A Multidimensional Computer Adaptive Test Approach to Dyspnea Assessment

Abstract Norweg A, Ni P, Garshick E, O'Connor G, Wilke K, Jette AM. A multidimensional computer adaptive test approach to dyspnea assessment. Objectives To develop and test a prototype dyspnea computer adaptive test (CAT). Design Prospective study. Setting Two outpatient medical facilities. Participants A convenience sample of adults (N=292) with chronic obstructive pulmonary disease (COPD). Interventions Not applicable. Main Outcome Measure We developed a modified and expanded item bank and CAT for the Dyspnea Management Questionnaire (DMQ), an outcome measure consisting of 4 dyspnea dimensions: dyspnea intensity, dyspnea anxiety, activity avoidance, and activity self-efficacy. Results Factor analyses supported a 4-dimensional model underlying the 71 DMQ items. The DMQ item bank achieved acceptable Rasch model fit statistics, good measurement breadth with minimal floor and ceiling effects, and evidence of high internal consistency reliability (α=.92–.98). With the use of CAT simulation analyses, the DMQ-CAT showed high measurement accuracy compared with the total item pool ( r =.83–.97, P