Examining differential item functioning due to item difficulty and alternative attractiveness

A method for analyzing test item responses is proposed to examine differential item functioning (DIF) in multiple-choice items through a combination of the usual notion of DIF, for correct/incorrect responses and information about DIF contained in each of the alternatives. The proposed method uses incomplete latent class models to examine whether DIF is caused by the attractiveness of the alternatives, difficulty of the item, or both. DIF with respect to either known or unknown subgroups can be tested by a likelihood ratio test that is asymptotically distributed as a chi-square random variable.     

Subjects' inferential performance and the interaction of data and hypotheses in probabilistic inference tasks

In a recent paper, Knez (1991) showed an interaction of data and hypotheses in probabilistic inference tasks. The results illustrated two, earlier not obtained, significant main effects on subjects' hypothesis sampling , viz. the effect of different forms of data presentation and subjects' execution of cognitive control over their hypothesis pool throughout the series of trials. The present paper followed up these results in that the subjects' hypothesis testing , in Knez (1991) was subjected to an analysis. Hence, to see if the effects mentioned above significantly influenced the subjects' hypothesis testing, as they did for subjects' hypothesis sampling. The results showed a consistency with Knez (1991), i.e. the results emphasize the interaction of data and hypothesis in probabilistic inference tasks, as well as the subjects' execution of cognitive control over their hypothesis pool concerning both the subjects' hypothesis sampling and testing.     

Statistical consistency and hypothesis testing for nonmetric multidimensional scaling

The properties of nonmetric multidimensional scaling (NMDS) are explored by specifying statistical models, proving statistical consistency, and developing hypothesis testing procedures. Statistical models with errors in the dependent and independent variables are described for quantitative and qualitative data. For these models, statistical consistency often depends crucially upon how error enters the model and how data are collected and summarized (e.g., by means, medians, or rank statistics). A maximum likelihood estimator for NMDS is developed, and its relationship to the standard Shepard-Kruskal estimation method is described. This maximum likelihood framework is used to develop a method for testing the overall fit of the model.     

Millon Clinical Multiaxial Inventory (MCMI) computer-generated diagnoses: How do they compare to clinician judgment?

During the past several decades, computers have achieved increasing prominence in psychological assessment procedures. This is particularly true for computer-based test interpretation and diagnosis. This study reports on a study designed to compare the accuracy of computer-based diagnoses with clinician-generated diagnoses. The Millon Clinical Multiaxial Inventory (MCMI) was administered to 151 consecutively admitted inpatients at a large private psychiatric hospital. The computer-generated diagnoses were compared with those generated by admitting psychiatrists. The results indicated that the MCMI diagnostic impressions underestimated the severity of depressive disorders when compared with clinician diagnoses on Axis I. Specifically, clinicians diagnosed major depression much more frequently than did the MCMI. In addition, clinicians diagnosed anxiety disorders much less frequently than did the MCMI.     

A survey of reimbursement for cystic fibrosis carrier testing

To assess the current status of reimbursement for cystic fibrosis (CF) carrier testing, we surveyed individuals tested in the Mid-Atlantic region. Results show that CF testing was covered by insurance in part or in full for greater than 50% of respondents. The test was nearly always covered when performed during pregnancy because of a positive family history, but it was also covered for more than 50% of pregnant respondents with a negative family history. There were no significant differences in coverage by type of insurance. Many respondents needed to supply additional information about the testing to their insurance company before a coverage decision could be made. Before population-based CF screening programs are initiated, more data are needed on insurance reimbursement for testing, especially when performed pre-conceptually.     

Amniocentesis in sociocultural perspective

This article reports on an anthropological investigation of the social impact and cultural meaning of amniocentesis conducted in New York City, illustrating how class differences, as well as sociocultural diversity, deeply affect pregnant women's acceptance, rejection, and interpretation of prenatal testing. The article also suggests the importance of recognizing how counselors' cultural backgrounds and styles affect patient-counselor communications.     

Offering predictive testing for Huntington disease in a medical genetics clinic: Practical applications

Predictive testing for Huntington disease is presently offered in a select few medical genetics centers in the United States. This is in part due to the labor intensive counseling and psychological testing suggested by the research protocols. We discuss some specific suggestions for establishing programs for Huntington disease predictive testing within pre-existing medical genetics clinics to encourage more centers to offer presymptomatic testing. This will allow more at risk individuals the opportunity to consider predictive testing and cut down the expenses of traveling to the few predictive testing centers that currently exist. The counseling principals will remain similar to those discussed here, even following the identification of the Huntington disease mutation.     

Whose Gene Is It? A Case Discussion About Familial Conflict over Genetic Testing for Breast Cancer

A multidisciplinary group of genetic and other professionals discuss a complex case of familial conflict over access to genetic information. One twin wishes to know the results of her deceased mother's tests for BRCA1 mutations; a second twin objects to researchers making this information available. As the case discussion unfolds, the apparent facts of this case are called into question and the lines of ethical certainty become less clear.     

Knowledge of Breast Cancer Genetics Among Breast Cancer Patients and First-Degree Relatives of Affected Individuals

The cloning of BRCA1, a susceptibility gene for inherited breast cancer, has made genetic screening possible for individuals and families whose medical histories are suggestive of an inherited predisposition to breast cancer. To date, few systematic attempts have been made to determine the level of knowledge about breast cancer genetics among women who are likely to seek BRCA1 screening when it becomes widely available. The present study attempted to assess the general knowledge about BRCA1 mutations in two groups: (1) first-degree relatives (FDRs) of breast cancer patients; and (2) women with a previous diagnosis of breast cancer. A self-administered, thirty-item questionnaire was developed through a pilot study. Ten of the items were objective, factual questions about breast cancer genetics. Responses to these questions were used to generate an overall knowledge score for each respondent. The study population was moderately knowledgeable about breast cancer genetics, with an average score of 5.35 out of 10. Counselors should not underestimate the importance of evaluating each counselee's existing knowledge about breast cancer, which can affect the provision and reception of genetic information. In particular, specific areas of knowledge that may be confusing or misunderstood were identified and these topics are discussed in detail.