Pilot Testing and Preliminary Psychometric Validation of the Polish Translation of the EORTC INFO25 Questionnaire

The quality of information that oncological patients receive from health care professionals is an underestimated issue in Poland and Eastern European countries. There is lack of sufficient data on this subject. The European Organization for Research and Treatment of Cancer (EORTC) supplies a new tool for measuring the quality of information provided to cancer patients. The purpose of the study is the translation into Polish, pilot testing and preliminary validation of the EORTC information module (INFO25). Following the EORTC translation procedures, forward and back translations of the questionnaire were performed (English?→?Polish, Polish?→?English). The intermediate version of the INFO25 was pilot-tested together with the general questionnaire of quality of life (EORTC QLQ-C30). Reliability, validity and known-group comparison tests were performed. A total of 21 patients with different cancer diagnoses were recruited into the study (7 women and 14 men; mean age of 60,2 years, age range 25–73 years). Apart from filling out the INFO25, patients were interviewed about the difficulties with answering every questionnaire item. Patients' comments were analyzed and minor language changes were made to the initial translation. The internal consistency of the INFO25 showed a reliability of 0,78. The final version of the Polish translation of the INFO25 module was obtained and approved by the EORTC Quality of Life Department. It can now be used in clinical setting and for scientific purposes.     

Quality of Life in Patients with Chronic Pain- A Study in Indian Population Using European Organization for Research and Treatment of Cancer(EORTC) Questionnaire

Quality of life in chronic pain Health-related quality of life was compared in patients of chronic pain with that of general population.We designed this study as a prospective, observational trial in a tertiary care centre. Quality of life was measured using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30). The EORTC QLQ-C30 is a valid alternative to the SF-36 in the assessment of QOL in patients with chronic pain especially when a broader assessment of symptoms is desired. All participants completed a set of questionnaires on demographic variables, cause, pain intensity (VAS) and quality of life (EORTC qlq c30). A total of two hundred participants were enrolled including 100 patients with chronic pain. Chronic pain was defined as one which is persisting beyond 3 months. The study revealed significantly decreased quality of life in patients with chronic pain as compared to general population (p?<?0.001). Patients with chronic pain had significantly decreased score in Physical functioning, Role functioning, emotional and social functioning on functional scales and increased scores of pain, fatigue, sleep disturbances and financial difficulties on symptom scales. The study revealed sex-related differences on the QoL with females having a lower global QOL. It is thus concluded that patients with chronic pain especially females have decreased quality of life as compared to general population     

EORTC QLQ—C30及其在胸部肿瘤患者生命质量研究中的应用

生命质量研究是近年来肿瘤研究的热点之一,其主要作用评价治疗效果,选择治疗方案;应用于抗肿瘤新药筛选;用于预测患者预后和远期生存状态。EORTC QLQ-C30及其子量表在世界范围内被应用于胸部肿瘤治疗和研究当中并取得了较好效果,为评价食管癌和肺癌的各种治疗方法提供了一个较好的参考标准,同时对提高食管癌和肺癌的治疗水平和改善病人生命质量起到了一定的推动作用。     

认知诊断计算机化自适应测验中在线标定方法的开发

项目增补对认知诊断计算机化自适应测验(CD-CAT)中的题库维护至关重要。在传统CAT中, 在线标定方法经常用于估计新题的项目参数。然而直到现在, 在CD-CAT领域还没有任何关于在线标定的论文公开发表。为将传统CAT中3种有代表性的在线标定方法(Method A、OEM和 MEM)推广至CD-CAT (CD-Method A、CD-OEM和CD-MEM)建立分析基础, 并采用模拟方法对这3种方法进行比较。研究表明：CD-Method A方法在项目参数的返真性方面优于其它两种方法; 自适应标定设计较随机标定设计可以提高项目参数的返真质量。     

