Lai Jin-Shei, Cella David, Dineen Kelly, Bode Rita, Von Roenn Jamie, Gershon Richard C, Shevrin Daniel
Evanston Northwestern Healthcare, 1001 University Place, #100, Evanston, IL 60201, USA.
J Clin Epidemiol. 2005 Feb;58(2):190-7. doi: 10.1016/j.jclinepi.2003.07.016.
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.
The sample included 301 cancer patients. Psychometric properties of items were examined by using Rasch analysis, an Item Response Theory (IRT) model.
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.
癌症相关疲劳（CRF）是患者经历的最常见的未缓解症状之一。由于缺乏易于整合到临床中的临床敏感工具，CRF未得到充分认识和治疗。现代计算机自适应测试（CAT）可以通过在无需大量问题的情况下精确评估疲劳来克服这些障碍。一个有效的项目库对于CAT平台的开发至关重要。本报告描述了一个用于临床环境的可操作项目库的构建，其最终目标是改善CRF的识别和治疗。
样本包括301名癌症患者。使用拉施分析（一种项目反应理论（IRT）模型）检查项目的心理测量特性。
最终的项目库包括72个项目。根据因子分析结果，这72个单维项目解释了57.5%的方差。发现具有出色的内部一致性（α=0.99）和可接受的项目-总分相关性（范围：0.51-0.85）。这72个项目涵盖了疲劳连续体的合理范围。未发现明显的天花板效应、地板效应或差距。为演示目的创建了一个简短样本。由此产生的项目库适合CAT平台的开发。
