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Applying multidimensional computerized adaptive testing to the MSQOL-54: a simulation study.

Andrea Giordano1,2, Silvia Testa3, Marta Bassi4

  • 1Unit of Neuroepidemiology, Fondazione IRRCS Istituto Neurologico Carlo Besta, Via Celoria 11, Milan, 20133, Italy.

Health and Quality of Life Outcomes
|June 25, 2023
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Summary
This summary is machine-generated.

A new computerized adaptive testing (CAT) version of the Multiple Sclerosis Quality of Life-54 (MSQOL-54) uses fewer items. This method maintains precision for the general health-related quality of life (HRQOL) factor, showing promise for clinical use.

Keywords:
Bifactor modelHealth-related quality of lifeItem response theoryMSQOL-54Multidimensional computerized adaptive testMultiple sclerosis

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Area of Science:

  • Psychometrics
  • Health Services Research
  • Clinical Informatics

Background:

  • The Multiple Sclerosis Quality of Life-54 (MSQOL-54) is a widely used measure of health-related quality of life (HRQOL) in multiple sclerosis (MS).
  • The MSQOL-54 combines generic SF-36 items with MS-specific items.
  • Developing a shorter, adaptive version could enhance usability and validity.

Purpose of the Study:

  • To apply multidimensional computerized adaptive testing (MCAT) to the MSQOL-54.
  • To assess the performance of an MCAT version of the MSQOL-54.

Main Methods:

  • Calibrated 52 MSQOL-54 items using a bifactor graded response model with 10 group factors and one general HRQOL factor.
  • Conducted eight simulations with varying standard error thresholds for factor estimates.
  • Assessed MCAT performance using the number of items administered, root mean square difference (RMSD), and correlation.

Main Results:

  • Eight items were removed due to local dependency.
  • A simulation with a standard error threshold of 0.32 for the general factor demonstrated satisfactory performance.
  • The optimized MCAT administered a median of 24 items with an RMSD of 0.32 and a correlation of 0.94.

Conclusions:

  • The simulated MCAT version of the MSQOL-54 requires fewer items than the full-length version while maintaining precision for the general HRQOL factor.
  • Further refinement of MSQOL-54 items is needed to improve calibration and MCAT efficiency for group factors.
  • The MCAT version holds potential for future clinical practice and research applications.