@article{91fd24c559a249f0ac5cd2e90e24cebb,
title = "Item response theory analysis of the Clinical Dementia Rating",
abstract = "Introduction: The Clinical Dementia Rating (CDR) is widely used in Alzheimer's disease research studies and has well established reliability and validity. To facilitate the development of an online, electronic CDR (eCDR) for more efficient clinical applications, this study aims to produce a shortened version of the CDR, and to develop the statistical model for automatic scoring. Methods: Item response theory (IRT) was used for item evaluation and model development. An automatic scoring algorithm was validated using existing CDR global and domain box scores as the reference standard. Results: Most CDR items discriminate well at mild and very mild levels of cognitive impairment. The bi-factor IRT model fits best and the shortened CDR still demonstrates very high classification accuracy (81%∼92%). Discussion: The shortened version of the CDR and the automatic scoring algorithm has established a good foundation for developing an eCDR and will ultimately improve the efficiency of cognitive assessment.",
keywords = "Alzheimer's disease, Clinical Dementia Rating, bi-factor model, cognitive assessment, dementia severity, item response theory",
author = "Yan Li and Chengjie Xiong and Aschenbrenner, {Andrew J.} and Chang, {Chih Hung} and Weiner, {Michael W.} and Nosheny, {Rachel L.} and Dan Mungas and Bateman, {Randall J.} and Jason Hassenstab and Moulder, {Krista L.} and Morris, {John C.}",
note = "Funding Information: Yan Li, Chengjie Xiong, Andrew J. Aschenbrenner, Chih‐Hung Chang, Michael W. Weiner, Rachel L. Nosheny, Dan Munga, Krista L. Moulder, and John C. Morris have nothing to report. Randall J. Bateman serves as principal investigator of the DIAN‐TU, which is supported by the Alzheimer's Association, GHR Foundation, an anonymous organization and the DIAN‐TU Pharma Consortium (Active: Eli Lilly and Company/Avid Radiopharmaceuticals, Hoffman‐La Roche/Genentech, Biogen, Eisai, Janssen, and United Neuroscience). Randall J. Bateman receives lab research funding from the National Institutes of Health, Alzheimer's Association, BrightFocus Foundation, Rainwater Foundation Tau Consortium, Association for Frontotemporal Degeneration, the Cure Alzheimer's Fund, Centene Corporation, Tau SILK Consortium (AbbVie, Biogen, and Eli Lilly and Company), and an anonymous foundation. Randall J. Bateman has received honoraria as a speaker/consultant/advisory board member from Amgen, AC Immune, Eisai, Hoffman‐LaRoche, Janssen, and Pfizer. Randall J. Bateman is a cofounder and serves on the scientific advisory board for C2N Diagnostics LLC. Randall J. Bateman has equity ownership interest in C2N Diagnostics and receives royalty income based on technology (stable isotope labeling kinetics and blood plasma assay) licensed by Washington University to C2N Diagnostics. Randall J. Bateman receives income from C2N Diagnostics for serving on the scientific advisory board. Jason Hassenstab serves as a consultant and advisory board member for Roche, Takeda, Biogen, and Lundbeck, and a DSMB member for Eisai. Funding Information: We would like to express our gratitude to the research participants in the Memory & Aging Project and their supportive families. We thank the Clinical Core and Biostatistic Core at the Knight Alzheimer Disease Research Center for sample and data collection. This work was supported by the National Institutes of Health 1RF1AG059009‐01. Data used in this research were from the Memory & Aging Project at Washington University funded by the National Institute on Aging (NIA) P50AG05681 and P01AG03991, and P01AG026276. Funding Information: We would like to express our gratitude to the research participants in the Memory & Aging Project and their supportive families. We thank the Clinical Core and Biostatistic Core at the Knight Alzheimer Disease Research Center for sample and data collection. This work was supported by the National Institutes of Health 1RF1AG059009-01. Data used in this research were from the Memory & Aging Project at Washington University funded by the National Institute on Aging (NIA) P50AG05681 and P01AG03991, and P01AG026276. NIH funding 1RF1AG059009-01 (PI: Michael W. Weiner) provided financial support for the conduction of this research, but was not involved in the collection or analysis of the data. Data used in preparation of this article were obtained from the Memory and Aging Project (MAP) database at Washington University. As such, the investigators within the MAP provided data but did not participate in analysis of this project. Publisher Copyright: {\textcopyright} 2020 the Alzheimer's Association",
year = "2021",
month = mar,
doi = "10.1002/alz.12210",
language = "English",
volume = "17",
pages = "534--542",
journal = "Alzheimer's and Dementia",
issn = "1552-5260",
number = "3",
}