res. 2007;16 Suppl 1:95-108. Epub 2007 Feb 15.},
	pages = {95-108},
	edition = {2007/05/29},
	abstract = {Item banks and Computerized Adaptive Testing (CAT) have the potential to greatly improve the assessment of health outcomes. This review describes the unique features of item banks and CAT and discusses how to develop item banks. In CAT, a computer selects the items from an item bank that are most relevant for and informative about the particular respondent; thus optimizing test relevance and precision. Item response theory (IRT) provides the foundation for selecting the items that are most informative for the particular respondent and for scoring responses on a common metric. The development of an item bank is a multi-stage process that requires a clear definition of the construct to be measured, good items, a careful psychometric analysis of the items, and a clear specification of the final CAT. The psychometric analysis needs to evaluate the assumptions of the IRT model such as unidimensionality and local independence; that the items function the same way in different subgroups of the population; and that there is an adequate fit between the data and the chosen item response models. Also, interpretation guidelines need to be established to help the clinical application of the assessment. Although medical research can draw upon expertise from educational testing in the development of item banks and CAT, the medical field also encounters unique opportunities and challenges.},
	keywords = {*Health Status, *Health Status Indicators, *Mental Health, *Outcome Assessment (Health Care), *Quality of Life, *Questionnaires, *Software, Algorithms, Factor Analysis, Statistical, Humans, Models, Statistical, Psychometrics},
	isbn = {0962-9343 (Print)},
	author = {Bjorner, J. B. and Chang, C-H. and Thissen, D. and Reeve, B. B.}
}
@article {86,
	title = {IRT health outcomes data analysis project: an overview and summary},
	journal = {Quality of Life Research},
	volume = {16},
	number = {Suppl. 1},
	year = {2007},
	note = {Cook, Karon FTeal, Cayla RBjorner, Jakob BCella, DavidChang, Chih-HungCrane, Paul KGibbons, Laura EHays, Ron DMcHorney, Colleen AOcepek-Welikson, KatjaRaczek, Anastasia ETeresi, Jeanne AReeve, Bryce B1U01AR52171-01/AR/United States NIAMSR01 (CA60068)/CA/United States NCIY1-PC-3028-01/PC/United States NCIResearch Support, N.I.H., ExtramuralNetherlandsQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitationQual Life Res. 2007;16 Suppl 1:121-32. Epub 2007 Mar 10.},
	pages = {121-132},
	edition = {2007/03/14},
	abstract = {BACKGROUND: In June 2004, the National Cancer Institute and the Drug Information Association co-sponsored the conference, "Improving the Measurement of Health Outcomes through the Applications of Item Response Theory (IRT) Modeling: Exploration of Item Banks and Computer-Adaptive Assessment." A component of the conference was presentation of a psychometric and content analysis of a secondary dataset. OBJECTIVES: A thorough psychometric and content analysis was conducted of two primary domains within a cancer health-related quality of life (HRQOL) dataset. RESEARCH DESIGN: HRQOL scales were evaluated using factor analysis for categorical data, IRT modeling, and differential item functioning analyses. In addition, computerized adaptive administration of HRQOL item banks was simulated, and various IRT models were applied and compared. SUBJECTS: The original data were collected as part of the NCI-funded Quality of Life Evaluation in Oncology (Q-Score) Project. A total of 1,714 patients with cancer or HIV/AIDS were recruited from 5 clinical sites. MEASURES: Items from 4 HRQOL instruments were evaluated: Cancer Rehabilitation Evaluation System-Short Form, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Functional Assessment of Cancer Therapy and Medical Outcomes Study Short-Form Health Survey. RESULTS AND CONCLUSIONS: Four lessons learned from the project are discussed: the importance of good developmental item banks, the ambiguity of model fit results, the limits of our knowledge regarding the practical implications of model misfit, and the importance in the measurement of HRQOL of construct definition. With respect to these lessons, areas for future research are suggested. The feasibility of developing item banks for broad definitions of health is discussed.},
	keywords = {*Data Interpretation, Statistical, *Health Status, *Quality of Life, *Questionnaires, *Software, Female, HIV Infections/psychology, Humans, Male, Neoplasms/psychology, Outcome Assessment (Health Care)/*methods, Psychometrics, Stress, Psychological},
	isbn = {0962-9343 (Print)},
	author = {Cook, K. F. and Teal, C. R. and Bjorner, J. B. and Cella, D. and Chang, C-H. and Crane, P. K. and Gibbons, L. E. and Hays, R. D. and McHorney, C. A. and Ocepek-Welikson, K. and Raczek, A. E. and Teresi, J. A. and Reeve, B. B.}
