A Multidimensional Computerized Adaptive Short-Form Quality of Life Questionnaire Developed and Validated for Multiple Sclerosis

Michel, Pierre; Baumstarck, Karine; Ghattas, Badih; Pelletier, Jean; Loundou, Anderson; Auquier, Pascal; Boyer, Laurent

doi:10.1097/md.0000000000003068

Cited by 15 publications

(12 citation statements)

References 52 publications

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“…In this study, women had lower QoL scores than men, which is consistent with findings from one previous study. 42 Older age was significantly associated with worse scores, which is also consistent with previous findings. 42 Higher educational level or being in a couple was associated with higher QoL levels, as previously reported in similar cross-sectional studies.…”

Section: Discussionsupporting

confidence: 91%

“… 42 Older age was significantly associated with worse scores, which is also consistent with previous findings. 42 Higher educational level or being in a couple was associated with higher QoL levels, as previously reported in similar cross-sectional studies. 26 , 43 As expected, the DRT-based CAT score was more correlated with the dimension scores of the SF-36, with the MusiQoL constituting the item bank.…”

Section: Discussionsupporting

confidence: 91%

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Computerized adaptive testing with decision regression trees: an alternative to item response theory for quality of life measurement in multiple sclerosis

Michel¹,

Baumstarck²,

Loundou³

et al. 2018

PPA

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BackgroundThe aim of this study was to propose an alternative approach to item response theory (IRT) in the development of computerized adaptive testing (CAT) in quality of life (QoL) for patients with multiple sclerosis (MS). This approach relied on decision regression trees (DRTs). A comparison with IRT was undertaken based on precision and validity properties.Materials and methodsDRT- and IRT-based CATs were applied on items from a unidi-mensional item bank measuring QoL related to mental health in MS. The DRT-based approach consisted of CAT simulations based on a minsplit parameter that defines the minimal size of nodes in a tree. The IRT-based approach consisted of CAT simulations based on a specified level of measurement precision. The best CAT simulation showed the lowest number of items and the best levels of precision. Validity of the CAT was examined using sociodemographic, clinical and QoL data.ResultsCAT simulations were performed using the responses of 1,992 MS patients. The DRT-based CAT algorithm with minsplit = 10 was the most satisfactory model, superior to the best IRT-based CAT algorithm. This CAT administered an average of nine items and showed satisfactory precision indicators (R = 0.98, root mean square error [RMSE] = 0.18). The DRT-based CAT showed convergent validity as its score correlated significantly with other QoL scores and showed satisfactory discriminant validity.ConclusionWe presented a new adaptive testing algorithm based on DRT, which has equivalent level of performance to IRT-based approach. The use of DRT is a natural and intuitive way to develop CAT, and this approach may be an alternative to IRT.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Computerized adaptive testing with decision regression trees: an alternative to item response theory for quality of life measurement in multiple sclerosis

Michel¹,

Baumstarck²,

Loundou³

et al. 2018

PPA

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“…The lower the SEM, the higher the CAT reliability 99. To achieve satisfactory reliability (≥0.70), the SEM must be less than 0.55 100…”

Section: Methodsmentioning

confidence: 99%

<p>The Patient-Reported Experience Measure for Improving qUality of care in Mental health (PREMIUM) project in France: study protocol for the development and implementation strategy</p>

Fernandes¹,

Fond²,

Zendjidjian³

et al. 2019

PPA

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BackgroundMeasuring the quality and performance of health care is a major challenge in improving the efficiency of a health system. Patient experience is one important measure of the quality of health care, and the use of patient-reported experience measures (PREMs) is recommended. The aims of this project are 1) to develop item banks of PREMs that assess the quality of health care for adult patients with psychiatric disorders (schizophrenia, bipolar disorder, and depression) and to validate computerized adaptive testing (CAT) to support the routine use of PREMs; and 2) to analyze the implementation and acceptability of the CAT among patients, professionals, and health authorities.MethodsThis multicenter and cross-sectional study is based on a mixed method approach, integrating qualitative and quantitative methodologies in two main phases: 1) item bank and CAT development based on a standardized procedure, including conceptual work and definition of the domain mapping, item selection, calibration of the item bank and CAT simulations to elaborate the administration algorithm, and CAT validation; and 2) a qualitative study exploring the implementation and acceptability of the CAT among patients, professionals, and health authorities.DiscussionThe development of a set of PREMs on quality of care in mental health that overcomes the limitations of previous works (ie, allowing national comparisons regardless of the characteristics of patients and care and based on modern testing using item banks and CAT) could help health care professionals and health system policymakers to identify strategies to improve the quality and efficiency of mental health care.Trial registrationNCT02491866.

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“…Summarizing the available literature illustrating the feasibility and advantages of using MCAT in the field of health measurement, it can be observed that—although each of these studies made important contributions to the field—each of them had serious limitations when it comes to demonstrating the incremental value of MCAT over using separate UCATs. Some articles focused only on dichotomous data ( Allen et al, 2008 ; Haley et al, 2006 ), which is atypical for health measurement applications; other studies used very short item banks based on existing instruments not specifically developed for computerized adaptive testing ( Michel et al, 2016 ; Petersen et al, 2006 ), while the study by Bass and colleagues had a relatively low maximum test length and was restricted to two dimensions ( Bass et al, 2015 ). Nikolaus and colleagues advanced the field by studying the working mechanism of the MCAT they had developed to measure fatigue in patients with rheumatoid arthritis ( Nikolaus et al, 2015 ), as well as patient acceptance ( Nikolaus et al, 2014 ); they did not, however, explicitly compare MCAT with UCAT conditions.…”

Section: Introductionmentioning

confidence: 99%

Measuring Patient-Reported Outcomes Adaptively: Multidimensionality Matters!

Paap

Kroeze

Glas

et al. 2017

Applied Psychological Measurement

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As there is currently a marked increase in the use of both unidimensional (UCAT) and multidimensional computerized adaptive testing (MCAT) in psychological and health measurement, the main aim of the present study is to assess the incremental value of using MCAT rather than separate UCATs for each dimension. Simulations are based on empirical data that could be considered typical for health measurement: a large number of dimensions (4), strong correlations among dimensions (.77-.87), and polytomously scored response data. Both variable- (SE < .316, SE < .387) and fixed-length conditions (total test length of 12, 20, or 32 items) are studied. The item parameters and variance–covariance matrix Φ are estimated with the multidimensional graded response model (GRM). Outcome variables include computerized adaptive test (CAT) length, root mean square error (RMSE), and bias. Both simulated and empirical latent trait distributions are used to sample vectors of true scores. MCATs were generally more efficient (in terms of test length) and more accurate (in terms of RMSE) than their UCAT counterparts. Absolute average bias was highest for variable-length UCATs with termination rule SE < .387. Test length of variable-length MCATs was on average 20% to 25% shorter than test length across separate UCATs. This study showed that there are clear advantages of using MCAT rather than UCAT in a setting typical for health measurement.

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A Multidimensional Computerized Adaptive Short-Form Quality of Life Questionnaire Developed and Validated for Multiple Sclerosis

Abstract: Supplemental Digital Content is available in the text

Cited by 15 publications

References 52 publications

Computerized adaptive testing with decision regression trees: an alternative to item response theory for quality of life measurement in multiple sclerosis

Computerized adaptive testing with decision regression trees: an alternative to item response theory for quality of life measurement in multiple sclerosis

<p>The Patient-Reported Experience Measure for Improving qUality of care in Mental health (PREMIUM) project in France: study protocol for the development and implementation strategy</p>

Measuring Patient-Reported Outcomes Adaptively: Multidimensionality Matters!

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