TY - JOUR T1 - Using computerized adaptive testing to reduce the burden of mental health assessment JF - Psychiatric Services Y1 - 2008 A1 - Gibbons, R. D. A1 - Weiss, D. J. A1 - Kupfer, D. J. A1 - Frank, E. A1 - Fagiolini, A. A1 - Grochocinski, V. J. A1 - Bhaumik, D. K. A1 - Stover, A. A1 - Bock, R. D. A1 - Immekus, J. C. KW - *Diagnosis, Computer-Assisted KW - *Questionnaires KW - Adolescent KW - Adult KW - Aged KW - Agoraphobia/diagnosis KW - Anxiety Disorders/diagnosis KW - Bipolar Disorder/diagnosis KW - Female KW - Humans KW - Male KW - Mental Disorders/*diagnosis KW - Middle Aged KW - Mood Disorders/diagnosis KW - Obsessive-Compulsive Disorder/diagnosis KW - Panic Disorder/diagnosis KW - Phobic Disorders/diagnosis KW - Reproducibility of Results KW - Time Factors AB - OBJECTIVE: This study investigated the combination of item response theory and computerized adaptive testing (CAT) for psychiatric measurement as a means of reducing the burden of research and clinical assessments. METHODS: Data were from 800 participants in outpatient treatment for a mood or anxiety disorder; they completed 616 items of the 626-item Mood and Anxiety Spectrum Scales (MASS) at two times. The first administration was used to design and evaluate a CAT version of the MASS by using post hoc simulation. The second confirmed the functioning of CAT in live testing. RESULTS: Tests of competing models based on item response theory supported the scale's bifactor structure, consisting of a primary dimension and four group factors (mood, panic-agoraphobia, obsessive-compulsive, and social phobia). Both simulated and live CAT showed a 95% average reduction (585 items) in items administered (24 and 30 items, respectively) compared with administration of the full MASS. The correlation between scores on the full MASS and the CAT version was .93. For the mood disorder subscale, differences in scores between two groups of depressed patients--one with bipolar disorder and one without--on the full scale and on the CAT showed effect sizes of .63 (p<.003) and 1.19 (p<.001) standard deviation units, respectively, indicating better discriminant validity for CAT. CONCLUSIONS: Instead of using small fixed-length tests, clinicians can create item banks with a large item pool, and a small set of the items most relevant for a given individual can be administered with no loss of information, yielding a dramatic reduction in administration time and patient and clinician burden. VL - 59 SN - 1075-2730 (Print) N1 - Gibbons, Robert DWeiss, David JKupfer, David JFrank, EllenFagiolini, AndreaGrochocinski, Victoria JBhaumik, Dulal KStover, AngelaBock, R DarrellImmekus, Jason CR01-MH-30915/MH/United States NIMHR01-MH-66302/MH/United States NIMHResearch Support, N.I.H., ExtramuralUnited StatesPsychiatric services (Washington, D.C.)Psychiatr Serv. 2008 Apr;59(4):361-8. ER -