J. Med. Internet Res. - Applying computer adaptive testing to optimize online assessment of suicidal behavior: a simulation study.


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CKGROUND: The Internet is used increasingly for both suicide research and prevention. To optimize online assessment of suicidal patients, there is a need for short, good-quality tools to assess elevated risk of future suicidal behavior. Computer adaptive testing (CAT) can be used to reduce response burden and improve accuracy, and make the available pencil-and-paper tools more appropriate for online administration.OBJECTIVE: The aim was to test whether an item response-based computer adaptive simulation can be used to reduce the length of the Beck Scale for Suicide Ideation (BSS).METHODS: The data used for our simulation was obtained from a large multicenter trial from The Netherlands: the Professionals in Training to STOP suicide (PITSTOP suicide) study. We applied a principal components analysis (PCA), confirmatory factor analysis (CFA), a graded response model (GRM), and simulated a CAT.RESULTS: The scores of 505 patients were analyzed. Psychometric analyses showed the questionnaire to be unidimensional with good internal consistency. The computer adaptive simulation showed that for the estimation of elevation of risk of future suicidal behavior 4 items (instead of the full 19) were sufficient, on average.CONCLUSIONS: This study demonstrated that CAT can be applied successfully to reduce the length of the Dutch version of the BSS. We argue that the use of CAT can improve the accuracy and the response burden when assessing the risk of future suicidal behavior online. Because CAT can be daunting for clinicians and applied scientists, we offer a concrete example of our computer adaptive simulation of the Dutch version of the BSS at the end of the paper.

Resumo Limpo

ckground internet use increas suicid research prevent optim onlin assess suicid patient need short goodqual tool assess elev risk futur suicid behavior comput adapt test cat can use reduc respons burden improv accuraci make avail pencilandpap tool appropri onlin administrationobject aim test whether item responsebas comput adapt simul can use reduc length beck scale suicid ideat bssmethod data use simul obtain larg multicent trial netherland profession train stop suicid pitstop suicid studi appli princip compon analysi pca confirmatori factor analysi cfa grade respons model grm simul catresult score patient analyz psychometr analys show questionnair unidimension good intern consist comput adapt simul show estim elev risk futur suicid behavior item instead full suffici averageconclus studi demonstr cat can appli success reduc length dutch version bss argu use cat can improv accuraci respons burden assess risk futur suicid behavior onlin cat can daunt clinician appli scientist offer concret exampl comput adapt simul dutch version bss end paper

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