计算机化自适应测验中原始题项目参数的估计

计算机化自适应测验(Computerized Adaptive Testing, 简称CAT)其安全性面临着新的挑战, 小题库的安全更受威胁。如何建设一个大型、优质的题库成为CAT研究中一个非常重要的课题。目前CAT题库的建设存在一些问题, 如成本高且保密性较差。尤其是等值技术较复杂且锚题重复使用容易造成泄露。如能在实施CAT过程中插入未经过参数估计的项目(原始题), 同时对原始题项目参数进行估计, 这对建设大型、优质的CAT题库来说其意义是不言而喻的。本文基于1PLM和2PLM对此进行研究, 提出了原始题在线估计的新方法以及推导出了求区分度参数a迭代初值的计算公式。研究结果表明：无论是模拟研究还是实证研究, 原始题被作答的次数对项目参数估计结果都会产生不同的影响, 并且原始题作答人数越多项目参数估计精度也越高。     

中国癌症病人生活质量的测定──EORTC QLQ—C30在中国的试用

引进EORTCQLQ-C30,验证其在中国大陆的应用情况,为中国肿瘤学领域生活质量研究提供有效和实用的评定工具.运用随机对照实验设计,测查了289名癌症病人,结果显示各分量表中项目与所属量表的相关均高于与其他量表的相关,各分量表间呈中等偏下相关,量表因子结构分析与EORTC结果大体相似,三种方法检验的临床效度均较高.由此得出QLQ-C30各项心理测量学特性均达到要求,临床效度和实用性也比较好,在中国大陆的癌症病人中是可行的、可信的、有效的和敏感的.     

Developing new online calibration methods for multidimensional computerized adaptive testing

Multidimensional computerized adaptive testing (MCAT) has received increasing attention over the past few years in educational measurement. Like all other formats of CAT, item replenishment is an essential part of MCAT for its item bank maintenance and management, which governs retiring overexposed or obsolete items over time and replacing them with new ones. Moreover, calibration precision of the new items will directly affect the estimation accuracy of examinees’ ability vectors. In unidimensional CAT (UCAT) and cognitive diagnostic CAT, online calibration techniques have been developed to effectively calibrate new items. However, there has been very little discussion of online calibration in MCAT in the literature. Thus, this paper proposes new online calibration methods for MCAT based upon some popular methods used in UCAT. Three representative methods, Method A, the ‘one EM cycle’ method and the ‘multiple EM cycles’ method, are generalized to MCAT. Three simulation studies were conducted to compare the three new methods by manipulating three factors (test length, item bank design, and level of correlation between coordinate dimensions). The results showed that all the new methods were able to recover the item parameters accurately, and the adaptive online calibration designs showed some improvements compared to the random design under most conditions.     

The feasibility,reliability and validity of the EORTC QLQ-C30 in assessing the quality of life of patients with a symptomatic HIV infection or AIDS (CDC IV)

Abstract

The objective of this study was to evaluate the feasibility, reliability and validity of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (the QLQ-C30) in a longitudinal study of the quality of life (QoL) of patients with a symptomatic HIV infection or AIDS. The OLQ-C30 is a 30-item questionnaire composed of five functional subscales. 3 symptom subscales, an overall QoL subscale, and a number of additional single item symptom measures. The questionnaire was administered serially to a sample of 156 Dutch patients. The average time to complete the questionnaire was less than 11 minutes, with most patients requiring no assistance. With one exception (role functioning subscale), the data supported the hypothesized scale structure of the questionnaire. Eight of the 9 subscales met or approached the minimal criterion for reliability (Cronbach's alpha ≤ .70) at baseline and/or follow-up. The validity of the QLQ-C30 was supported by 3 findings: (1) the correlations observed among the subscales. while statistically significant, were of only a moderate magnitude, indicating that distinct components of QoL are being assessed; (2) a number of the subscales could discriminate clearly between patients differing in stage of disease and in Karnofsky Performance Status; and (3) significant changes in QLQ-C30 scores in the expected direction, were observed over time. These results lend support to the QLQ-C30 as a reasonably reliable and valid instrument for assessing the QoL of patients with HIV infection. Additional research is needed to improve the role functioning subscale. to evaluate the QLQ-C30's concurrent validity by comparing it with other available QoL instruments, and to examine more thoroughly its responsiveness to clinically important changes in patients' health status over the entire disease and treatment trajectory.     

