02893nas a2200169   4500008004100000020001400041245011300055210006900168300001200237490000700249520229000256100001302546700001602559700001302575700001402588856012102602       2007                        eng d  a0962-934300aThe future of outcomes measurement: item banking, tailored short-forms, and computerized adaptive assessment0 afuture of outcomes measurement item banking tailored shortforms   a133-1410 v163 aThe use of item banks and computerized adaptive testing (CAT) begins with clear definitions of important outcomes, and references those definitions to specific questions gathered into large and well-studied pools, or “banks” of items. Items can be selected from the bank to form customized short scales, or can be administered in a sequence and length determined by a computer programmed for precision and clinical relevance. Although far from perfect, such item banks can form a common definition and understanding of human symptoms and functional problems such as fatigue, pain, depression, mobility, social function, sensory function, and many other health concepts that we can only measure by asking people directly. The support of the National Institutes of Health (NIH), as witnessed by its cooperative agreement with measurement experts through the NIH Roadmap Initiative known as PROMIS (www.nihpromis.org), is a big step in that direction. Our approach to item banking and CAT is practical; as focused on application as it is on science or theory. From a practical perspective, we frequently must decide whether to re-write and retest an item, add more items to fill gaps (often at the ceiling of the measure), re-test a bank after some modifications, or split up a bank into units that are more unidimensional, yet less clinically relevant or complete. These decisions are not easy, and yet they are rarely unforgiving. We encourage people to build practical tools that are capable of producing multiple short form measures and CAT administrations from common banks, and to further our understanding of these banks with various clinical populations and ages, so that with time the scores that emerge from these many activities begin to have not only a common metric and range, but a shared meaning and understanding across users. In this paper, we provide an overview of item banking and CAT, discuss our approach to item banking and its byproducts, describe testing options, discuss an example of CAT for fatigue, and discuss models for long term sustainability of an entity such as PROMIS. Some barriers to success include limitations in the methods themselves, controversies and disagreements across approaches, and end-user reluctance to move away from the familiar. 1 aCella, D1 aGershon, RC1 aLai, J-S1 aChoi, S W  uhttp://www.iacat.org/content/future-outcomes-measurement-item-banking-tailored-short-forms-and-computerized-adaptive02398nas a2200301   4500008004100000020002200041245010800063210006900171260002400240300000900264490000600273520142200279653002201701653003401723653002301757653003201780653001801812653002101830653001801851100001401869700001301883700001401896700001901910700001501929700001701944700001301961856012201974       2006                        eng d  a1529-7713 (Print)00aExpansion of a physical function item bank and development of an abbreviated form for clinical research0 aExpansion of a physical function item bank and development of an  bRichard M Smith: US  a1-150 v73 aWe expanded an existing 33-item physical function (PF) item bank with a sufficient number of items to enable computerized adaptive testing (CAT). Ten items were written to expand the bank and the new item pool was administered to 295 people with cancer. For this analysis of the new pool, seven poorly performing items were identified for further examination. This resulted in a bank with items that define an essentially unidimensional PF construct, cover a wide range of that construct, reliably measure the PF of persons with cancer, and distinguish differences in self-reported functional performance levels. We also developed a 5-item (static) assessment form ("BriefPF") that can be used in clinical research to express scores on the same metric as the overall bank. The BriefPF was compared to the PF-10 from the Medical Outcomes Study SF-36. Both short forms significantly differentiated persons across functional performance levels. While the entire bank was more precise across the PF continuum than either short form, there were differences in the area of the continuum in which each short form was more precise: the BriefPF was more precise than the PF-10 at the lower functional levels and the PF-10 was more precise than the BriefPF at the higher levels. Future research on this bank will include the development of a CAT version, the PF-CAT. (PsycINFO Database Record (c) 2007 APA, all rights reserved)10aclinical research10acomputerized adaptive testing10aperformance levels10aphysical function item bank10aPsychometrics10atest reliability10aTest Validity1 aBode, R K1 aLai, J-S1 aDineen, K1 aHeinemann, A W1 aShevrin, D1 aVon Roenn, J1 aCella, D  uhttp://www.iacat.org/content/expansion-physical-function-item-bank-and-development-abbreviated-form-clinical-research02160nas a2200289   4500008004100000245010000041210006900141260000800210300001200218490000700230520127700237653003401514653002101548653000901569653001201578653002201590653001101612653001101623653000901634653001601643653002901659653001901688100001301707700001501720700001301735856012201748       2006                        eng d00aFactor analysis techniques for assessing sufficient unidimensionality of cancer related fatigue0 aFactor analysis techniques for