@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 {52,
	title = {Improving patient reported outcomes using item response theory and computerized adaptive testing},
	journal = {Journal of Rheumatology},
	volume = {34},
	number = {6},
	year = {2007},
	note = {Chakravarty, Eliza FBjorner, Jakob BFries, James FAr052158/ar/niamsConsensus Development ConferenceResearch Support, N.I.H., ExtramuralCanadaThe Journal of rheumatologyJ Rheumatol. 2007 Jun;34(6):1426-31.},
	month = {Jun},
	pages = {1426-31},
	edition = {2007/06/07},
	abstract = {OBJECTIVE: Patient reported outcomes (PRO) are considered central outcome measures for both clinical trials and observational studies in rheumatology. More sophisticated statistical models, including item response theory (IRT) and computerized adaptive testing (CAT), will enable critical evaluation and reconstruction of currently utilized PRO instruments to improve measurement precision while reducing item burden on the individual patient. METHODS: We developed a domain hierarchy encompassing the latent trait of physical function/disability from the more general to most specific. Items collected from 165 English-language instruments were evaluated by a structured process including trained raters, modified Delphi expert consensus, and then patient evaluation. Each item in the refined data bank will undergo extensive analysis using IRT to evaluate response functions and measurement precision. CAT will allow for real-time questionnaires of potentially smaller numbers of questions tailored directly to each individual{\textquoteright}s level of physical function. RESULTS: Physical function/disability domain comprises 4 subdomains: upper extremity, trunk, lower extremity, and complex activities. Expert and patient review led to consensus favoring use of present-tense "capability" questions using a 4- or 5-item Likert response construct over past-tense "performance"items. Floor and ceiling effects, attribution of disability, and standardization of response categories were also addressed. CONCLUSION: By applying statistical techniques of IRT through use of CAT, existing PRO instruments may be improved to reduce questionnaire burden on the individual patients while increasing measurement precision that may ultimately lead to reduced sample size requirements for costly clinical trials.},
	keywords = {*Rheumatic Diseases/physiopathology/psychology, Clinical Trials, Data Interpretation, Statistical, Disability Evaluation, Health Surveys, Humans, International Cooperation, Outcome Assessment (Health Care)/*methods, Patient Participation/*methods, Research Design/*trends, Software},
	isbn = {0315-162X (Print)},
	author = {Chakravarty, E. F. and Bjorner, J. B. and Fries, J.F.}
}
@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.}
}
