Dataset Information

A Psychometric Model for Discrete-Option Multiple-Choice Items.

ABSTRACT: Discrete-option multiple-choice (DOMC) items differ from traditional multiple-choice (MC) items in the sequential administration of response options (up to display of the correct option). DOMC can be appealing in computer-based test administrations due to its protection of item security and its potential to reduce testwiseness effects. A psychometric model for DOMC items that attends to the random positioning of key location across different administrations of the same item is proposed, a feature that has been shown to affect DOMC item difficulty. Using two empirical data sets having items administered in both DOMC and MC formats, the variability in key location effects across both items and persons is considered. The proposed model exploits the capacity of the DOMC format to isolate both (a) distinct sources of item difficulty (i.e., related to the identification of keyed responses versus the ruling out of distractor options) and (b) distinct person proficiencies related to the same two components. Practical implications in terms of the randomized process applied to schedule item key location in DOMC test administrations are considered.

SUBMITTER: Bolt DM

PROVIDER: S-EPMC6906389 | biostudies-literature | 2020 Jan

REPOSITORIES: biostudies-literature

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A Psychometric Model for Discrete-Option Multiple-Choice Items.

Bolt Daniel M DM Kim Nana N Wollack James J Pan Yiqin Y Eckerly Carol C Sowles John J

Applied psychological measurement 20190319 1

Discrete-option multiple-choice (DOMC) items differ from traditional multiple-choice (MC) items in the sequential administration of response options (up to display of the correct option). DOMC can be appealing in computer-based test administrations due to its protection of item security and its potential to reduce testwiseness effects. A psychometric model for DOMC items that attends to the random positioning of key location across different administrations of the same item is proposed, a featur ...[more]

PMID: 31853157

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Project description:ObjectivesThe aim of this study was to assess the relative importance of features of a hypothetical injectable disease-modifying treatment for patients with multiple sclerosis using a discrete-choice experiment.MethodsGerman residents at least 18 years of age with a self-reported physician diagnosis of multiple sclerosis completed a 25-30 minute online discrete-choice experiment. Patients were asked to choose one of two hypothetical injectable treatments for multiple sclerosis, defined by different levels of six attributes (disability progression, the number of relapses in the next 4 years, injection time, frequency of injections, presence of flu-like symptoms, and presence of injection-site reactions). The data were analyzed using a random-parameters logit model.ResultsOf 202 adults who completed the survey, results from 189 were used in the analysis. Approximately 50% of all patients reported a diagnosis of relapsing-remitting multiple sclerosis, and 31% reported secondary progressive multiple sclerosis. Approximately 71% of patients had current or prior experience with injectable multiple sclerosis medication. Approximately 53% had experienced flu-like symptoms caused by their medication, and 47% had experienced mild injection-site reactions. At least one significant difference was seen between levels in all attributes, except injection time. The greatest change in relative importance between levels of an attribute was years until symptoms get worse from 1 to 4 years. The magnitude of this difference was about twice that of relapses in the next 4 years, frequency of injections, and flu-like symptoms.ConclusionsMost attributes examined in this experiment had an influence on patient preference. Patients placed a significant value on improvements in the frequency of dosing and disability progression. Results suggest that changes in injection frequency can be as important as changes in efficacy and safety attributes. Understanding which attributes of injectable therapies influence patient preference could potentially improve outcomes and adherence in patients with multiple sclerosis.

Project description:Background and objectivePatients' perceptions and experiences of medication efficacy, medication adverse events, dosing frequency, and dosing complexity have been found to influence adherence to injectable disease-modifying treatments (DMTs) in patients with multiple sclerosis (MS). The aim of this study was to quantify patient preferences for features of injectable DMTs for MS.MethodsAdult patients in the United States (US) with a self-reported diagnosis of MS completed an online discrete-choice experiment survey to assess preference for a number of features of a hypothetical injectable DMT. Patients chose hypothetical treatments in paired comparisons, where each treatment was described by features or attributes, including the number of years until disability progression, the number of relapses in the next 4 years, injection time, the frequency of injections, the occurrence of flu-like symptoms (FLS), and severity of injection-site reactions. Random-parameters logit regression parameters were used to calculate preference weights of attribute levels and the relative importance of changes in treatment features.ResultsOf the 205 patients who completed the survey, 192 provided sufficient data for analysis. The results indicated a broad range of tradeoffs that patients would be willing to make. With regard to this, the relative importance of an improvement in the number of years until disability progression from 1 to 2 (i.e., vertical distance between preference weights for these attribute levels) was 0.9 [95% confidence interval (CI) 0.5-1.2], the relative importance of this change was approximately equivalent to that of an improvement from 12 injections per month to two (mean 0.8, 95% CI 0.4-1.2), or approximately equivalent to a decrease from four to one relapses in the next 4 years (mean 0.8, 95% CI 0.5-1.2), or FLS 3 days after every injection to 3 days after some injections (mean 1.0, 95% CI 0.6-1.4).ConclusionsThese results suggest that an improvement in treatment efficacy may be as important as a reduction in injection frequency or a reduction in some adverse events for patients who self-administer injectable DMTs for MS. Understanding the preferences of patients who use injectable treatments will inform the development of such treatments, which may in turn improve patient medication adherence and well-being.

Dataset Information

A Psychometric Model for Discrete-Option Multiple-Choice Items.

Publications

A Psychometric Model for Discrete-Option Multiple-Choice Items.

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