Lian Jie, Cai Yan, Tu Dongbo, Xi Chongqin
School of Psychology, Jiangxi Normal University, Nanchang, China.
Front Psychol. 2020 Jul 8;11:1652. doi: 10.3389/fpsyg.2020.01652. eCollection 2020.
To detect the individual's severity of alcohol use disorder (AUD) in an effective and accurate manner, this study aimed to build an item bank for AUD screening and derive the computerized adaptive testing (CAT) version of AUD (CAT-AUD).
The initial CAT-AUD item bank was selected from the Chinese version of the questionnaires related to AUD according to the DSM-5 criteria. Then 915 valid Chinese samples, covering the healthy individuals and the AUD high-risk individuals, completed the initial CAT-AUD item bank. By testing the unidimensionality, test fit, item fit, discrimination parameter and differential item functioning of the initial item bank, the final CAT-AUD item bank confirming to the requirements of the item response theory (IRT) were obtained. Subsequently, the CAT-AUD simulation study based on the real data of the final item bank conducted to detect characteristics, reliability, validity, and predictive utility (sensitivity and specificity) of CAT-AUD.
The CAT-AUD item bank meeting the IRT psychometric measurement requirements could be well geared into the graded response model. The Pearson's correlation between the estimated theta via CAT-AUD and the estimated theta via the full-length item bank reached 0.95, and the criterion-related validity was 0.63. CAT-AUD can provide highly reliable test results for subjects whose theta above -0.8 with an average of 16 items. Besides, the predictive utility of CAT-AUD was better than AUDIT and AUDIT-C.
In brief, the CAT-AUD developed in this study can effectively screen the AUD high-risk group and accurately measure the AUD severity of individuals.
为有效、准确地检测个体酒精使用障碍（AUD）的严重程度，本研究旨在构建一个用于AUD筛查的题库，并得出AUD的计算机自适应测试（CAT）版本（CAT-AUD）。
根据DSM-5标准，从与AUD相关问卷的中文版中选取初始CAT-AUD题库。然后，915名有效的中国样本，包括健康个体和AUD高危个体，完成了初始CAT-AUD题库。通过测试初始题库的单维性、测验拟合度、项目拟合度、区分度参数和项目功能差异，获得了符合项目反应理论（IRT）要求的最终CAT-AUD题库。随后，基于最终题库的真实数据进行CAT-AUD模拟研究，以检测CAT-AUD的特征、信度、效度和预测效用（敏感性和特异性）。
符合IRT心理测量要求的CAT-AUD题库能够很好地拟合等级反应模型。通过CAT-AUD估计的θ与通过全长题库估计的θ之间的皮尔逊相关性达到0.95，且与标准相关的效度为0.63。对于θ高于-0.8的受试者，CAT-AUD平均用16个项目就能提供高度可靠的测试结果。此外，CAT-AUD的预测效用优于AUDIT和AUDIT-C。
简而言之，本研究开发的CAT-AUD能够有效筛查AUD高危群体，并准确测量个体的AUD严重程度。
