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Psychophysiological Assessment of the Effectiveness of Emotion Regulation Strategies in Childhood

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Published on: February 11, 2017

Customizing CAT Stopping Rules for Clinical Settings: A Simulation Study Using the NIH Toolbox Emotion Battery

Saki Amagai¹, Aaron J Kaat¹, Rina S Fox²

¹Northwestern University Feinberg School of Medicine, 625 N. Michigan Avenue, Suite 2700, Chicago, IL 60611, Chicago, US.

JMIR Formative Research

|January 22, 2025

Summary

Optimizing patient-reported outcome measures (PROMs) involves balancing test burden and clinical reliability. Modified stopping rules, particularly reducing maximum items, offer a promising approach for enhancing PROMs in clinical settings.

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Last Updated: May 31, 2025

Psychophysiological Assessment of the Effectiveness of Emotion Regulation Strategies in Childhood

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Area of Science:

Psychometrics
Clinical Assessment
Health Outcomes Research

Background:

Patient-reported outcome measures (PROMs) are vital for clinical decision-making and treatment evaluation.
However, PROMs can impose a significant burden on patients and may lack the reliability needed for clear clinical interpretation.

Purpose of the Study:

To evaluate alternative stopping rules for computerized adaptive testing (CAT) in the NIH Toolbox® Emotion Battery.
To assess the impact of these rules on test burden, score precision, and reliability.

Main Methods:

Computerized adaptive testing (CAT) simulations were performed on adult item banks within the Negative Affect subdomain of the NIH Toolbox®.
Simulations compared original stopping rules (standard error < 0.3) with modified rules, including SE-change rules, fixed-length CATs, and reduced maximum item counts.
Measures included administered items (burden), reliability cutoffs (precision), and root mean squared error (score recovery).

Main Results:

Alternative stopping rules generally reduced burden and increased the proportion of assessments achieving high reliability compared to original rules.
However, some alternative rules, like the SE-change rule and short fixed-length CATs, increased assessments with low reliability (< 0.85).
A reduced maximum stopping rule demonstrated the best balance between precision and parsimony.

Conclusions:

Reducing test burden while maintaining score precision for clinical use presents a significant challenge.
The choice of stopping rules for PROMs should be tailored to the specific study population and research objectives.