Aix-Marseille University, EA 3279 - Public Health, Chronic Diseases and Quality of Life - Research Unit, 13005, Marseille, France.
Aix-Marseille University - I2M UMR 7373 - Mathematics Institute of Marseille, 13009, Marseille, France.
Qual Life Res. 2018 Apr;27(4):1041-1054. doi: 10.1007/s11136-017-1553-1. Epub 2017 Mar 25.
Quality of life (QoL) is still assessed using paper-based and fixed-length questionnaires, which is one reason why QoL measurements have not been routinely implemented in clinical practice. Providing new QoL measures that combine computer technology with modern measurement theory may enhance their clinical use. The aim of this study was to develop a QoL multidimensional computerized adaptive test (MCAT), the SQoL-MCAT, from the fixed-length SQoL questionnaire for patients with schizophrenia.
In this multicentre cross-sectional study, we collected sociodemographic information, clinical characteristics (i.e., duration of illness, the PANSS, and the Calgary Depression Scale), and quality of life (i.e., SQoL). The development of the SQoL-CAT was divided into three stages: (1) multidimensional item response theory (MIRT) analysis, (2) multidimensional computerized adaptive test (MCAT) simulations with analyses of accuracy and precision, and (3) external validity.
Five hundred and seventeen patients participated in this study. The MIRT analysis found that all items displayed good fit with the multidimensional graded response model, with satisfactory reliability for each dimension. The SQoL-MCAT was 39% shorter than the fixed-length SQoL questionnaire and had satisfactory accuracy (levels of correlation >0.9) and precision (standard error of measurement <0.55 and root mean square error <0.3). External validity was confirmed via correlations between the SQoL-MCAT dimension scores and symptomatology scores.
The SQoL-MCAT is the first computerized adaptive QoL questionnaire for patients with schizophrenia. Tailored for patient characteristics and significantly shorter than the paper-based version, the SQoL-MCAT may improve the feasibility of assessing QoL in clinical practice.
生活质量（QoL）的评估仍然采用纸质固定长度问卷，这也是 QoL 测量并未常规应用于临床实践的原因之一。提供将计算机技术与现代测量理论相结合的新的 QoL 测量方法，可能会增强其临床应用。本研究旨在从固定长度的精神分裂症患者 SQoL 问卷中开发出一种 QoL 多维计算机化自适应测试（MCAT），即 SQoL-MCAT。
在这项多中心横断面研究中，我们收集了社会人口统计学信息、临床特征（即病程、PANSS 和 Calgary 抑郁量表）和生活质量（即 SQoL）。SQoL-CAT 的开发分为三个阶段：（1）多维项目反应理论（MIRT）分析；（2）多维计算机化自适应测试（MCAT）模拟以及准确性和精密度分析；（3）外部有效性。
共有 517 名患者参与了这项研究。MIRT 分析发现，所有项目与多维等级反应模型拟合良好，每个维度的可靠性均令人满意。与固定长度的 SQoL 问卷相比，SQoL-MCAT 缩短了 39%，且具有令人满意的准确性（相关水平>0.9）和精密度（测量标准误差<0.55 和均方根误差<0.3）。通过 SQoL-MCAT 维度评分与症状评分之间的相关性，验证了其外部有效性。
SQoL-MCAT 是首个针对精神分裂症患者的计算机化自适应 QoL 问卷。针对患者特征量身定制，且比纸质版本显著缩短，SQoL-MCAT 可能会提高在临床实践中评估 QoL 的可行性。
