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.
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H Wainer (2000) Computerized Adaptive testing: A Primer Lawrence Erlbaum Associates Inc. Mahwah, NJ
WJ Linden Particlevan der RK Hambleton (1997) Handbook of Modern Item Response Theory Springer Berlin
DO Segall (1996) ArticleTitleMultidimensional adaptive testing Psychometrika 61 IssueID2 331–354 Occurrence Handle10.1007/BF02294343
WJ Linden Particlevan der (1999) ArticleTitleMultidimensional adaptive testing with a minimum error-variance criterion J Educ Behav Stat 24 IssueID4 398–412
W Gardner KJ Kelleher KA Pajer (2002) ArticleTitleMultidimensional adaptive testing for mental health problems in primary care Med Care 40 IssueID9 812–823 Occurrence Handle10.1097/00005650-200209000-00010 Occurrence Handle12218771
WC Wang PH Chen YY Cheng (2004) ArticleTitleImproving measurement precision of test batteries using multidimensional item response models Psychol Methods 9 IssueID1 116–136 Occurrence Handle10.1037/1082-989X.9.1.116 Occurrence Handle15053722
WC Wang PH Chen (2004) ArticleTitleImplementation and measurement efficiency of multidimensional computerized adaptive testing Appl Psychol Meas 28 IssueID5 295–316
NK Aaronson S Ahmedzai B Bergman M Bullinger A Cull NJ Duez A Filiberti H Flechtner SB Fleishman JC Haes Particlede (1993) ArticleTitleThe European Organization for Research and Treatment of Cancer QLQ-C30: a quality-of-life instrument for use in international clinical trials in oncology J Natl Cancer Inst 85 IssueID5 365–376 Occurrence Handle1:STN:280:ByyC28vivVc%3D Occurrence Handle8433390
P Fayers A Bottomley (2002) ArticleTitleQuality of life research within the EORTC-the EORTC QLQ-C30. European Organisation for Research and Treatment of Cancer Eur J Cancer 38 IssueIDSuppl 4 S125–S133 Occurrence Handle11858978
A Garratt L Schmidt A Mackintosh R Fitzpatrick (2002) ArticleTitleQuality of life measurement: bibliographic study of patient assessed health outcome measures BMJ 324 IssueID7351 1417–1419 Occurrence Handle10.1136/bmj.324.7351.1417 Occurrence Handle12065262
LK Muthen BO Muthen (2001) Mplus User’s Guide Muthen & Muthen Los Angeles, CA
PM Fayers NK Aaronson K Bjordal M Groenvold D Curran A Bottomley (2001) The EORTC QLQ-C30 Scoring Manual European Organisation for Research and Treatment of Cancer Brussels
JB Bjorner MAa Petersen M Groenvold N Aaronson M Ahlner-Elmqvist JI Arraras P Fayers MS Jordhoy MA Sprangers T Young (2004) ArticleTitleUse of item response theory to develop a shortened version of the EORTC QLQ-C30 emotional function scale Qual Life Res 13 1683–1697 Occurrence Handle10.1007/s11136-004-7866-x Occurrence Handle1:STN:280:DC%2BD2M%2FisVyitg%3D%3D Occurrence Handle15651539
MAa Petersen M Groenvold JB Bjorner NK Aaronson T Conroy A Cull PM Fayers M Hjermstad MA Sprangers M Sullivan (2003) ArticleTitleUse of differential item functioning analysis to assess the equivalence of translations of a questionnaire Qual Life Res 12 IssueID4 373–385 Occurrence Handle10.1023/A:1023488915557 Occurrence Handle12797710
Lord FM. A theory of test scores. Psychometric Monogr 1952; 7.
RD Bock R Gibbons E Muraki (1988) ArticleTitleFull-information item factor analysis Appl Psychol Meas 12 IssueID3 261–280
Y Takane (1987) ArticleTitleOn the relationship between item response theory and factor analysis of discretized variables Psychometrika 52 IssueID3 393–408
RD Bock RJ Mislevy (1982) ArticleTitleAdaptive EAP estimation of ability in a microcomputer enviroment Appl Psychol Meas 6 IssueID4 431–444
H Wainer D Thissen (1987) ArticleTitleEstimating ability with the wrong model J Educ Stat 12 IssueID4 339–368
WH Press SA Teukolsky WT Vetterling BP Flannery (2002) Numerical Recipes in C++: The Art of Scientific Computing Cambridge University Press Cambridge
AD Mead F Drasgow (1993) ArticleTitleEquivalence of computerized and paper-and pencil cognitive ability tests: A meta-analysis Psychol Bull 114 IssueID3 449–458 Occurrence Handle10.1037/0033-2909.114.3.449
PM Fayers D Machin (2000) Quality of Life. Assessment, Analysis and Interpretation John Wiley & Sons Ltd Chichester
DT Karnofsky WH Abelman LF Craver JH Burchenal (1948) ArticleTitleThe use of the nitrogen mustards in the palliative treatment of carcinoma – with particular reference to Bronchogenic Carcinoma Cancer 1 IssueID4 634–656
AS Zigmond RP Snaith (1983) ArticleTitleThe hospital anxiety and depression scale Acta Psychiatr Scand 67 IssueID6 361–370 Occurrence Handle1:STN:280:BiyB2sbhtVw%3D Occurrence Handle6880820
InstitutionalAuthorNameSAS Institute Inc (1999) SAS Procedures Guide, Version 8 SAS Institute Inc. Cary, NC, USA
D Osoba (2002) ArticleTitleA taxonomy of the uses of health-related quality-of-life instruments in cancer care and the clinical meaningfulness of the results Med Care 40 IssueID6 Suppl III31–III38 Occurrence Handle12064756
Bartholomew D, Knott M. Latent Variable Models and Factor Analysis. Hodder & Stoughton, 1999.
JB Bjorner M Kosinski JE Ware SuffixJr (2003) ArticleTitleThe feasibility of applying item response theory to measures of migraine impact: A re-analysis of three clinical studies Qual Life Res 12 IssueID8 887–902 Occurrence Handle14651410
DA Revicki DF Cella (1997) ArticleTitleHealth status assessment for the twenty-first century: item response theory, item banking and computer adaptive testing Qual Life Res 6 IssueID6 595–600 Occurrence Handle10.1023/A:1018420418455 Occurrence Handle1:STN:280:ByiH2s7mtFM%3D Occurrence Handle9330558
JE Ware SuffixJr JB Bjorner M Kosinski (2000) ArticleTitlePractical implications of item response theory and computerized adaptive testing: a brief summary of ongoing studies of widely used headache impact scales Med Care 38 IssueID9 Suppl II73–II82 Occurrence Handle10982092
JE Ware SuffixJr M Kosinski JB Bjorner MS Bayliss A Batenhorst (2003) ArticleTitleApplications of computerized adaptive testing (CAT) to the assessment of headache impact Qual Life Res 12 IssueID8 935–952 Occurrence Handle14651413
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Petersen, M.A., Groenvold, M., Aaronson, N. et al. Multidimensional Computerized Adaptive Testing of the EORTC QLQ-C30: Basic Developments and Evaluations. Qual Life Res 15, 315–329 (2006). https://doi.org/10.1007/s11136-005-3214-z
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DOI: https://doi.org/10.1007/s11136-005-3214-z