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Development of an item bank for computerized adaptive test (CAT) measurement of pain

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Abstract

Purpose

Patient-reported outcomes should ideally be adapted to the individual patient while maintaining comparability of scores across patients. This is achievable using computerized adaptive testing (CAT). The aim here was to develop an item bank for CAT measurement of the pain domain as measured by the EORTC QLQ-C30 questionnaire.

Methods

The development process consisted of four steps: (1) literature search, (2) formulation of new items and expert evaluations, (3) pretesting and (4) field-testing and psychometric analyses for the final selection of items.

Results

In step 1, we identified 337 pain items from the literature. Twenty-nine new items fitting the QLQ-C30 item style were formulated in step 2 that were reduced to 26 items by expert evaluations. Based on interviews with 31 patients from Denmark, France and the UK, the list was further reduced to 21 items in step 3. In phase 4, responses were obtained from 1103 cancer patients from five countries. Psychometric evaluations showed that 16 items could be retained in a unidimensional item bank. Evaluations indicated that use of the CAT measure may reduce sample size requirements with 15–25 % compared to using the QLQ-C30 pain scale.

Conclusions

We have established an item bank of 16 items suitable for CAT measurement of pain. While being backward compatible with the QLQ-C30, the new item bank will significantly improve measurement precision of pain. We recommend initiating CAT measurement by screening for pain using the two original QLQ-C30 pain items. The EORTC pain CAT is currently available for “experimental” purposes.

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Acknowledgments

This study was funded by grants from the EORTC Quality of Life Group. The authors would like to thank the participating experts and patients and our collaborators for helping with the collection of the essential patient data.

Author information

Authors and Affiliations

  1. The Research Unit, Department of Palliative Medicine, Bispebjerg Hospital, University of Copenhagen, Bispebjerg Bakke 23, 2400, Copenhagen, NV, Denmark

    Morten Aa. Petersen & Mogens Groenvold

  2. Division of Psychosocial Research and Epidemiology, The Netherlands Cancer Institute, Amsterdam, The Netherlands

    Neil K. Aaronson

  3. Department of Public Health, Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei City, Taiwan

    Wei-Chu Chie

  4. Medical Oncology Department, Institut de cancérologie de Lorraine, Vandoeuvre-lès-Nancy, France

    Thierry Conroy

  5. Psychoncology Unit, Sant’Andrea Hospital, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy

    Anna Costantini

  6. Department of Otolaryngology Head and Neck Surgery, Sahlgrenska University Hospital, Göteborg University, Göteborg, Sweden

    Eva Hammerlid

  7. Regional Centre for Excellence in Palliative Care, Department of Oncology, Oslo University Hospital, Oslo, Norway

    Marianne J. Hjermstad

  8. European Palliative Care Research Centre, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway

    Marianne J. Hjermstad & Jon H. Loge

  9. Palliative Medicine Unit, University Hospital of Trondheim, Trondheim, Norway

    Stein Kaasa

  10. National Resource Centre for Late Effects After Cancer Treatment, Oslo University Hospital, Oslo, Norway

    Jon H. Loge

  11. Cancer Research UK Centre, University of Leeds, Leeds, UK

    Galina Velikova

  12. Lynda Jackson Macmillan Centre, Mount Vernon Hospital, Middlesex, UK

    Teresa Young

  13. Institute of Public Health, University of Copenhagen, Copenhagen, Denmark

    Mogens Groenvold

Authors
  1. Morten Aa. Petersen
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  2. Neil K. Aaronson
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  7. Marianne J. Hjermstad
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  8. Stein Kaasa
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  9. Jon H. Loge
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  10. Galina Velikova
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  11. Teresa Young
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  12. Mogens Groenvold
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Corresponding author

Correspondence to Morten Aa. Petersen.

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On behalf of the EORTC Quality of Life Group.

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Petersen, M.A., Aaronson, N.K., Chie, WC. et al. Development of an item bank for computerized adaptive test (CAT) measurement of pain. Qual Life Res 25, 1–11 (2016). https://doi.org/10.1007/s11136-015-1069-5

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  • DOI: https://doi.org/10.1007/s11136-015-1069-5

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