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Screening for mental disorders in heart failure patients using computer-adaptive tests.

H Felix Fischer¹, Cassandra Klug, Koosje Roeper

¹Department of Psychosomatic Medicine, Clinic for Internal Medicine, Charité - Universitätsmedizin, Berlin, Germany, felix.fischer@charite.de.

Quality of Life Research : an International Journal of Quality of Life Aspects of Treatment, Care and Rehabilitation

|December 17, 2013

Summary

Modern psychometric methods like computer-adaptive tests (CATs) show promise for screening depression and anxiety in heart failure patients. While diagnostic accuracy was similar to traditional tools, CATs significantly reduced patient burden.

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Area of Science:

Psychometrics
Clinical Psychology
Cardiology

Background:

Heart failure patients often experience comorbid depression and anxiety.
Accurate screening for mental health conditions is crucial for comprehensive patient care.

Purpose of the Study:

To evaluate if modern psychometric methods, specifically item response theory (IRT) and computer-adaptive tests (CATs), improve self-reported screening for depression and anxiety in heart failure patients.
To compare the diagnostic accuracy of IRT-based parameters and CATs against traditional sum scores and clinical interviews.

Main Methods:

194 heart failure patients completed six depression and anxiety screening tools.
Diagnostic accuracy was compared between traditional sum scores and IRT-based person parameters.
Performance of static instruments was compared with simulated individual-tailored CATs for depression, anxiety, and negative affect.

Main Results:

Depression screening was generally more efficient than anxiety screening.
IRT-based person parameters showed comparable diagnostic accuracy to sum scores.
CATs demonstrated similar screening performance but required fewer items, especially for identifying patients without mental conditions.

Conclusions:

All investigated instruments showed similar diagnostic performance, irrespective of the method used.
Computer-adaptive tests (CATs) offer personalized testing, significantly reducing patient burden.
CATs hold potential for increasing the acceptability and efficiency of mental health screening in clinical settings.