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Abberger, Birgit; Haschke, Anne; Wirtz, Markus; Kroehne, Ulf; Bengel, Juergen; Baumeister, Harald:

Development and evaluation of a computer adaptive test to assess anxiety in cardiovascular rehabilitation patients

In: Archives of Physical Medicine and Rehabilitation, 94 (2013) 12 , 2433-2439

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3a. Beiträge in begutachteten Zeitschriften; Aufsatz (keine besondere Kategorie)

Angst, Benutzerfreundlichkeit, Evaluation, Item-Response-Theory, Kranker, Messung, Psychodiagnostik, Psychometrie, Technologiebasiertes Testen, Test

Objective: To develop and evaluate a computer adaptive test for the assessment of anxiety in cardiovascular rehabilitation patients (ACAT-cardio) that tailors an optimal test for each patient and enables precise and time-effective measurement. Design: Simulation study, validation study (against the anxiety subscale of the Hospital Anxiety and Depression Scale and the physical component summary scale of the 12-Item Short-Form Health Survey), and longitudinal study (beginning and end of rehabilitation). Setting: Cardiac rehabilitation centers. Participants: Cardiovascular rehabilitation patients: simulation study sample (n=106; mean age, 57.8y; 25.5% women) and validation and longitudinal study sample (n=138; mean age, 58.6 and 57.9y, respectively; 16.7% and 12.1% women, respectively). Interventions: Not applicable. Main Outcome Measures: Hospital Anxiety and Depression Scale, 12-Item Short-Form Health Survey, and ACAT-cardio. Results: The mean number of items was 9.2 with an average processing time of 1:13 minutes when an SE .50 was used as a stopping rule; with an SE .32, there were 28 items and a processing time of 3:47 minutes. Validity could be confirmed via correlations between .68 and .81 concerning convergent validity (ACAT-cardio vs Hospital Anxiety and Depression Scale anxiety subscale) and correlations between .47 and .30 concerning discriminant validity (ACAT-cardio vs 12-Item Short-Form Health Survey physical component summary scale). Sensitivity to change was moderate to high with standardized response means between .45 and .82. Conclusions: The ACAT-cardio shows good psychometric properties and provides the opportunity for an innovative and time-effective assessment of anxiety in cardiovascular rehabilitation. A more flexible stopping rule might further improve the ACAT-cardio. Additionally, testing in other cardiovascular populations would increase generalizability.

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