认知诊断CAT中具有非统计约束选题方法的比较

项目曝光控制和内容约束关系到测验安全、测验的信度和效度, 是计算机化自适应测验(Computerized Adaptive Testing, CAT)中两类重要的非统计约束条件。本文在认知诊断CAT中针对内容约束和项目曝光控制要求, 运用5种方法选择测验项目。它们分别是：(1) Monte Carlo方法与项目合格方法相结合, 记为MC-IE; (2) Monte Carlo方法与最大优先指标方法相结合, 记为MC-MPI; (3) Monte Carlo方法与限制阈值方法相结合, 记为MC-RT; (4) Monte Carlo方法与限制进度指标方法相结合, 记为MC-RPG以及(5) Monte Carlo方法与最大后验概率方法相结合, 记为MC-PP。然后通过在线性、收敛、发散、无结构和独立五种属性结构下构建题库并运用重参化融融统和模型模拟被试反应比较它们的选题表现。研究发现, (1) 相同选题方法在不同属性结构下项目曝光率的分布类似, 测量精度按线性、收敛、发散、无结构和独立结构的顺序依次降低; (2) 相同属性结构下, 不同方法的测量精度高低依次为MC-PP、MC-IE、MC-RT、MC-MPI和MC-RPG方法; 项目曝光均匀性优劣依次为MC-RPG、MC-MPI、MC-RT、MC-IE和MC-PP方法。统一量纲值表明, MC-RPG方法的综合表现最好, MC-MPI方法的表现次之。     

Associations of Quality of Life,Physical Activity and Mood States in Women with Breast Cancer Treated with Curative Intent

This study aims to investigate the associations between quality of life, physical activity and mood states in women with breast cancer. A total of 354 women (mean age, 51.74?±?8.63 years; body mass index (BMI), 28?±?5.67 kg/m²) completed the Baecke Physical Activity Questionnaire, Profile of Mood States (POMS), European Organisation for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) and European Organisation for Research and Treatment of Cancer Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Pearson’s correlation and multiple linear regressions were used to verify the relations between outcomes and independent variables. Correlations between scores on POMS, Baecke Physical Activity Questionnaire and global health status/quality of life subscale of EORTC QLQ-C30 found associations (p?<?0.01) between physical activity (r?=?0.191), vigour (r?=?0.333) and fatigue (r?=??0.433). Multiple linear regression analysis of the global health status/quality of life subscale of the EORTC QLQ-C30 showed significant differences for vigour (p?<?0.001), social function (p?=?0.003), side effects of systemic therapy (p?=?0.019), arm and breast symptoms (p?<?0.001) and Baecke physical activity score (p?=?0.006). Physical activity is an independent factor related to the quality of life in women with breast cancer. Understanding these variables may influence clinical decisions during treatment and allow positive interventions regarding symptoms, functions and lifestyle.     

应征公民计算机自适应化拼图测验的编制

在文献回顾和参考外军有关资料的基础上,根据项目反应理论和空间能力测验的有关理论编制试题库。首先采用纸笔测验的形式进行预实验,探讨采用IRT理论编制CAT拼图测验的可行性。然后,在预实验的基础上对试题进行修订并扩充试题数量,编制计算机辅助测验。选择三参数Logistic模型,采用铆题等值设计,分7份不同的试卷在全国征兵心理检测的过程中对55777名应征公民进行施测。根据测试结果,对题目进行分析,选择高质量的题目构成CAT试题库,采用a系数分层抽样的方法控制曝光率,并采用不同的测验终止策略编制CAT拼图测验。最后用WAIS智力测验积木分测验和三门功课的考试成绩为效标,通过72名被试对CAT拼图测验进行效度验证。结果显示该测验符合项目反应理论三参数Logistic模型的假设,各题目参数比较理想,所编制的测验具有较好的信度和效度,可用于应征公民心理选拔的实践     

