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

Seung W. Choi, Steven P. Reise, Paul A. Pilkonis, Ron D. Hays, David Cella

Research output: Contribution to journalArticlepeer-review

179 Scopus citations


Purpose: 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. Methods: 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. Results: 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. Conclusions: 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.

Original languageEnglish (US)
Pages (from-to)125-136
Number of pages12
JournalQuality of Life Research
Issue number1
StatePublished - Feb 2010


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

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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