}
@article {328,
	title = {Psychometric evaluation and calibration of health-related quality of life item banks: plans for the Patient-Reported Outcomes Measurement Information System (PROMIS)},
	journal = {Medical Care},
	volume = {45},
	number = {5 Suppl 1},
	year = {2007},
	note = {Reeve, Bryce BHays, Ron DBjorner, Jakob BCook, Karon FCrane, Paul KTeresi, Jeanne AThissen, DavidRevicki, Dennis AWeiss, David JHambleton, Ronald KLiu, HonghuGershon, RichardReise, Steven PLai, Jin-sheiCella, DavidPROMIS Cooperative GroupAG015815/AG/United States NIAResearch Support, N.I.H., ExtramuralUnited StatesMedical careMed Care. 2007 May;45(5 Suppl 1):S22-31.},
	month = {May},
	pages = {S22-31},
	edition = {2007/04/20},
	abstract = {BACKGROUND: The construction and evaluation of item banks to measure unidimensional constructs of health-related quality of life (HRQOL) is a fundamental objective of the Patient-Reported Outcomes Measurement Information System (PROMIS) project. OBJECTIVES: Item banks will be used as the foundation for developing short-form instruments and enabling computerized adaptive testing. The PROMIS Steering Committee selected 5 HRQOL domains for initial focus: physical functioning, fatigue, pain, emotional distress, and social role participation. This report provides an overview of the methods used in the PROMIS item analyses and proposed calibration of item banks. ANALYSES: Analyses include evaluation of data quality (eg, logic and range checking, spread of response distribution within an item), descriptive statistics (eg, frequencies, means), item response theory model assumptions (unidimensionality, local independence, monotonicity), model fit, differential item functioning, and item calibration for banking. RECOMMENDATIONS: Summarized are key analytic issues; recommendations are provided for future evaluations of item banks in HRQOL assessment.},
	keywords = {*Health Status, *Information Systems, *Quality of Life, *Self Disclosure, Adolescent, Adult, Aged, Calibration, Databases as Topic, Evaluation Studies as Topic, Female, Humans, Male, Middle Aged, Outcome Assessment (Health Care)/*methods, Psychometrics, Questionnaires/standards, United States},
	isbn = {0025-7079 (Print)},
	author = {Reeve, B. B. and Hays, R. D. and Bjorner, J. B. and Cook, K. F. and Crane, P. K. and Teresi, J. A. and Thissen, D. and Revicki, D. A. and Weiss,  D. J. and Hambleton, R. K. and Liu, H. and Gershon, R. C. and Reise, S. P. and Lai, J. S. and Cella, D.}
}
@article {311,
	title = {Multidimensional computerized adaptive testing of the EORTC QLQ-C30: basic developments and evaluations},
	journal = {Quality of Life Research},
	volume = {15},
	number = {3},
	year = {2006},
	note = {Petersen, Morten AaGroenvold, MogensAaronson, NeilFayers, PeterSprangers, MirjamBjorner, Jakob BEuropean Organisation for Research and Treatment of Cancer Quality of Life GroupResearch Support, Non-U.S. Gov{\textquoteright}tNetherlandsQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitationQual Life Res. 2006 Apr;15(3):315-29.},
	month = {Apr},
	pages = {315-29},
	edition = {2006/03/21},
	abstract = {OBJECTIVE: Self-report questionnaires are widely used to measure health-related quality of life (HRQOL). Ideally, such questionnaires should be adapted to the individual patient and at the same time scores should be directly comparable across patients. This may be achieved using computerized adaptive testing (CAT). Usually, CAT is carried out for a single domain at a time. However, many HRQOL domains are highly correlated. Multidimensional CAT may utilize these correlations to improve measurement efficiency. We investigated the possible advantages and difficulties of multidimensional CAT. STUDY DESIGN AND SETTING: We evaluated multidimensional CAT of three scales from the EORTC QLQ-C30: the physical functioning, emotional functioning, and fatigue scales. Analyses utilised a database with 2958 European cancer patients. RESULTS: It was possible to obtain scores for the three domains with five to seven items administered using multidimensional CAT that were very close to the scores obtained using all 12 items and with no or little loss of measurement precision. CONCLUSION: The findings suggest that multidimensional CAT may significantly improve measurement precision and efficiency and encourage further research into multidimensional CAT. Particularly, the estimation of the model underlying the multidimensional CAT and the conceptual aspects need further investigations.},
	keywords = {*Quality of Life, *Self Disclosure, Adult, Female, Health Status, Humans, Male, Middle Aged, Questionnaires/*standards, User-Computer Interface},
	isbn = {0962-9343 (Print)},
	author = {Petersen, M. A. and Groenvold, M. and Aaronson, N. K. and Fayers, P. and Sprangers, M. and Bjorner, J. B.}
}
@article {30,
