TNO Child Health, P. O. Box 3005, 2301 DA, Leiden, the Netherlands.
GGD Hollands Noorden, Alkmaar, the Netherlands.
BMC Pediatr. 2020 Mar 12;20(1):119. doi: 10.1186/s12887-020-2018-1.
Questionnaires to detect emotional and behavioral problems (EBP) in Preventive Child Healthcare (PCH) should be short which potentially affects validity and reliability. Simulation studies have shown that Computerized Adaptive Testing (CAT) could overcome these weaknesses. We studied the applicability (using the measures participation rate, satisfaction, and efficiency) and the validity of CAT in routine PCH practice.
We analyzed data on 461 children aged 10-11 years (response 41%), who were assessed during routine well-child examinations by PCH professionals. Before the visit, parents completed the CAT and the Child Behavior Checklist (CBCL). Satisfaction was measured by parent- and PCH professional-report. Efficiency of the CAT procedure was measured as number of items needed to assess whether a child has serious problems or not. Its validity was assessed using the CBCL as the criterion.
Parents and PCH professionals rated the CAT on average as good. The procedure required at average 16 items to assess whether a child has serious problems or not. Agreement of scores on the CAT scales with corresponding CBCL scales was high (range of Spearman correlations 0.59-0.72). Area Under Curves (AUC) were high (range: 0.95-0.97) for the Psycat total, externalizing, and hyperactivity scales using corresponding CBCL scale scores as criterion. For the Psycat internalizing scale the AUC was somewhat lower but still high (0.86).
CAT is a valid procedure for the identification of emotional and behavioral problems in children aged 10-11 years. It may support the efficient and accurate identification of children with overall, and potentially also specific, emotional and behavioral problems in routine PCH.
在预防儿童保健（PCH）中，用于检测情绪和行为问题（EBP）的问卷应该简短，这可能会影响其有效性和可靠性。模拟研究表明，计算机化自适应测试（CAT）可以克服这些弱点。我们研究了 CAT 在常规 PCH 实践中的适用性（使用参与率、满意度和效率来衡量）和有效性。
我们分析了 461 名 10-11 岁儿童的数据（应答率为 41%），这些儿童在常规儿童健康检查期间由 PCH 专业人员进行评估。在就诊前，家长完成了 CAT 和儿童行为检查表（CBCL）。满意度通过家长和 PCH 专业人员报告来衡量。CAT 程序的效率通过评估儿童是否存在严重问题所需的项目数量来衡量。其有效性使用 CBCL 作为标准进行评估。
家长和 PCH 专业人员平均对 CAT 评价良好。该程序平均需要 16 个项目来评估儿童是否存在严重问题。CAT 量表的评分与相应 CBCL 量表的评分高度一致（Spearman 相关系数范围为 0.59-0.72）。使用相应 CBCL 量表评分作为标准时， Psycat 总分、外化和多动量表的曲线下面积（AUC）较高（范围为 0.95-0.97）。对于 Psycat 内部化量表，AUC 虽然略低，但仍然较高（0.86）。
CAT 是识别 10-11 岁儿童情绪和行为问题的有效方法。它可以支持在常规 PCH 中有效和准确地识别总体上、以及可能特定的情绪和行为问题的儿童。
