TY - JOUR T1 - Developing tailored instruments: item banking and computerized adaptive assessment JF - Quality of Life Research Y1 - 2007 A1 - Bjorner, J. B. A1 - Chang, C-H. A1 - Thissen, D. A1 - Reeve, B. B. KW - *Health Status KW - *Health Status Indicators KW - *Mental Health KW - *Outcome Assessment (Health Care) KW - *Quality of Life KW - *Questionnaires KW - *Software KW - Algorithms KW - Factor Analysis, Statistical KW - Humans KW - Models, Statistical KW - Psychometrics AB - Item banks and Computerized Adaptive Testing (CAT) have the potential to greatly improve the assessment of health outcomes. This review describes the unique features of item banks and CAT and discusses how to develop item banks. In CAT, a computer selects the items from an item bank that are most relevant for and informative about the particular respondent; thus optimizing test relevance and precision. Item response theory (IRT) provides the foundation for selecting the items that are most informative for the particular respondent and for scoring responses on a common metric. The development of an item bank is a multi-stage process that requires a clear definition of the construct to be measured, good items, a careful psychometric analysis of the items, and a clear specification of the final CAT. The psychometric analysis needs to evaluate the assumptions of the IRT model such as unidimensionality and local independence; that the items function the same way in different subgroups of the population; and that there is an adequate fit between the data and the chosen item response models. Also, interpretation guidelines need to be established to help the clinical application of the assessment. Although medical research can draw upon expertise from educational testing in the development of item banks and CAT, the medical field also encounters unique opportunities and challenges. VL - 16 SN - 0962-9343 (Print) N1 - Bjorner, Jakob BueChang, Chih-HungThissen, DavidReeve, Bryce B1R43NS047763-01/NS/United States NINDSAG015815/AG/United States NIAResearch Support, N.I.H., ExtramuralNetherlandsQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitationQual Life Res. 2007;16 Suppl 1:95-108. Epub 2007 Feb 15. ER - TY - JOUR T1 - Item banking to improve, shorten and computerized self-reported fatigue: an illustration of steps to create a core item bank from the FACIT-Fatigue Scale JF - Quality of Life Research Y1 - 2003 A1 - Lai, J-S. A1 - Crane, P. K. A1 - Cella, D. A1 - Chang, C-H. A1 - Bode, R. K. A1 - Heinemann, A. W. KW - *Health Status Indicators KW - *Questionnaires KW - Adult KW - Fatigue/*diagnosis/etiology KW - Female KW - Humans KW - Male KW - Middle Aged KW - Neoplasms/complications KW - Psychometrics KW - Research Support, Non-U.S. Gov't KW - Research Support, U.S. Gov't, P.H.S. KW - Sickness Impact Profile AB - Fatigue 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. VL - 12 N1 - 0962-9343Journal Article ER -