Development of the ThyCAT: A clinically useful computerized adaptive test to assess quality of life in thyroid cancer survivors

Abstract

BackgroundCurrent quality of life assessment tools for thyroid cancer survivors are not clinically useful due to the length of available questionnaires. Computerized adaptive tests are easily administered electronically and can achieve highly accurate and efficient results in minimal time. We aimed to develop a quality of life computerized adaptive tests (ThyCAT) for thyroid cancer survivors. MethodsA bifactor item response theory model was fit to questionnaire responses from 1,078 North American Thyroid Cancer Survivorship Study participants—a longitudinal cohort study of quality of life in thyroid cancer survivors. Tuning parameters were selected to maintain a correlation of r > 0.9 with the total item bank quality of life score obtained from the original North American Thyroid Cancer Survivorship Study questions, using a minimal number of adaptively administered ThyCAT items. ResultsThe ThyCAT assesses quality of life with strong correlation (r = 0.96) with the original 75 North American Thyroid Cancer Survivorship Study questions using an average of 9.94 questions (SD ± 3.03) administered in <2 minutes. There was no statistically significant difference in the number of ThyCAT questions required based on demographic or tumor characteristics. ConclusionThe ThyCAT can be administered on a smartphone app in <10 questions, and <2 minutes, allowing efficient and accurate in or out of clinic identification of patients struggling with quality of life issues after thyroid cancer treatment.