Quality of Life Research

, Volume 19, Issue 1, pp 125-136

First online:

Efficiency of static and computer adaptive short forms compared to full-length measures of depressive symptoms

  • Seung W. ChoiAffiliated withDepartment of Medical Social Sciences, Northwestern University Feinberg School of Medicine Email author 
  • , Steven P. ReiseAffiliated withDepartment of Psychology, University of California, Los Angeles
  • , Paul A. PilkonisAffiliated withDepartment of Psychiatry, University of Pittsburgh Medical Center
  • , Ron D. HaysAffiliated withDepartment of Medicine, University of California, Los AngelesHealth Program, RAND
  • , David CellaAffiliated withDepartment of Medical Social Sciences, Northwestern University Feinberg School of Medicine

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Short-form patient-reported outcome measures are popular because they minimize patient burden. We assessed the efficiency of static short forms and computer adaptive testing (CAT) using data from the Patient-Reported Outcomes Measurement Information System (PROMIS) project.


We evaluated the 28-item PROMIS depressive symptoms bank. We used post hoc simulations based on the PROMIS calibration sample to compare several short-form selection strategies and the PROMIS CAT to the total item bank score.


Compared with full-bank scores, all short forms and CAT produced highly correlated scores, but CAT outperformed each static short form in almost all criteria. However, short-form selection strategies performed only marginally worse than CAT. The performance gap observed in static forms was reduced by using a two-stage branching test format.


Using several polytomous items in a calibrated unidimensional bank to measure depressive symptoms yielded a CAT that provided marginally superior efficiency compared to static short forms. The efficiency of a two-stage semi-adaptive testing strategy was so close to CAT that it warrants further consideration and study.


Computer adaptive testing PROMIS Item response theory Short form Two-stage testing