02371nas a2200217   4500008004100000020002200041245010800063210006900171250001500240260001000255300001200265490000700277520166400284100001401948700001401962700001601976700001201992700001702004700001502021856011702036       2009                        Eng d  a1049-8931 (Print)00aEvaluation of a computer-adaptive test for the assessment of depression (D-CAT) in clinical application0 aEvaluation of a computeradaptive test for the assessment of depr  a2009/02/06  cFeb 4  a233-2360 v183 aIn the past, a German Computerized Adaptive Test, based on Item Response Theory (IRT), was developed for purposes of assessing the construct depression [Computer-adaptive test for depression (D-CAT)]. This study aims at testing the feasibility and validity of the real computer-adaptive application.The D-CAT, supplied by a bank of 64 items, was administered on personal digital assistants (PDAs) to 423 consecutive patients suffering from psychosomatic and other medical conditions (78 with depression). Items were adaptively administered until a predetermined reliability (r >/= 0.90) was attained. For validation purposes, the Hospital Anxiety and Depression Scale (HADS), the Centre for Epidemiological Studies Depression (CES-D) scale, and the Beck Depression Inventory (BDI) were administered. Another sample of 114 patients was evaluated using standardized diagnostic interviews [Composite International Diagnostic Interview (CIDI)].The D-CAT was quickly completed (mean 74 seconds), well accepted by the patients and reliable after an average administration of only six items. In 95% of the cases, 10 items or less were needed for a reliable score estimate. Correlations between the D-CAT and the HADS, CES-D, and BDI ranged between r = 0.68 and r = 0.77. The D-CAT distinguished between diagnostic groups as well as established questionnaires do.The D-CAT proved an efficient, well accepted and reliable tool. Discriminative power was comparable to other depression measures, whereby the CAT is shorter and more precise. Item usage raises questions of balancing the item selection for content in the future. Copyright (c) 2009 John Wiley & Sons, Ltd.1 aFliege, H1 aBecker, J1 aWalter, O B1 aRose, M1 aBjorner, J B1 aKlapp, B F  uhttp://mail.iacat.org/content/evaluation-computer-adaptive-test-assessment-depression-d-cat-clinical-application02752nas a2200433   4500008004100000020004600041245012800087210006900215250001500284300001200299490000700311520139300318653003401711653001501745653001001760653000901770653002201779653002501801653001101826653001101837653000901848653001601857653001501873653003801888653001901926653003101945653002801976653004802004653002202052100002002074700001202094700001402106700001602120700001402136700001702150700001502167700001502182856012102197       2009                        eng d  a1878-5921 (Electronic)0895-4356 (Linking)00aAn evaluation of patient-reported outcomes found computerized adaptive testing was efficient in assessing stress perception0 aevaluation of patientreported outcomes found computerized adapti  a2008/07/22  a278-2870 v623 aOBJECTIVES: 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.10a*Diagnosis, Computer-Assisted10aAdolescent10aAdult10aAged10aAged, 80 and over10aConfidence Intervals10aFemale10aHumans10aMale10aMiddle Aged10aPerception10aQuality of Health Care/*standards10aQuestionnaires10aReproducibility of Results10aSickness Impact Profile10aStress, Psychological/*diagnosis/psychology10aTreatment Outcome1 aKocalevent, R D1 aRose, M1 aBecker, J1 aWalter, O B1 aFliege, H1 aBjorner, J B1 aKleiber, D1 aKlapp, B F  uhttp://mail.iacat.org/content/evaluation-patient-reported-outcomes-found-computerized-adaptive-testing-was-efficient