Test-Retest Reliability of a Computerized Adaptive Depression Screener

Beiser, David G.; Vu, Milkie; Gibbons, Robert D.

doi:10.1176/appi.ps.201500304

Cited by 22 publications

(16 citation statements)

References 15 publications

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“…Because the CAT‐SUD asks different questions upon repeat administration, it can be repeatedly administered at any interval in time without response bias produced by repeated administration of the same items. Previous study of test–retest reliability using CAT for the measurement of depression showed higher reliability ( r = 0.92) than traditional fixed‐length tests despite the use of different items upon repeat testing .…”

Section: Discussionmentioning

confidence: 90%

Development of a computerized adaptive substance use disorder scale for screening and measurement: the CAT‐SUD

et al. 2020

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Background and aims The focus of this paper is on the improvement of substance use disorder (SUD) screening and measurement. Using a multi‐dimensional item response theory model, the bifactor model, we provide a psychometric harmonization between SUD, depression, anxiety, trauma, social isolation, functional impairment and risk‐taking behavior symptom domains, providing a more balanced view of SUD. The aims are to (1) develop the item‐bank, (2) calibrate the item‐bank using a bifactor model that includes a primary dimension and symptom‐specific subdomains, (3) administer using computerized adaptive testing (CAT) and (4) validate the CAT‐SUD in Spanish and English in the United States and Spain. Design Item bank construction, item calibration phase, CAT‐SUD validation phase. Setting Primary care, community clinics, emergency departments and patient‐to‐patient referrals in Spain (Barcelona and Madrid) and the United States (Boston and Los Angeles). Participants/cases Calibration phase: the CAT‐SUD was developed via simulation from complete item responses in 513 participants. Validation phase: 297 participants received the Composite International Diagnostic Interview (CIDI) and the CAT‐SUD. Measurements A total of 252 items from five subdomains: (1) SUD, (2) psychological disorders, (3) risky behavior, (4) functional impairment and (5) social support. CAT‐SUD scale scores and CIDI SUD diagnosis. Findings Calibration: the bifactor model provided excellent fit to the multi‐dimensional item bank; 168 items had high loadings (> 0.4 with the majority > 0.6) on the primary SUD dimension. Using an average of 11 items (four to 26), which represents a 94% reduction in respondent burden (average administration time of approximately 2 minutes), we found a correlation of 0.91 with the 168‐item scale (precision of 5 points on a 100‐point scale). Validation: strong agreement was found between the primary CAT‐SUD dimension estimate and the results of a structured clinical interview. There was a 20‐fold increase in the likelihood of a CIDI SUD diagnosis across the range of the CAT‐SUD (AUC = 0.85). Conclusions We have developed a new approach for the screening and measurement of SUD and related severity based on multi‐dimensional item response theory. The bifactor model harmonized information from mental health, trauma, social support and traditional SUD items to provide a more complete characterization of SUD. The CAT‐SUD is highly predictive of a current SUD diagnosis based on a structured clinical interview, and may be predictive of the development of SUD in the future.

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Section: Discussionmentioning

confidence: 90%

Development of a computerized adaptive substance use disorder scale for screening and measurement: the CAT‐SUD

et al. 2020

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“…Further, as the same questions on the CAT-MH are not repeatedly administered, patients can be routinely assessed in or out of the clinic without producing response bias due to repeated administration of the same questions using traditional instruments. 40 The CAT-MH was developed using multidimensional item response theory, which permits measurement of complex traits such as depression and anxiety, and allows for much larger item banks than CATs based on unidimensional item response theory. These features offer advantages over other electronic tools that have been tested in primary care, such as the PsyScan e-tool, 59 Patient-Reported Outcome Measure Information System (PROMIS) symptom measures (for which CATs are available), 54,60,61 and the Adaptive Pediatric Symptom Checklist.…”