	title = {Calibration of an item pool for assessing the burden of headaches: an application of item response theory to the Headache Impact Test (HIT)},
	journal = {Quality of Life Research},
	volume = {12},
	number = {8},
	year = {2003},
	note = {0962-9343Journal Article},
	pages = {913-933},
	abstract = {BACKGROUND: Measurement of headache impact is important in clinical trials, case detection, and the clinical monitoring of patients. Computerized adaptive testing (CAT) of headache impact has potential advantages over traditional fixed-length tests in terms of precision, relevance, real-time quality control and flexibility. OBJECTIVE: To develop an item pool that can be used for a computerized adaptive test of headache impact. METHODS: We analyzed responses to four well-known tests of headache impact from a population-based sample of recent headache sufferers (n = 1016). We used confirmatory factor analysis for categorical data and analyses based on item response theory (IRT). RESULTS: In factor analyses, we found very high correlations between the factors hypothesized by the original test constructers, both within and between the original questionnaires. These results suggest that a single score of headache impact is sufficient. We established a pool of 47 items which fitted the generalized partial credit IRT model. By simulating a computerized adaptive health test we showed that an adaptive test of only five items had a very high concordance with the score based on all items and that different worst-case item selection scenarios did not lead to bias. CONCLUSION: We have established a headache impact item pool that can be used in CAT of headache impact.},
	keywords = {*Cost of Illness, *Decision Support Techniques, *Sickness Impact Profile, Adolescent, Adult, Aged, Comparative Study, Disability Evaluation, Factor Analysis, Statistical, Headache/*psychology, Health Surveys, Human, Longitudinal Studies, Middle Aged, Migraine/psychology, Models, Psychological, Psychometrics/*methods, Quality of Life/*psychology, Software, Support, Non-U.S. Gov{\textquoteright}t},
	author = {Bjorner, J. B. and Kosinski, M. and Ware, J. E., Jr.}
}
@article {31,
	title = {The feasibility of applying item response theory to measures of migraine impact: a re-analysis of three clinical studies},
	journal = {Quality of Life Research},
	volume = {12},
	number = {8},
	year = {2003},
	note = {0962-9343Journal Article},
	pages = {887-902},
	abstract = {BACKGROUND: Item response theory (IRT) is a powerful framework for analyzing multiitem scales and is central to the implementation of computerized adaptive testing. OBJECTIVES: To explain the use of IRT to examine measurement properties and to apply IRT to a questionnaire for measuring migraine impact--the Migraine Specific Questionnaire (MSQ). METHODS: Data from three clinical studies that employed the MSQ-version 1 were analyzed by confirmatory factor analysis for categorical data and by IRT modeling. RESULTS: Confirmatory factor analyses showed very high correlations between the factors hypothesized by the original test constructions. Further, high item loadings on one common factor suggest that migraine impact may be adequately assessed by only one score. IRT analyses of the MSQ were feasible and provided several suggestions as to how to improve the items and in particular the response choices. Out of 15 items, 13 showed adequate fit to the IRT model. In general, IRT scores were strongly associated with the scores proposed by the original test developers and with the total item sum score. Analysis of response consistency showed that more than 90\% of the patients answered consistently according to a unidimensional IRT model. For the remaining patients, scores on the dimension of emotional function were less strongly related to the overall IRT scores that mainly reflected role limitations. Such response patterns can be detected easily using response consistency indices. Analysis of test precision across score levels revealed that the MSQ was most precise at one standard deviation worse than the mean impact level for migraine patients that are not in treatment. Thus, gains in test precision can be achieved by developing items aimed at less severe levels of migraine impact. CONCLUSIONS: IRT proved useful for analyzing the MSQ. The approach warrants further testing in a more comprehensive item pool for headache impact that would enable computerized adaptive testing.},
	keywords = {*Sickness Impact Profile, Adolescent, Adult, Aged, Comparative Study, Cost of Illness, Factor Analysis, Statistical, Feasibility Studies, Female, Human, Male, Middle Aged, Migraine/*psychology, Models, Psychological, Psychometrics/instrumentation/*methods, Quality of Life/*psychology, Questionnaires, Support, Non-U.S. Gov{\textquoteright}t},
	author = {Bjorner, J. B. and Kosinski, M. and Ware, J. E., Jr.}
}
