Computer Adaptive Tests in der Medizin

 

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Zusammenfassung

Die Methodik zur Messung psychischer Variablen steht in der Medizin allgemein, aber auch in der psychosomatischen Medizin weiter deutlich hinter der der Erfassung biomedizinischer Parameter zurück. Für wichtige Konstrukte existieren meist mehrere Instrumente, deren Ergebnisse nur schwer vergleichbar sind. Viele Fragebögen sind zudem entweder zu lang oder zu ungenau für den Einsatz in der klinischen Routine. Moderne psychometrische Methoden, wie die Entwicklung von Item Banken und Computer Adaptiver Tests (CAT) auf Grundlage der Item Response Theory (IRT), versprechen einige dieser Probleme zu lösen. Simulationsstudien zeigen, dass CATs mit einer geringeren Itemanzahl eine höhere Messpräzision über einen größeren Messbereich erreichen als statische Fragebögen. Untersuchungen mit realen CAT Anwendungen bestätigen diese Befunde, jedoch existieren bislang kaum longitudinale Untersuchungen. Die Skalierung etablierter Fragebögen auf einer gemeinsamen IRT-basierten Metrik stellt eine weitere vielversprechende Option der Nutzung der Item Response Theory dar und einen möglichen Schritt hin zu einer Standardisierung der Messung psychischer Parameter.

Abstract

Measurement of Patient-reported Outcomes (PRO) still lacks behind clinical standards. Most established tools are also either too burdensome or too imprecise to be used in clinical practice. Item Response Theory (IRT) methods and Computer Adaptive Tests (CAT) promise to overcome these shortcomings. Simulation studies have shown that individually tailored CATs can provide more precise and less burdensome measurements over a larger measurement range than static tools. Several studies with real CAT application have supported the psychometric superiority of CATs, but results from longitudinal studies are still scarce. IRT item banks also allow scoring different established tools measuring the same construct on one common metric, which could greatly facilitate the harmonization of PRO-assessments.

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