Section: Discussionmentioning

confidence: 99%

“…Several CATs for depression and anxiety have been developed, [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] including the Computerized Adaptive Test for Mental Health (CAT-MH). The CAT-MH comprises a suite of assessments, including ones for MDD screening, 38 MDD severity, 39,40 and anxiety severity. 41 It was developed using multidimensional item response theory and random forests to capture the multidimensional nature of psychological disorders.…”

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confidence: 99%

Validation of the Computerized Adaptive Test for Mental Health in Primary Care

et al. 2019

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PURPOSE The US Preventive Services Task Force recommends screening for depression in the general adult population. Although screening questionnaires for depression and anxiety exist in primary care settings, electronic health tools such as computerized adaptive tests based on item response theory can advance screening practices. This study evaluated the validity of the Computerized Adaptive Test for Mental Health (CAT-MH) for screening for major depressive disorder (MDD) and assessing MDD and anxiety severity among adult primary care patients. METHODS We approached 402 English-speaking adults for participation from a primary care clinic, of whom 271 adults (71% female, 65% black) participated. Participants completed modules from the CAT-MH (Computerized Adaptive Diagnostic Test for MDD, CAT-Depression Inventory, CAT-Anxiety Inventory); brief paper questionnaires (9-item Patient Health Questionnaire [PHQ-9], 2-item Patient Health Questionnaire [PHQ-2], Generalized Anxiety Disorder 7-item Scale [GAD-7]); and a reference-standard interview, the Structured Clinical Interview for DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) Diagnoses. RESULTS On the basis of the interview, 31 participants met criteria for MDD and 29 met criteria for GAD. The diagnostic accuracy of the Computerized Adaptive Diagnostic Test for MDD (area under curve [AUC] = 0.85) was similar to that of the PHQ-9 (AUC = 0.84) and higher than that of the PHQ-2 (AUC = 0.76) for MDD screening. Using the interview as the reference standard, the accuracy of the CAT-Anxiety Inventory (AUC = 0.93) was similar to that of the GAD-7 (AUC = 0.97) for assessing anxiety severity. The patient-preferred screening method was assessment via tablet/computer with audio. CONCLUSIONS Computerized adaptive testing could be a valid and efficient patient-centered screening strategy for depression and anxiety screening in primary care settings.

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“…Indeed, Clinical and Health Psychology are the areas in which the development of CAT has been encouraged for the detection of pathological levels of Depression and Anxiety (e.g. Beiser et al, 2016;Devine et al, 2016;Gibbons et al, 2016).…”

Section: Psychological Thoughtmentioning

confidence: 99%

Item Banking for an Adaptive Measurement of Neuroticism

Abal

Lozzia

Auné

et al. 2020

PSYCT

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The psychometric properties of a bank of 36 items are presented measuring Neuroticism based on the Five-Factor Model. These items pertain to the facets that were identified by the work of McCrae and Costa. The sample was comprised of 1133 adult subjects that reside in the Buenos Aires Metropolitan Area in Argentina. Women accounted for 52.1% of those subjects with an average age of 29.5 years (SD = 11.32). In order to get the items calibrated according to Item Response Theory (Graded Response Model), acquire the bank’s information functions and assess the estimated associations with other instruments, 70% of the cases were randomly selected. An adaptive administration simulation was made with the remaining 30% so as to test two stopping rules: a) using 18 items and b) standard error of ≤ 0.25. Correlations greater than .95 were found between the estimated bank scores and the two adaptive versions. The advantages of using the adaptive Neuroticism measurement over other well-renowned instruments that use conventional large formats, as well as abbreviated ones, are discussed.

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Test-Retest Reliability of a Computerized Adaptive Depression Screener

Cited by 22 publications

References 15 publications

Development of a computerized adaptive substance use disorder scale for screening and measurement: the CAT‐SUD

Development of a computerized adaptive substance use disorder scale for screening and measurement: the CAT‐SUD

Validation of the Computerized Adaptive Test for Mental Health in Primary Care

Item Banking for an Adaptive Measurement of Neuroticism

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