Dong Fanghong, Moore Tyler M, Westfall Megan, Kohler Christian, Calkins Monica E
School of Nursing, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
Early Interv Psychiatry. 2023 Jan;17(1):96-106. doi: 10.1111/eip.13298. Epub 2022 Mar 27.
The Pennsylvania first episode psychosis program evaluation (PA-FEP-PE) core assessment battery was developed as a standard and comprehensive clinical assessment and data collection tool in Pennsylvania coordinated specialty care programs (CSC). To reduce administrative time and maximize clinical utility by maintaining acceptable levels of precision, we aimed to generate a short form using item response theory (IRT)-based computer-adaptive test (CAT) simulation and analyse the implementation and acceptability of the short form among providers from PA-CSC.
FEP participants (n = 759; age 14-36) from nine coordinated specialty care programs completed 156 items drawn from the PA-FEP-PE battery. Multidimensional IRT-based CAT simulations were used to select the best PA-FEP-PE items for abbreviated forms.
A 67-item PA-FEP-PE short form was developed to capture six factors: (1) positive affect and surgency (with negative loadings on Anxious-Misery items); (2) psychiatric services satisfaction; (3) antipsychotic side effect severity; (4) family turmoil and associated traumas; (5) trauma load; and (6) psychosis. The total number of items was reduced more than 50% in the PA-FEP-PE shortened forms. The short form demonstrated good psychometric properties, and it was well accepted by our providers in the implementation.
The empirical derivation and implementation of abbreviated measures of key domains and constructs in FEP care have streamlined and facilitated PA-FEP program evaluation. Our work supports potential application of IRT based methods to empirically reduce core assessment battery measures in large-scale data collection efforts such as in the Early Psychosis Intervention Network.
宾夕法尼亚首发精神病项目评估（PA - FEP - PE）核心评估量表是作为宾夕法尼亚协调专科护理项目（CSC）中的一种标准且全面的临床评估和数据收集工具而开发的。为了减少管理时间并通过保持可接受的精确水平来最大化临床效用，我们旨在使用基于项目反应理论（IRT）的计算机自适应测试（CAT）模拟生成一个简表，并分析该简表在宾夕法尼亚CSC提供者中的实施情况和可接受性。
来自九个协调专科护理项目的首发精神病参与者（n = 759；年龄14 - 36岁）完成了从PA - FEP - PE量表中抽取的156个项目。基于多维IRT的CAT模拟被用于为简化形式选择最佳的PA - FEP - PE项目。
开发了一个包含67个项目的PA - FEP - PE简表，以涵盖六个因素：（1）积极情感和活力（在焦虑 - 痛苦项目上为负向负荷）；（2）精神科服务满意度；（3）抗精神病药物副作用严重程度；（4）家庭动荡及相关创伤；（5）创伤负荷；以及（6）精神病。PA - FEP - PE简化形式中的项目总数减少了50%以上。该简表显示出良好的心理测量特性，并且在实施过程中得到了我们的提供者的良好接受。
首发精神病护理中关键领域和结构的简化测量方法的实证推导和实施简化并促进了PA - FEP项目评估。我们的工作支持基于IRT的方法在大规模数据收集工作（如早期精神病干预网络）中实证减少核心评估量表测量的潜在应用。
