02390nas a2200205   4500008004100000020001400041245008800055210006900143300001400212490000700226520173800233100001401971700001401985700002001999700001702019700001202036700001602048700001502064856010502079       2008                        eng d  a1520-639400aFunctioning and validity of a computerized adaptive test to measure anxiety (A CAT)0 aFunctioning and validity of a computerized adaptive test to meas  aE182-E1940 v253 aBackground: The aim of this study was to evaluate the Computerized Adaptive Test to measure anxiety (A-CAT), a patient-reported outcome questionnaire that uses computerized adaptive testing to measure anxiety. Methods: The A-CAT builds on an item bank of 50 items that has been built using conventional item analyses and item response theory analyses. The A-CAT was administered on Personal Digital Assistants to n=357 patients diagnosed and treated at the department of Psychosomatic Medicine and Psychotherapy, Charité Berlin, Germany. For validation purposes, two subgroups of patients (n=110 and 125) answered the A-CAT along with established anxiety and depression questionnaires. Results: The A-CAT was fast to complete (on average in 2 min, 38 s) and a precise item response theory based CAT score (reliability>.9) could be estimated after 4–41 items. On average, the CAT displayed 6 items (SD=4.2). Convergent validity of the A-CAT was supported by correlations to existing tools (Hospital Anxiety and Depression Scale-A, Beck Anxiety Inventory, Berliner Stimmungs-Fragebogen A/D, and State Trait Anxiety Inventory: r=.56–.66); discriminant validity between diagnostic groups was higher for the A-CAT than for other anxiety measures. Conclusions: The German A-CAT is an efficient, reliable, and valid tool for assessing anxiety in patients suffering from anxiety disorders and other conditions with significant potential for initial assessment and long-term treatment monitoring. Future research directions are to explore content balancing of the item selection algorithm of the CAT, to norm the tool to a healthy sample, and to develop practical cutoff scores. Depression and Anxiety, 2008. © 2008 Wiley-Liss, Inc.1 aBecker, J1 aFliege, H1 aKocalevent, R D1 aBjorner, J B1 aRose, M1 aWalter, O B1 aKlapp, B F  uhttp://www.iacat.org/content/functioning-and-validity-computerized-adaptive-test-measure-anxiety-cat03166nas a2200361   4500008004100000245012500041210006900166300001200235490000700247520200400254653002902258653001502287653001002302653000902312653002202321653002002343653003302363653002402396653001102420653001002431653000902441653001602450653002502466653002602491653004302517653003202560653001902592653002802611100001702639700001602656700001402672856011802686       2003                        eng d00aThe feasibility of applying item response theory to measures of migraine impact: a re-analysis of three clinical studies0 afeasibility of applying item response theory to measures of migr  a887-9020 v123 aBACKGROUND: 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.10a*Sickness Impact Profile10aAdolescent10aAdult10aAged10aComparative Study10aCost of Illness10aFactor Analysis, Statistical10aFeasibility Studies10aFemale10aHuman10aMale10aMiddle Aged10aMigraine/*psychology10aModels, Psychological10aPsychometrics/instrumentation/*methods10aQuality of Life/*psychology10aQuestionnaires10aSupport, Non-U.S. Gov't1 aBjorner, J B1 aKosinski, M1 aWare, Jr.  uhttp://www.iacat.org/content/feasibility-applying-item-response-theory-measures-migraine-impact-re-analysis-three