Becker Janine, Fliege Herbert, Kocalevent Rüya-Daniela, Bjorner Jakob B, Rose Matthias, Walter Otto B, Klapp Burghard F
Department of Psychosomatic Medicine and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany.
Depress Anxiety. 2008;25(12):E182-94. doi: 10.1002/da.20482.
The aim of this study was to evaluate the Computerized Adaptive Test to measure anxiety (A-CAT), a patient-reported outcome questionnaire that uses computerized adaptive testing to measure anxiety.
The A-CAT builds on an item bank of 50 items that has been built using conventional item analyses and item response theory analyses. The A-CAT was administered on Personal Digital Assistants to n=357 patients diagnosed and treated at the department of Psychosomatic Medicine and Psychotherapy, Charité Berlin, Germany. For validation purposes, two subgroups of patients (n=110 and 125) answered the A-CAT along with established anxiety and depression questionnaires.
The A-CAT was fast to complete (on average in 2 min, 38 s) and a precise item response theory based CAT score (reliability>.9) could be estimated after 4-41 items. On average, the CAT displayed 6 items (SD=4.2). Convergent validity of the A-CAT was supported by correlations to existing tools (Hospital Anxiety and Depression Scale-A, Beck Anxiety Inventory, Berliner Stimmungs-Fragebogen A/D, and State Trait Anxiety Inventory: r=.56-.66); discriminant validity between diagnostic groups was higher for the A-CAT than for other anxiety measures.
The German A-CAT is an efficient, reliable, and valid tool for assessing anxiety in patients suffering from anxiety disorders and other conditions with significant potential for initial assessment and long-term treatment monitoring. Future research directions are to explore content balancing of the item selection algorithm of the CAT, to norm the tool to a healthy sample, and to develop practical cutoff scores.
本研究旨在评估用于测量焦虑的计算机自适应测试（A-CAT），这是一种患者报告结局问卷，采用计算机自适应测试来测量焦虑。
A-CAT基于一个包含50个条目的题库构建，该题库使用传统的项目分析和项目反应理论分析构建而成。A-CAT在个人数字助理上对n = 357名在德国柏林夏里特医院身心医学与心理治疗科诊断和治疗的患者进行施测。为了进行效度验证，两组患者亚组（n = 110和125）在回答A-CAT的同时还回答了既定的焦虑和抑郁问卷。
A-CAT完成速度快（平均用时2分38秒），在回答4 - 41个条目后即可估计出基于精确项目反应理论的CAT分数（信度>.9）。平均而言，CAT显示6个条目（标准差 = 4.2）。A-CAT与现有工具（医院焦虑抑郁量表-A、贝克焦虑量表、柏林情绪问卷A/D和状态特质焦虑量表）的相关性支持了其收敛效度（r =.56 -.66）；A-CAT在诊断组之间的区分效度高于其他焦虑测量工具。
德国版A-CAT是一种高效、可靠且有效的工具，可用于评估焦虑症患者以及其他有显著初始评估和长期治疗监测潜力的疾病患者的焦虑情况。未来的研究方向是探索CAT项目选择算法的内容平衡、将该工具标准化到健康样本以及制定实用的截断分数。