assessing sufficient unidimension  cSep  a1179-900 v153 aBACKGROUND: Fatigue is the most common unrelieved symptom experienced by people with cancer. The purpose of this study was to examine whether cancer-related fatigue (CRF) can be summarized using a single score, that is, whether CRF is sufficiently unidimensional for measurement approaches that require or assume unidimensionality. We evaluated this question using factor analysis techniques including the theory-driven bi-factor model. METHODS: Five hundred and fifty five cancer patients from the Chicago metropolitan area completed a 72-item fatigue item bank, covering a range of fatigue-related concerns including intensity, frequency and interference with physical, mental, and social activities. Dimensionality was assessed using exploratory and confirmatory factor analysis (CFA) techniques. RESULTS: Exploratory factor analysis (EFA) techniques identified from 1 to 17 factors. The bi-factor model suggested that CRF was sufficiently unidimensional. CONCLUSIONS: CRF can be considered sufficiently unidimensional for applications that require unidimensionality. One such application, item response theory (IRT), will facilitate the development of short-form and computer-adaptive testing. This may further enable practical and accurate clinical assessment of CRF.10a*Factor Analysis, Statistical10a*Quality of Life10aAged10aChicago10aFatigue/*etiology10aFemale10aHumans10aMale10aMiddle Aged10aNeoplasms/*complications10aQuestionnaires1 aLai, J-S1 aCrane, P K1 aCella, D  uhttp://www.iacat.org/content/factor-analysis-techniques-assessing-sufficient-unidimensionality-cancer-related-fatigue02443nas a2200373   4500008004100000020004100041245008200082210006900164250001500233260000800248300001000256490000700266520136700273653001001640653000901650653002201659653003301681653003301714653001101747653001101758653000901769653001601778653004001794653001801834653001901852100001301871700001301884700001401897700001201911700001701923700001601940700001501956856009801971       2005                        eng d  a0895-4356 (Print)0895-4356 (Linking)00aAn item bank was created to improve the measurement of cancer-related fatigue0 aitem bank was created to improve the measurement of cancerrelate  a2005/02/01  cFeb  a190-70 v583 aOBJECTIVE: Cancer-related fatigue (CRF) is one of the most common unrelieved symptoms experienced by patients. CRF is underrecognized and undertreated due to a lack of clinically sensitive instruments that integrate easily into clinics. Modern computerized adaptive testing (CAT) can overcome these obstacles by enabling precise assessment of fatigue without requiring the administration of a large number of questions. A working item bank is essential for development of a CAT platform. The present report describes the building of an operational item bank for use in clinical settings with the ultimate goal of improving CRF identification and treatment. STUDY DESIGN AND SETTING: The sample included 301 cancer patients. Psychometric properties of items were examined by using Rasch analysis, an Item Response Theory (IRT) model. RESULTS AND CONCLUSION: The final bank includes 72 items. These 72 unidimensional items explained 57.5% of the variance, based on factor analysis results. Excellent internal consistency (alpha=0.99) and acceptable item-total correlation were found (range: 0.51-0.85). The 72 items covered a reasonable range of the fatigue continuum. No significant ceiling effects, floor effects, or gaps were found. A sample short form was created for demonstration purposes. The resulting bank is amenable to the development of a CAT platform.10aAdult10aAged10aAged, 80 and over10aFactor Analysis, Statistical10aFatigue/*etiology/psychology10aFemale10aHumans10aMale10aMiddle Aged10aNeoplasms/*complications/psychology10aPsychometrics10aQuestionnaires1 aLai, J-S1 aCella, D1 aDineen, K1 aBode, R1 aVon Roenn, J1 aGershon, RC1 aShevrin, D  uhttp://www.iacat.org/content/item-bank-was-created-improve-measurement-cancer-related-fatigue01743nas a2200229   4500008004100000245008300041210006900124300001100193490000700204520103000211653003401241100001301275700001401288700001501302700001701317700001501334700001501349700001401364700001301378700001301391856010901404       2005                        eng d00aAn item response theory-based pain item bank can enhance measurement precision0 aitem response theorybased pain item bank can enhance measurement  a278-880 v303 aCancer-related pain is often under-recognized and undertreated. This is partly due to the lack of appropriate assessments, which need to be comprehensive and precise yet easily integrated into clinics. Computerized adaptive testing (CAT) can enable precise-yet-brief assessments by only selecting the most informative items from a calibrated item bank. The purpose of this study was to create such a bank. The sample included 400 cancer patients who were asked to complete 61 pain-related items. Data were analyzed using factor analysis and the Rasch model. The final bank consisted of 43 items which satisfied the measurement requirement of factor analysis and the Rasch model, demonstrated high internal consistency and reasonable item-total correlations, and discriminated patients with differing degrees of pain. We conclude that this bank demonstrates good psychometric properties, is sensitive to pain reported by patients, and can be used as the foundation for a CAT pain-testing platform for use in clinical practice.10acomputerized adaptive testing1 aLai, J-S1 aDineen, K1 aReeve, B B1 aVon Roenn, J1 aShervin, D1 aMcGuire, M1 aBode, R K1 aPaice, J1 aCella, D  