De Beurs Derek Paul, de Vries Anton Lm, de Groot Marieke H, de Keijser Jos, Kerkhof Ad Jfm
Faculty of Psychology and Education, Department of Clinical Psychology, VU University Amsterdam, Amsterdam, Netherlands.
J Med Internet Res. 2014 Sep 11;16(9):e207. doi: 10.2196/jmir.3511.
The Internet is used increasingly for both suicide research and prevention. To optimize online assessment of suicidal patients, there is a need for short, good-quality tools to assess elevated risk of future suicidal behavior. Computer adaptive testing (CAT) can be used to reduce response burden and improve accuracy, and make the available pencil-and-paper tools more appropriate for online administration.
The aim was to test whether an item response-based computer adaptive simulation can be used to reduce the length of the Beck Scale for Suicide Ideation (BSS).
The data used for our simulation was obtained from a large multicenter trial from The Netherlands: the Professionals in Training to STOP suicide (PITSTOP suicide) study. We applied a principal components analysis (PCA), confirmatory factor analysis (CFA), a graded response model (GRM), and simulated a CAT.
The scores of 505 patients were analyzed. Psychometric analyses showed the questionnaire to be unidimensional with good internal consistency. The computer adaptive simulation showed that for the estimation of elevation of risk of future suicidal behavior 4 items (instead of the full 19) were sufficient, on average.
This study demonstrated that CAT can be applied successfully to reduce the length of the Dutch version of the BSS. We argue that the use of CAT can improve the accuracy and the response burden when assessing the risk of future suicidal behavior online. Because CAT can be daunting for clinicians and applied scientists, we offer a concrete example of our computer adaptive simulation of the Dutch version of the BSS at the end of the paper.
互联网越来越多地用于自杀研究和预防。为了优化对自杀患者的在线评估，需要简短、高质量的工具来评估未来自杀行为风险升高的情况。计算机自适应测试（CAT）可用于减轻应答负担并提高准确性，使现有的纸笔工具更适合在线使用。
目的是测试基于项目反应的计算机自适应模拟是否可用于缩短贝克自杀意念量表（BSS）的长度。
我们模拟所用的数据来自荷兰一项大型多中心试验：预防自杀培训专业人员（PITSTOP自杀）研究。我们应用了主成分分析（PCA）、验证性因子分析（CFA）、等级反应模型（GRM）并模拟了CAT。
分析了505名患者的得分。心理测量分析表明该问卷为单维且具有良好的内部一致性。计算机自适应模拟表明，平均而言，对于未来自杀行为风险升高的估计，4个项目（而非全部19个项目）就足够了。
本研究表明，CAT可成功应用于缩短荷兰版BSS的长度。我们认为，在在线评估未来自杀行为风险时，使用CAT可以提高准确性并减轻应答负担。由于CAT对临床医生和应用科学家来说可能令人生畏，因此我们在论文末尾提供了荷兰版BSS计算机自适应模拟的具体示例。
