Providence VA Medical Center, Providence, RI 02908, USA.
BMC Med Res Methodol. 2012 Sep 17;12:145. doi: 10.1186/1471-2288-12-145.
The Computer Adaptive Test version of the Community Reintegration of Injured Service Members measure (CRIS-CAT) consists of three scales measuring Extent of, Perceived Limitations in, and Satisfaction with community integration. The CRIS-CAT was developed using item response theory methods. The purposes of this study were to assess the reliability, concurrent, known group and predictive validity and respondent burden of the CRIS-CAT.The CRIS-CAT was developed using item response theory methods. The purposes of this study were to assess the reliability, concurrent, known group and predictive validity and respondent burden of the CRIS-CAT.
This was a three-part study that included a 1) a cross-sectional field study of 517 homeless, employed, and Operation Enduring Freedom/Operation Iraqi Freedom (OEF/OIF) Veterans; who completed all items in the CRIS item set, 2) a cohort study with one year follow-up study of 135 OEF/OIF Veterans, and 3) a 50-person study of CRIS-CAT administration. Conditional reliability of simulated CAT scores was calculated from the field study data, and concurrent validity and known group validity were examined using Pearson product correlations and ANOVAs. Data from the cohort were used to examine the ability of the CRIS-CAT to predict key one year outcomes. Data from the CRIS-CAT administration study were used to calculate ICC (2,1) minimum detectable change (MDC), and average number of items used during CAT administration.
Reliability scores for all scales were above 0.75, but decreased at both ends of the score continuum. CRIS-CAT scores were correlated with concurrent validity indicators and differed significantly between the three Veteran groups (P < .001). The odds of having any Emergency Room visits were reduced for Veterans with better CRIS-CAT scores (Extent, Perceived Satisfaction respectively: OR = 0.94, 0.93, 0.95; P < .05). CRIS-CAT scores were predictive of SF-12 physical and mental health related quality of life scores at the 1 year follow-up. Scales had ICCs >0.9. MDCs were 5.9, 6.2, and 3.6, respectively for Extent, Perceived and Satisfaction subscales. Number of items (mn, SD) administered at Visit 1 were 14.6 (3.8) 10.9 (2.7) and 10.4 (1.7) respectively for Extent, Perceived and Satisfaction subscales.
The CRIS-CAT demonstrated sound measurement properties including reliability, construct, known group and predictive validity, and it was administered with minimal respondent burden. These findings support the use of this measure in assessing community reintegration.
社区伤兵重返社会适应度测试版（CRIS-CAT）的计算机自适应测试版由三个量表组成，分别测量社区融入的程度、感知限制和满意度。CRIS-CAT 是使用项目反应理论方法开发的。本研究的目的是评估 CRIS-CAT 的可靠性、同时效度、已知组和预测效度以及受访者负担。
这是一项三部分的研究，包括 1）对 517 名无家可归、就业和持久自由/伊拉克自由行动（OEF/OIF）退伍军人进行的横断面现场研究；他们完成了 CRIS 项目集中的所有项目，2）对 135 名 OEF/OIF 退伍军人进行了为期一年的随访研究，3）对 50 名 CRIS-CAT 管理进行了研究。使用现场研究数据计算模拟 CAT 分数的条件可靠性，并使用 Pearson 产品相关性和 ANOVA 检查同时效度和已知组有效性。队列数据用于检验 CRIS-CAT 预测关键一年结果的能力。CRIS-CAT 管理研究的数据用于计算 ICC（2,1）最小可检测变化（MDC）和 CAT 管理过程中使用的平均项目数量。
所有量表的可靠性得分均高于 0.75，但在得分连续体的两端均有所下降。CRIS-CAT 得分与同时效度指标相关，并且在三个退伍军人组之间存在显著差异（P<.001）。CRIS-CAT 得分较高的退伍军人急诊就诊的可能性降低（程度、感知满意度分别为：OR=0.94，0.93，0.95；P<.05）。CRIS-CAT 得分可预测 SF-12 生理和心理健康相关生活质量评分在 1 年随访时的得分。各量表的 ICC 均大于 0.9。MDC 分别为 5.9、6.2 和 3.6，分别为程度、感知和满意度分量表。在第 1 次就诊时，项目数量（mn，SD）分别为 14.6（3.8）、10.9（2.7）和 10.4（1.7），分别为程度、感知和满意度分量表。
CRIS-CAT 表现出良好的测量特性，包括可靠性、结构、已知组和预测效度，且受访者负担最小。这些发现支持在评估社区重新融入方面使用该措施。
