Article

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.
CI - Copyright (c) 2013 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS