{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T20:00:35Z","timestamp":1773172835607,"version":"3.50.1"},"reference-count":52,"publisher":"Oxford University Press (OUP)","issue":"5","funder":[{"DOI":"10.13039\/100000092","name":"National Library of Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000092","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2017,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Objective: The Patient Reported Outcomes Measurement Information System (PROMIS) initiative developed an array of patient reported outcome (PRO) measures. To reduce the number of questions administered, PROMIS utilizes unidimensional item response theory and unidimensional computer adaptive testing (UCAT), which means a separate set of questions is administered for each measured trait. Multidimensional item response theory (MIRT) and multidimensional computer adaptive testing (MCAT) simultaneously assess correlated traits. The objective was to investigate the extent to which MCAT reduces patient burden relative to UCAT in the case of PROs.<\/jats:p>\n               <jats:p>Methods: One MIRT and 3 unidimensional item response theory models were developed using the related traits anxiety, depression, and anger. Using these models, MCAT and UCAT performance was compared with simulated individuals.<\/jats:p>\n               <jats:p>Results: Surprisingly, the root mean squared error for both methods increased with the number of items. These results were driven by large errors for individuals with low trait levels. A second analysis focused on individuals aligned with item content. For these individuals, both MCAT and UCAT accuracies improved with additional items. Furthermore, MCAT reduced the test length by 50%.<\/jats:p>\n               <jats:p>Discussion: For the PROMIS Emotional Distress banks, neither UCAT nor MCAT provided accurate estimates for individuals at low trait levels. Because the items in these banks were designed to detect clinical levels of distress, there is little information for individuals with low trait values. However, trait estimates for individuals targeted by the banks were accurate and MCAT asked substantially fewer questions.<\/jats:p>\n               <jats:p>Conclusion: By reducing the number of items administered, MCAT can allow clinicians and researchers to assess a wider range of PROs with less patient burden.<\/jats:p>","DOI":"10.1093\/jamia\/ocx003","type":"journal-article","created":{"date-parts":[[2017,1,5]],"date-time":"2017-01-05T20:05:55Z","timestamp":1483646755000},"page":"897-902","source":"Crossref","is-referenced-by-count":12,"title":["Advancing the efficiency and efficacy of patient reported outcomes with multivariate computer adaptive testing"],"prefix":"10.1093","volume":"24","author":[{"given":"Scott","family":"Morris","sequence":"first","affiliation":[{"name":"Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA"}]},{"given":"Mike","family":"Bass","sequence":"additional","affiliation":[{"name":"Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA"}]},{"given":"Mirinae","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA"}]},{"given":"Richard E","family":"Neapolitan","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine, Northwestern University Feinberg School of Medicine"}]}],"member":"286","published-online":{"date-parts":[[2017,3,11]]},"reference":[{"key":"2020110612444192700_ocx003-B1","volume-title":"Toward Precision Medicine: Building a Knowledge Network for Biomedical Research and a New Taxonomy of Disease","author":"National Research Council (US) Committee on a Framework for Developing a New Taxonomy of Disease","year":"2011"},{"key":"2020110612444192700_ocx003-B2","doi-asserted-by":"crossref","first-page":"S73","DOI":"10.1097\/MLR.0b013e31829b1d84","article-title":"Patient-reported outcomes (PROs): putting the patient perspective in patient-centered outcomes research","volume":"51","author":"Snyder","year":"2013","journal-title":"Med Care."},{"key":"2020110612444192700_ocx003-B3","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1177\/082585979200800303","article-title":"Quality of life: the concept","volume":"8","author":"Cella","year":"1992","journal-title":"J Palliat Care."},{"key":"2020110612444192700_ocx003-B4","doi-asserted-by":"crossref","first-page":"959","DOI":"10.1200\/JCO.1989.7.7.959","article-title":"Measuring quality of life in cancer patients","volume":"7","author":"Donovan","year":"1989","journal-title":"J Clin Oncol"},{"key":"2020110612444192700_ocx003-B5","doi-asserted-by":"crossref","first-page":"327","DOI":"10.3109\/07357909309024860","article-title":"Quality of life in cancer: definition, purpose, and method of measurement","volume":"11","author":"Cella","year":"1993","journal-title":"Cancer Invest."},{"key":"2020110612444192700_ocx003-B6","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1093\/jncimonographs\/lgm009","article-title":"Should health-related quality of life be measured in cancer symptom management clinical trials? 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