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Abstract：
OBJECTIVE: Computerised adaptive test (CAT) provides individualised patient reported outcome measurement while retaining direct comparability of scores across patients and studies. Optimal CAT measurement requires an appropriate CAT-setting, the set of criteria defining the CAT including start item, item selection criterion, and stop criterion. The European Organisation for Research and Treatment of Cancer (EORTC) CAT Core allows for assessing the 14 functional and symptom domains covered by the EORTC QLQ-C30 questionnaire. The aim was to present a general approach for selecting CAT-settings and to use this to develop a portfolio of standard settings for the EORTC CAT Core optimised for different purposes and populations.
METHODS: Using simulations, the measurement properties of CATs of different length and precision were evaluated and compared allowing for identifying the most suitable settings. All CATs were initiated with the most informative QLQ-C30 item. For each domain two fixed-length and two fixed-precision standard CATs were selected focusing on efficiency (brief version) and precision (long), respectively.
RESULTS: The brief fixed-length CATs included 3-5 items each while the long versions included 5-8 items. The fixed-precision CATs aimed for reliability of 0.65-0.95 (brief versions) and 0.85-0.98 (long versions), respectively. Median sample size savings using the CATs compared to the QLQ-C30 scales ranged 20%-31%, although savings varied considerably across the domains.
CONCLUSIONS: The EORTC CAT Core standard settings simplify selection of relevant and appropriate CATs. The CATs prioritise either brevity and efficiency or precision, but all provide increased measurement precision and hence, reduced sample size requirements compared to the QLQ-C30 scales. The CATs may be used as they are or modified to accommodate specific requirements.
METHODS: Using simulations, the measurement properties of CATs of different length and precision were evaluated and compared allowing for identifying the most suitable settings. All CATs were initiated with the most informative QLQ-C30 item. For each domain two fixed-length and two fixed-precision standard CATs were selected focusing on efficiency (brief version) and precision (long), respectively.
RESULTS: The brief fixed-length CATs included 3-5 items each while the long versions included 5-8 items. The fixed-precision CATs aimed for reliability of 0.65-0.95 (brief versions) and 0.85-0.98 (long versions), respectively. Median sample size savings using the CATs compared to the QLQ-C30 scales ranged 20%-31%, although savings varied considerably across the domains.
CONCLUSIONS: The EORTC CAT Core standard settings simplify selection of relevant and appropriate CATs. The CATs prioritise either brevity and efficiency or precision, but all provide increased measurement precision and hence, reduced sample size requirements compared to the QLQ-C30 scales. The CATs may be used as they are or modified to accommodate specific requirements.
摘要：
目的：计算机自适应测试（CAT）提供个性化的患者报告结果测量，同时保持患者和研究之间分数的直接可比性。最佳CAT测量需要适当的CAT设置，定义CAT的一组标准，包括开始项目，项目选择标准，停止标准。欧洲癌症研究和治疗组织（EORTC）CATCore允许评估EORTCQLQ-C30问卷涵盖的14个功能和症状领域。目的是提出一种选择CAT设置的通用方法，并以此为EORTCCATCore开发针对不同目的和人群进行优化的标准设置组合。
方法：使用模拟，评估并比较了不同长度和精度的CAT的测量特性，从而确定了最合适的设置。所有CAT均以最丰富的QLQ-C30项目启动。对于每个域，选择了两个固定长度和两个固定精度的标准CAT，重点关注效率（简短版本）和精度（长）。分别。
结果：简短的固定长度的CAT包含3-5个项目，而长版包含5-8个项目。固定精度的CAT旨在实现0.65-0.95（简短版本）和0.85-0.98（长版本）的可靠性，分别。与QLQ-C30量表相比，使用CAT节省的样本量中位数为20%-31%，尽管不同领域的节省差异很大。
结论：EORTCCATCore标准设置简化了相关和合适的CAT的选择。CAT优先考虑简洁、高效或精确，但所有这些都提供了更高的测量精度，因此，与QLQ-C30量表相比，样本量要求降低。CAT可以按原样使用或修改以适应特定要求。
方法：使用模拟，评估并比较了不同长度和精度的CAT的测量特性，从而确定了最合适的设置。所有CAT均以最丰富的QLQ-C30项目启动。对于每个域，选择了两个固定长度和两个固定精度的标准CAT，重点关注效率（简短版本）和精度（长）。分别。
结果：简短的固定长度的CAT包含3-5个项目，而长版包含5-8个项目。固定精度的CAT旨在实现0.65-0.95（简短版本）和0.85-0.98（长版本）的可靠性，分别。与QLQ-C30量表相比，使用CAT节省的样本量中位数为20%-31%，尽管不同领域的节省差异很大。
结论：EORTCCATCore标准设置简化了相关和合适的CAT的选择。CAT优先考虑简洁、高效或精确，但所有这些都提供了更高的测量精度，因此，与QLQ-C30量表相比，样本量要求降低。CAT可以按原样使用或修改以适应特定要求。