Computerized adaptive testing: the capitalization on chance problem

This paper describes several simulation studies that examine the effects of capitalization on chance in the selection of items and the ability estimation in CAT, employing the 3-parameter logistic model. In order to generate different estimation errors for the item parameters, the calibration sample size was manipulated (N = 500, 1000 and 2000 subjects) as was the ratio of item bank size to test length (banks of 197 and 788 items, test lengths of 20 and 40 items), both in a CAT and in a random test. Results show that capitalization on chance is particularly serious in CAT, as revealed by the large positive bias found in the small sample calibration conditions. For broad ranges of theta, the overestimation of the precision (asymptotic Se) reaches levels of 40%, something that does not occur with the RMSE (theta). The problem is greater as the item bank size to test length ratio increases. Potential solutions were tested in a second study, where two exposure control methods were incorporated into the item selection algorithm. Some alternative solutions are discussed.     

认知诊断CAT中项目曝光控制方法的比较

项目曝光率关系到题库建设和测验安全,是计算机化自适应测验(Computerized Adaptive Testing, CAT)需要考虑的重要问题。在认知诊断 CAT 情形下,首先基于传统 CAT 中 a-分层方法的思想提出按项目信息量对题库分层的分层多阶段(Stratified Multistage, SM)选题方法;然后将 SM 方法与项目合格(Item Eligibility, IE)方法相结合得到SMIE方法。在此基础上,开展模拟研究比较SM、IE、SMIE、最大修正优先指标(Maximum Modified Priority Index, MMPI)方法、限制阈值(Restrictive Threshold, RT)方法和限制进度(Restrictive Progressive, RPG)方法的选题表现。总体上,它们的测量精度从高到低依次为IE、SM、SMIE、RT、RPG和MMPI方法;项目曝光分布均匀性的优劣次序为MMPI、RPG、SMIE、RT、SM和IE方法;SMIE和RT方法能较好地平衡测量精度和项目曝光均匀性要求。     

Assessment of quality of life in a multicultural cancer patient population

Quality of life (QOL) is increasingly assessed in cancer patients. In this article, the authors examined the psychometric performance of a commonly used QOL questionnaire, the Quality of Life Questionnaire--Cancer 30 (QLQ-C30; N. K. Aaronson et al., 1993), in multiethnic cancer patients. Content validation studies in patients and clinicians identified possible new items. Multiple-group confirmatory factor analysis supported equivalent structure across ethnic groups (Caucasians and Asian/Pacific Islanders [APIs]). A higher order QOL factor appeared to directly affect functioning scales and symptom count. Exploratory factor analysis examined effects of new items. Ten factors were extracted, 6 consistent with the original instrument and 4 reflecting potentially new aspects of QOL: Positive Social Support, Coping, Existential Well-Being, and Sexuality/Intimacy. The QLQ-C30 appears appropriate for use in API cancer patients. Further work needs to ensure that it includes all important domains.     

基于GRM模型的BP神经网络参数估计

目前参数估计多采用统计方法,存在耗时长、要求被试样本容量大和项目数多等缺点。本文将BP神经网络和降维法相结合,对GRM的项目参数和考生能力参数进行估计。蒙特卡洛模拟结果显示：（1）不管是人多题少还是题多人少,该网络设计下的参数估计精度都较高;（2）可以应用到多个不同等级评分的参数估计中,甚至是超过15个等级的项目参数,估计精度也较高,这是其他参数估计方法所不可比拟的;（3）运行的时长和统计估计方法相比大大缩减。     

