摘要
目的 探讨运用项目反应理论（IRT）将不同的常用神经心理学量表得分进行统一的可能性. 方法 共入组203例老年研究对象,认知能力正常者101例,轻度认知障碍患者（MCI） 102例,平均年龄（80.9±9.5）岁.采集蒙特利尔认知评估量表（MoCA）和简易智能状态检查量表（MMSE）资料,使用Stata 14.0进行IRT分析.分析时,总体选择Hybrid模型分析,对定性资料项目选择2PL模型,等级资料项目选择GRM模型,共同进行模型拟合.拟合成功后,利用测试特征曲线图（TCC）计算出不同θ值下MMSE与MoCA的相应分值并制图. 结果 MoCA与MMSE量表资料符合单维性要求,本研究正常组MoCA得分（26.37±2.63）分,MMSE得分（29.06±1.32）分;MCI组MoCA得分（21.57±3.47）分,MMSE得分（26.62±2.89）分.MoCA拟合Log likelihood=-1 670.9012,MMSE拟合Log likelihood=一773.9797.TCC图提示在同样的认知能力下,MoCA得分较MMSE低,两者均呈现先陡后平缓的曲线形态.MoCA对于认知能力的区分更加精细一些,MMSE更容易出现天花板效应. 结论 通过IRT可以将2个常用量表评分信息互通,使各个研究组、不同量表之间可以资料通用.
Objective To explore the probability to unify the scores of different neuropsychological scales under the guideline of item response theory （IRT）.Methods Two hundred and three old individuals with a mean age of （80.86±9.52） years were enrolled in this study,including 101 normal individuals and 102 patients with mild cognitive impairment （MCI）.The data of cognitive ability assessed using MoCA and MMSE scales were collected and analyzed according to IRT with Stata 14.0 software.The population,qualitative data,and scaled data were analyzed by Hybrid model,2PL model,and GRM model,respectively.Finally,model fitting was conducted in these data.We used test characteristic curves（TCC）to calculate corresponding theta values of the scores of MMSE and MoCA,and draw cartograms after fitting the model.Results The data of MoCA and MMSE conformed to the characteristics of unidimension.The scores of MoCA and MMSE were 26.37 ±2.63 and 29.06±1.32,respectively,in the normal group,and those were 21.57±3.47 and 26.62± 2.89,respectively,in the MCI group.The Log likelihood for the fitting model of MoCA and MMSE was-1 670.9012 and-773.9797,respectively.The TCC indicated that the score of MoCA was lower than that of MMSE at the same level of theta value.The TCC of the two scales were both steep at first,and then became flat.In evaluating the cognition ability,the MoCA score was more precise than MMSE score,and MMSE score was easier to show ceiling effect than MoCA score.Conclusions Under the guideline of item response theory,we can unify the scores of two scales in order to make the scores of two scales fit with each other and be in common use during study and research.
作者
潘晓东
周辰
何一然
Pan Xiaodong;Zhou Chen;He Yiran(Jiangsu Geriatric Research Institute,Nanjing 210024,China)
出处
《中华老年医学杂志》
CAS
CSCD
北大核心
2018年第8期870-874,共5页
Chinese Journal of Geriatrics
关键词
认知障碍
神经心理学量表
项目反应理论
Cognition disorders
Neuropsychological scale
Item response theory