uhttp://www.iacat.org/content/item-response-theory-based-pain-item-bank-can-enhance-measurement-precision00525nas a2200145   4500008004100000245008400041210006900125300001200194490000700206100001300213700001400226700001300240700001700253856010900270       2003                        eng d00aCan an item response theory-based pain item bank enhance measurement precision?0 aCan an item response theorybased pain item bank enhance measurem  aD34-D360 v251 aLai, J-S1 aDineen, K1 aCella, D1 aVon Roenn, J  uhttp://www.iacat.org/content/can-item-response-theory-based-pain-item-bank-enhance-measurement-precision02748nas a2200349   4500008004100000245015800041210006900199260000800268300001200276490000700288520160300295653003001898653002001928653001001948653003201958653001101990653001102001653000902012653001602021653002802037653001802065653003702083653004102120653002802161100001302189700001502202700001302217700001502230700001402245700001902259856012002278       2003                        eng d00aItem banking to improve, shorten and computerized self-reported fatigue: an illustration of steps to create a core item bank from the FACIT-Fatigue Scale0 aItem banking to improve shorten and computerized selfreported fa  cAug  a485-5010 v123 aFatigue is a common symptom among cancer patients and the general population. Due to its subjective nature, fatigue has been difficult to effectively and efficiently assess. Modern computerized adaptive testing (CAT) can enable precise assessment of fatigue using a small number of items from a fatigue item bank. CAT enables brief assessment by selecting questions from an item bank that provide the maximum amount of information given a person's previous responses. This article illustrates steps to prepare such an item bank, using 13 items from the Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-F) as the basis. Samples included 1022 cancer patients and 1010 people from the general population. An Item Response Theory (IRT)-based rating scale model, a polytomous extension of the Rasch dichotomous model was utilized. Nine items demonstrating acceptable psychometric properties were selected and positioned on the fatigue continuum. The fatigue levels measured by these nine items along with their response categories covered 66.8% of the general population and 82.6% of the cancer patients. Although the operational CAT algorithms to handle polytomously scored items are still in progress, we illustrated how CAT may work by using nine core items to measure level of fatigue. Using this illustration, a fatigue measure comparable to its full-length 13-item scale administration was obtained using four items. The resulting item bank can serve as a core to which will be added a psychometrically sound and operational item bank covering the entire fatigue continuum.10a*Health Status Indicators10a*Questionnaires10aAdult10aFatigue/*diagnosis/etiology10aFemale10aHumans10aMale10aMiddle Aged10aNeoplasms/complications10aPsychometrics10aResearch Support, Non-U.S. Gov't10aResearch Support, U.S. Gov't, P.H.S.10aSickness Impact Profile1 aLai, J-S1 aCrane, P K1 aCella, D1 aChang, C-H1 aBode, R K1 aHeinemann, A W  uhttp://www.iacat.org/content/item-banking-improve-shorten-and-computerized-self-reported-fatigue-illustration-steps00572nas a2200145   4500008004100000245011700041210006900158300000800227490001000235100001500245700001500260700001300275700001300288856012500301       2002                        eng d00aFeasibility and acceptability of computerized adaptive testing (CAT) for fatigue monitoring in clinical practice0 aFeasibility and acceptability of computerized adaptive testing C  a1340 v11(7)1 aDavis, K M1 aChang, C-H1 aLai, J-S1 aCella, D  uhttp://www.iacat.org/content/feasibility-and-acceptability-computerized-adaptive-testing-cat-fatigue-monitoring-clinical01910nas a2200229   4500008004100000245008600041210006900127300001000196490000700206520111400213653003201327653003701359653001001396653003401406653003001440653002901470653003201499100001601531700001801547700001301565856010201578       1999                        eng d00aThe use of Rasch analysis to produce scale-free measurement of functional ability0 ause of Rasch analysis to produce scalefree measurement of functi  a83-900 v533 aInnovative applications of Rasch analysis can lead to solutions for traditional measurement problems and can produce new assessment applications in occupational therapy and health care practice. First, Rasch analysis is a mechanism that translates scores across similar functional ability assessments, thus enabling the comparison of functional ability outcomes measured by different instruments. This will allow for the meaningful tracking of functional ability outcomes across the continuum of care. Second, once the item-difficulty order of an instrument or item bank is established by Rasch analysis, computerized adaptive testing can be used to target items to the patient's ability level, reducing assessment length by as much as one half. More importantly, Rasch analysis can provide the foundation for "equiprecise" measurement or the potential to have precise measurement across all levels of functional ability. The use of Rasch analysis to create scale-free measurement of functional ability demonstrates how this methodlogy can be used in practical applications of clinical and outcome assessment.10a*Activities of Daily Living10aDisabled Persons/*classification10aHuman10aOccupational Therapy/*methods10aPredictive Value of Tests10aQuestionnaires/standards10aSensitivity and Specificity1 aVelozo, C A1 aKielhofner, G1 aLai, J-S  uhttp://www.iacat.org/content/use-rasch-analysis-produce-scale-free-measurement-functional-ability