Application of a multidimensional computerized adaptive test for a Clinical Dementia Rating Scale through computer-aided techniques

Annals of General Psychiatry

Yi-Lien Lee¹  Tsair-Wei Chien²  Kao-Chang Lin³ 

[1] 0000 0004 0572 9255, grid.413876.f, Department of Medical Affairs, Chi-Mei Medical Center, No. 901, Chung Hwa Road, Yung Kung Dist., 710, Tainan, Taiwan;0000 0004 0532 3650, grid.412047.4, Institute of Information Management, National Chung Cheng University, Chiayi, Taiwan;0000 0004 0572 9255, grid.413876.f, Department of Medical Research, Chi-Mei Medical Center, 901 Chung Hwa Road, Yung Kung Dist, 710, Tainan, Taiwan;0000 0004 0634 2255, grid.411315.3, Department of Hospital and Health Care Administration, Chia-Nan University of Pharmacy and Science, Tainan, Taiwan;0000 0004 0572 9255, grid.413876.f, Department of Neurology and Holistic Care Unit, Chi-Mei Medical Center, Tainan, Taiwan;

关键词: Dementia;    Clinical Dementia Rating (CDR);    Computer adaptive testing;    Multidimensional;    Cut-off point;   

DOI  :  10.1186/s12991-019-0228-4

来源: publisher

【 摘 要 】

BackgroundWith the increasingly rapid growth of the elderly population, individuals aged 65 years and above now compose 14% of Taiwanese citizens, thereby making Taiwanese society an aged society. A leading factor that affects the elderly population is dementia. A method of precisely and efficiently examining patients with dementia through multidimensional computer adaptive testing (MCAT) to accurately determine the patients’ stage of dementia needs to be developed. This study aimed to develop online MCAT that family members can use on their own computers, tablets, or smartphones to predict the extent of dementia for patients responding to the Clinical Dementia Rating (CDR) instrument.MethodsThe CDR was applied to 366 outpatients in a hospital in Taiwan. MCAT was employed with parameters for items across eight dimensions, and responses were simulated to compare the efficiency and precision between MCAT and non-adaptive testing (NAT). The number of items saved and the estimated person measures was compared between the results of MCAT and NAT, respectively.ResultsMCAT yielded substantially more precise measurements and was considerably more efficient than NAT. MCAT achieved 20.19% (= [53 − 42.3]/53) saving in item length when the measurement differences were less than 5%. Pearson correlation coefficients were highly consistent among the eight domains. The cut-off points for the overall measures were − 1.4, − 0.4, 0.4, and 1.4 logits, which was equivalent to 20% for each portion in percentile scores. Substantially fewer items were answered through MCAT than through NAT without compromising the precision of MCAT.ConclusionsDeveloping a website that family members can use on their own computers, tablets, and smartphones to help them perform online screening and prediction of dementia in older adults is useful and manageable.

【 授权许可】

CC BY