Development and Validation of an Item Bank for Depression Screening in the Chinese Population Using Computer Adaptive Testing: A Simulation Study.

Qingrong Tan,Dongbo Tu,Qiuyun Li,Yong Zhang,Yan Cai

doi:10.3389/fpsyg.2018.01225

Abstract

With the increasing prevalence of depression, creating a simple and precise tool for measuring depression is becoming more important. This study developed a computer adaptive testing for depression (CAT-Depression) from a Chinese sample. The depression item bank was constructed from a sample of 1,135 participants with or without depression using the Graded Response Model (GRM; Samejima, 1969). The final depression item bank with strict unidimensionality comprised 68 items, which had local independence, good item-fit, high discrimination, no differential item functioning (DIF), and each item measured at least one symptom of diagnostic criteria for depression in ICD-10. In addition, the mean IRT discrimination of the item bank reached 1.784, which clearly showed that the item bank of CAT-Depression was high-quality. Moreover, a simulation CAT study with real response data was conducted to investigate the characteristics, marginal reliability, criterion-related validity, and predictive utility (sensitivity and specificity) of CAT-Depression. The results revealed that the proposed CAT-Depression had acceptable and reasonable marginal reliability, criterion-related validity, and sensitivity and specificity.

Highlights

Depression is one of the most prevalent psychological and behavioral disorders, and the number of people who commit suicide because of depression is growing
Unidimensionality and Local Independence In the one-factor model Confirmatory factor analysis (CFA) run in the initial computerized adaptive testing (CAT)-Depression item bank of 117 items, 23 items were eliminated because the factor loadings were less than 0.3 or not significant at p = 0.05
The results clearly showed that the remaining item bank met the assumption of unidimensionality

Summary

INTRODUCTION

Depression is one of the most prevalent psychological and behavioral disorders, and the number of people who commit suicide because of depression is growing. Some versions of CAT for depression (e.g., Gardner et al, 2004; Smits et al, 2011) were developed based on only one depression scale, which meant that there were very few items in the item bank tailored for different respondents/patients. Five commonly polytomously-scored IRT models, that is, GRM, GPCM, Partial Credit Model (PCM; Masters, 1982), Rating Scale Model (RSM; Andrich, 1978), and Nominal Response Model (NRM; Bock, 1972), were compared based on test-level modelfit checks to choose one optimal model to fit CAT-Depression. A CAT simulation study was carried out to investigate the marginal reliability, criterion-related validity, and predictive utility (sensitivity and specificity) of CAT-Depression

Participants

RESULTS

DISCUSSION