Evaluation of a computer-adaptive test for the assessment of depression (D-CAT) in clinical application
Article first published online: 4 FEB 2009
Copyright © 2009 John Wiley & Sons, Ltd.
International Journal of Methods in Psychiatric Research
Volume 18, Issue 1, pages 23–36, March 2009
How to Cite
Fliege, H., Becker, J., Walter, O. B., Rose, M., Bjorner, J. B. and Klapp, B. F. (2009), Evaluation of a computer-adaptive test for the assessment of depression (D-CAT) in clinical application. Int. J. Methods Psychiatr. Res., 18: 23–36. doi: 10.1002/mpr.274
- Issue published online: 17 FEB 2009
- Article first published online: 4 FEB 2009
- Manuscript Accepted: 31 JAN 2008
- Manuscript Revised: 29 NOV 2007
- Manuscript Received: 22 JUN 2007
- diagnostic assessment;
- computer-adaptive testing;
- item response theory
In the past, a German Computerized Adaptive Test, based on Item Response Theory (IRT), was developed for purposes of assessing the construct depression [Computer-adaptive test for depression (D-CAT)]. This study aims at testing the feasibility and validity of the real computer-adaptive application.
The D-CAT, supplied by a bank of 64 items, was administered on personal digital assistants (PDAs) to 423 consecutive patients suffering from psychosomatic and other medical conditions (78 with depression). Items were adaptively administered until a predetermined reliability (r ≥ 0.90) was attained. For validation purposes, the Hospital Anxiety and Depression Scale (HADS), the Centre for Epidemiological Studies Depression (CES-D) scale, and the Beck Depression Inventory (BDI) were administered. Another sample of 114 patients was evaluated using standardized diagnostic interviews [Composite International Diagnostic Interview (CIDI)].
The D-CAT was quickly completed (mean 74 seconds), well accepted by the patients and reliable after an average administration of only six items. In 95% of the cases, 10 items or less were needed for a reliable score estimate. Correlations between the D-CAT and the HADS, CES-D, and BDI ranged between r = 0.68 and r = 0.77. The D-CAT distinguished between diagnostic groups as well as established questionnaires do.
The D-CAT proved an efficient, well accepted and reliable tool. Discriminative power was comparable to other depression measures, whereby the CAT is shorter and more precise. Item usage raises questions of balancing the item selection for content in the future. Copyright © 2009 John Wiley & Sons, Ltd.