两种新的计算机化自适应测验在线标定方法

在线标定技术由于具有诸多优点而被广泛应用于计算机化自适应测验(CAT)的新题标定。Method A是想法最直接、算法最简单的CAT在线标定方法, 但它具有明显的理论缺陷--在标定过程中将能力估计值视为能力真值。将全功能极大似然估计方法(FFMLE)与“利用充分性结果”估计方法(ECSE)的误差校正思路融入Method A (新方法分别记为FFMLE-Method A和ECSE-Method A), 从理论上对能力估计误差进行校正, 进而克服Method A的标定缺陷。模拟研究的结果表明：(1)在大多数实验条件下, 两种新方法较Method A总体上可以改进标定精度, 且在测验长度为10的短测验上的改进幅度最大; (2)当CAT测验长度较短或中等(10或20题)时, 两种新方法的表现与性能最优的MEM已非常接近。当测验长度较长(30题)时, ECSE-Method A的总体表现最好、优于MEM; (3)样本量越大, 各种方法的标定精度越高。     

基于CAT的在线标定:设计与方法

项目增补是题库建设和维护的重要手段, 而标定新题参数是项目增补的重要内容。在线标定设计和在线标定方法分别研究新题的施测方式和参数估计方法, 是计算机化自适应测验(computerized adaptive testing, CAT)情景下项目增补的核心技术。重点厘清在线标定设计与在线标定方法的发展思路和脉络, 并对它们的特点、联系和表现进行介绍和评价。未来应基于其他信息指标进一步研究在线标定设计, 可基于联合估计和误差校正的思路探究在线标定方法, 应加强研究认知诊断CAT和多维CAT的在线标定技术, 深入开展项目增补方法的实证研究。     

Recency, immediate recognition memory, and reaction time

Four classes of possible mechanisms for short-term item recognition are distinguished: (I) pure list-search, (II) direct-access activation (or trace strength) discrimination, (III) mixtures (of I and II), and (IV) response-association. Manipulations of recency, particularly of negative probe items, provide critical tests between them. Two experiments are reported using Sternberg' s 1966 varied-set reaction time paradigm, coupled with procedures intended to minimize rehearsal and control the recency of probes and memory set items. RT and error rate were greater for negative probe items that had recently been presented than for items less recently presented, and this effect increased with positive set size. In contrast, positive RT was, except for the initial item, a decreasing function of recency (= serial position), and there was no additional effect of set size per se. A brief filled delay between list and probe increased positive RT but not the slope of the set size function. These and other findings appear to reject models of Classes I and IV and, while implying some direct discrimination of an item's recency, require modification of the models of Classes II and III. The implications are discussed with respect to the relation between the two versions of Sternberg's paradigm and also in connection with facilitatory “priming” effects in memory.     

认知诊断计算机化自适应测验中的项目增补

项目的增补对认知诊断计算机化自适应测验(CD-CAT)题库的开发与维护至关重要。借鉴单维项目反应理论(IRT)中联合极大似然估计方法(JMLE)的思路, 提出联合估计算法(JEA), 仅依赖被试在旧题和新题上的作答反应联合地、自动地估计新题的属性向量和新题的项目参数。研究结果表明：当项目参数相对较小且样本量相对较大时, JEA算法在新题属性向量和新题项目参数估计精度方面表现不错; 而且样本大小、项目参数大小以及项目参数初值都影响着JEA算法的表现。     

Initial codes for order in memory

The roles of positional and associative information in preserving the order of short sequences of items were investigated either by presenting an item in the same serial position on successive trials (position transfer), or by presenting the same pair of items in adjacent but shifted positions on successive trials (association transfer). While Experiment I found that positive transfer of position information occurred after just one repetition of an item in the same serial position, Experiment II found no evidence for association transfer after a single trial. If an item is presented in the same position, or if a pair of items are presented in adjacent positions on several successive trials, position transfer effects built up more rapidly than association transfer effects (Experiments III and IV). However, the rate at which association transfer effects are established depends on the type of item used, with lists of concrete words showing rapid establishment of associations (Experiment V) but lists of digits showing only slow development of associations (Experiment IV). It was concluded that serial order may be preserved both by positional and associative codes, but the establishment of an associative code is linked to the extraction of information about the items themselves.