Multidimensional Adaptive Testing for Mental Health Problems in Primary Care

Bibliographic Data

ID9101941
AuthorsWendi Gardner (0000-0003-1918-3540, University of Pittsburgh, corresponding author), William Gardner (0000-0001-9721-1602), Kelly J Kelleher (0000-0002-4420-8044, University of Pittsburgh), Kathleen Pajer (0000-0002-3699-9966, University of Pittsburgh), Kathleen A Pajer
Year2002
Volume40
Issue9
Pages812-823
Publication date2002-09-01
Peer ReviewedYes
Open AccessNo
TypeARTICLE
VenueMedical Care (JOURNAL)
Journal identifiersISSN: 0025-7079 • E-ISSN: 1537-1948
PublisherOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-200209000-00010
PMID12218771
OpenAlexW2043690027
LanguageEN
Citations received15
References cited43

OBJECTIVES: Efficient and accurate instruments for assessing child psychopathology are increasingly important in clinical practice and research. For example, screening in primary care settings can identify children and adolescents with disorders that may otherwise go undetected. However, primary care offices are notorious for the brevity of visits and screening must not burden patients or staff with long questionnaires. One solution is to shorten assessment instruments, but dropping questions typically makes an instrument less accurate. An alternative is adaptive testing, in which a computer selects the items to be asked of a patient based on the patient's previous responses. This research used a simulation to test a child mental health screen based on this technology. RESEARCH DESIGN: Using half of a large sample of data, a computerized version was developed of the Pediatric Symptom Checklist (PSC), a parental-report psychosocial problem screen. With the unused data, a simulation was conducted to determine whether the Adaptive PSC can reproduce the results of the full PSC with greater efficiency. SUBJECTS: PSCs were completed by parents on 21,150 children seen in a national sample of primary care practices. RESULTS: Four latent psychosocial problem dimensions were identified through factor analysis: internalizing problems, externalizing problems, attention problems, and school problems. A simulated adaptive test measuring these traits asked an average of 11.6 questions per patient, and asked five or fewer questions for 49% of the sample. There was high agreement between the adaptive test and the full (35-item) PSC: only 1.3% of screening decisions were discordant (kappa = 0.93). This agreement was higher than that obtained using a comparable length (12-item) short-form PSC (3.2% of decisions discordant; kappa = 0.84). CONCLUSIONS: Multidimensional adaptive testing may be an accurate and efficient technology for screening for mental health problems in primary care settings

Checklist · Computerized adaptive testing · Family medicine · Mental health · Primary care · Psychiatry · Psychometrics · Psychopathology · Psychosocial · Sample (material) · Test (biology) · Child and Adolescent Psychosocial and Emotional Development · Clinical Psychology · Medicine · Personality Disorders and Psychopathology · Psychology · Psychometric Methodologies and Testing

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