Computerized Adaptive Tests for Rapid and Accurate Assessment of Psychopathology Dimensions in Youth - 27/10/20
, David J. Kupfer, MD b, Ellen Frank, PhD b, Benjamin B. Lahey, PhD a, Brandie A. George-Milford, MA c, Candice L. Biernesser, LCSW, MPH d, Giovanna Porta, MS c, Tara L. Moore, MA, MPH e, Jong Bae Kim, PhD f, David A. Brent, MD b, cAbstract |
Objective |
At least half of youths with mental disorders are unrecognized and untreated. Rapid, accurate assessment of child mental disorders could facilitate identification and referral and potentially reduce the occurrence of functional disability that stems from early-onset mental disorders.
Method |
Computerized adaptive tests (CATs) based on multidimensional item response theory were developed for depression, anxiety, mania/hypomania, attention-deficit/hyperactivity disorder, conduct disorder, oppositional defiant disorder, and suicidality, based on parent and child ratings of 1,060 items each. In phase 1, CATs were developed from 801 participants. In phase 2, predictive, discriminant, and convergent validity were tested against semi-structured research interviews for diagnoses and suicidality in 497 patients and 104 healthy controls. Overall strength of association was determined by area under the receiver operating characteristic curve (AUC).
Results |
The child and parent independently completed the Kiddie−Computerized Adaptive Tests (K-CATs) in a median time of 7.56 and 5.03 minutes, respectively, with an average of 7 items per domain. The K-CATs accurately captured the presence of diagnoses (AUCs from 0.83 for generalized anxiety disorder to 0.92 for major depressive disorder) and suicidal ideation (AUC = 0.996). Strong correlations with extant measures were found (r ≥ 0.60). Test−retest reliability averaged r = 0.80.
Conclusion |
These K-CATs provide a new approach to child psychopathology screening and measurement. Testing can be completed by child and parent in less than 8 minutes and yields results that are highly convergent with much more time-consuming structured clinical interviews and dimensional severity assessment and measurement. Testing of the implementation of the K-CAT is now indicated.
Le texte complet de cet article est disponible en PDF.Key words : adaptive testing, multidimensional item response theory, child and adolescent psychopathology, measurement, diagnosis
Plan
| The K-CAT will be licensed for research and clinical use by Adaptive Testing Technologies (www.adaptivetestingtechnologies.com/). The study was supported by the National Institutes of Health (NIH) grant MH100155, with support for recruitment from the National Center for Advancing Translational Sciences (NCATS) grant TR001857. |
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| Drs. Gibbons, Kim, and Ms. Porta served as the statistical experts for this research. |
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| Disclosure: Dr. Gibbons is a founder of Adaptive Testing Technologies, which distributes the CAT-MH battery of adaptive tests. The terms of this arrangement have been reviewed and approved by the University of Chicago in accordance with its conflict of interest policies. He has served as an expert witness for Merck, Pfizer, GlaxoSmithKline, and the US Department of Justice. Dr. Kupfer is a founder of Adaptive Testing Technologies, which distributes the CAT-MH battery of adaptive tests. He has an equity interest in Adaptive Testing Technologies, Inc. and in HealthRhythms, Inc. of which he is a founder. He is a board member and holds an equity interest in Minerva Neuroscience, has served on an Advisory Board for and received honoraria from Servier, and has received royalties for the Pittsburgh Sleep Quality Index (PSQI) from the University of Pittsburgh. Dr. Frank is a founder of Adaptive Testing Technologies, which distributes the CAT-MH battery of adaptive tests. She has an equity interest in Adaptive Testing Technologies, Inc. and in HealthRhythms, Inc. and is a founder and an employee of HealthRhythms, Inc. She has received royalties from the American Psychological Association Press, has received honoraria from Pfizer, and has served on an advisory board for and received honoraria from Servier. Dr. Brent has received research support from the National Institute of Mental Health, the American Foundation for Suicide Prevention, the Once Upon a Time Foundation, and the Beckwith Foundation, has received royalties from Guilford Press from the electronic self-rated version of the C-SSRS from eRT, Inc. and from performing duties as an UptoDate Psychiatry Section Editor, and has received consulting fees from Healthwise. Drs. Lahey and Kim and Mss. George-Milford, Biernesser, Porta, and Moore have reported no biomedical financial interests or potential conflicts of interest. |
Vol 59 - N° 11
P. 1264-1273 - novembre 2020 Retour au numéro
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