1219. Unfavorable Clinical Outcomes with Polymyxins Compared to Ceftolozane/Tazobactam for the Treatment of Carbapenem-Resistant Pseudomonas aeruginosa

Background Patients with carbapenem-resistant Pseudomonas aeruginosa (CRPA) have high in-hospital mortality rates. It is unknown if patients with CRPA treated with ceftolozane/tazobactam (C/T) have improved clinical outcomes compared to those treated with polymyxins. Methods The CDC-funded, Georgia Emerging Infections Program performed active population- and laboratory-based surveillance for CRPA isolated from sterile sites, urine, lower respiratory tract and wounds in metropolitan Atlanta, GA from 8/1/2016–7/31/2018. We reviewed charts of adults without cystic fibrosis who were hospitalized within 1 week of CRPA culture. Using a desirability of outcome ranking (DOOR) analysis which incorporates both benefits and risks into a single outcome, we estimated the probability that a patient treated first with C/T would have a more desirable clinical outcome at 30-days than a patient treated with polymyxins (polymyxin B or colistin). We adjusted for confounding using inverse probability of treatment weighting (IPTW) based on culture source and need for dialysis at baseline. A partial credit analysis allowed for variable weighting of DOOR ranks and calculation of differences in mean partial credit scores. Results Among 710 cases from 18 different hospitals, we identified 73 patients treated for CRPA infections with polymyxins (n=31) or C/T (n=42). Most patients were male (64%) and Black (80%), and those receiving polymyxins were more likely to have required dialysis at baseline (35% vs. 14%, p=0.03) (Table 1). At 30 days after culture, 34 (47%) were alive with no adverse events, 21 (29%) were alive with ≥ 1 adverse event, and 18 (25%) had died. Patients first treated with C/T had a lower 30-day mortality rate than those treated with polymyxins (14% vs 39%, p=0.03). Additionally, those receiving C/T had better overall clinical outcomes, with an adjusted DOOR probability of having an improved outcome of 67% (95% CI 53%–80%) compared to those receiving polymyxins (Figure 1). Partial credit analyses indicated consistent results across different patient values of survival with adverse events (Figure 2). Figure 1: Inverse probability of treatment weighting-adjusted desirability of outcome ranking (DOOR) distributions by treatment group, accounting for adverse events and survival status that occurred up to 30 days after CRPA culture. 1. Percentages are adjusted using inverse probability of treatment weighting, controlling for culture source and need for dialysis at baseline 2. Adverse events measured included: acute kidney injury, discharge to higher acuity location than previous residence, or being hospitalized 30 days after culture Figure 2: Inverse probability of treatment weighting-adjusted partial credit analysis. This displays the difference (ceftolozane/tazobactam minus polymyxin) in mean partial credit scores (black line) and associated 95% confidence bands (gray lines) as a function of the partial credit score assigned to an individual having at least one adverse event (range 0 – 100%). A score of 100% is assigned to patients alive with no adverse events and a score of 0% is assigned to patients who die. A difference in mean partial credit scores of approximately zero suggests there was no difference observed between treatment groups. Conclusion These findings support the recent Infectious Diseases Society of America guidance favoring C/T over polymyxins for treatment of CRPA infections. Disclosures David van Duin, MD, PhD, Entasis (Advisor or Review Panel member)genentech (Advisor or Review Panel member)Karius (Advisor or Review Panel member)Merck (Grant/Research Support, Advisor or Review Panel member)Pfizer (Consultant, Advisor or Review Panel member)Qpex (Advisor or Review Panel member)Shionogi (Grant/Research Support, Scientific Research Study Investigator, Advisor or Review Panel member)Utility (Advisor or Review Panel member) Scott R. Evans, PhD, Abbvie (Consultant)Advantagene (Consultant)Alexion (Consultant)Amgen (Consultant)AstraZeneca (Consultant)Atricure (Consultant)Breast International Group (Consultant)Cardinal Health (Consultant)Clover (Consultant)FHI Clinical (Consultant)Genentech (Consultant)Gilead (Consultant)Horizon (Consultant)International Drug Development Institute (Consultant)Lung Biotech (Consultant)Microbiotix (Consultant)Neovasc (Consultant)Nobel Pharma (Consultant)Novartis (Consultant)Nuvelution (Consultant)Pfizer (Consultant)Rakuten (Consultant)Roche (Consultant)Roivant (Consultant)SAB Biopharm (Consultant)Shire (Consultant)Stryker (Consultant)SVB Leerink (Consultant)Takeda (Consultant)Teva (Consultant)Tracon (Consultant)Vir (Consultant)

Modern Test Theory Techniques for Adaptive Testing in Short Scales Comprising Polytomous Items: A Monte Carlo Simulation Study Comparing Rasch Measurement Theory to Unidimensional and Multidimensional Graded Response Models. (Preprint)

BACKGROUND There are two philosophical approaches to contemporary psychometrics: Rasch measurement theory (RMT) and item response theory (IRT). Either measurement strategy can be applied to computerized adaptive testing (CAT). There are potential benefits of IRT over RMT with regards to measurement precision, but also potential risks to measurement generalizability. RMT CAT assessments have demonstrated good performance with the CLEFT-Q, a patient-reported outcome measure for use in orofacial clefting. OBJECTIVE To test whether the post-hoc application of IRT (graded response models, GRMs, and multidimensional GRMs) to RMT-validated CLEFT-Q appearance scales could improve CAT accuracy at given assessment lengths. METHODS Partial credit Rasch models, unidimensional GRMs and a multidimensional GRM were calibrated for each of the 7 CLEFT-Q appearance scales (which measure the appearance of the: face, jaw, teeth, nose, nostrils, cleft lip scar and lips) using data from the CLEFT-Q field test. A second, simulated dataset was generated with 1000 plausible response sets to each scale. Rasch and GRM scores were calculated for each simulated response set, scaled to 0-100 scores, and compared by Pearson’s correlation coefficient, root mean square error (RMSE), mean absolute error (MAE) and 95% limits of agreement. For the face, teeth and jaw scales, we repeated this in a an independent, real patient dataset. We then used the simulated data to compare the performance of a range of fixed-length CAT assessments that were generated with partial credit Rasch models, unidimensional GRMs and the multidimensional GRM. Median standard error of measurement (SEM) was recorded for each assessment. CAT scores were scaled to 0-100 and compared to linear assessment Rasch scores with RMSE, MAE and 95% limits of agreement. This was repeated in the independent, real patient dataset with the RMT and unidimensional GRM CAT assessments for the face, teeth and jaw scales to test the generalizability of our simulated data analysis. RESULTS Linear assessment scores generated by Rasch models and unidimensional GRMs showed close agreement, with RMSE ranging from 2.2 to 6.1, and MAE ranging from 1.5 to 4.9 in the simulated dataset. These findings were closely reproduced in the real patient dataset. Unidimensional GRM CAT algorithms achieved lower median SEM than Rasch counterparts, but reproduced linear assessment scores with very similar accuracy (RMSE, MAE and 95% limits of agreement). The multidimensional GRM had poorer accuracy than the unidimensional models at comparable assessment lengths. CONCLUSIONS Partial credit Rasch models and GRMs produce very similar CAT scores. GRM CAT assessments achieve a lower SEM, but this does not translate into better accuracy. Commonly used SEM heuristics for target measurement reliability should not be generalized across CAT assessments built with different psychometric models. In this study, a relatively parsimonious multidimensional GRM CAT algorithm performed more poorly than unidimensional GRM comparators.

Using partial knowledge to inform the creation of learning progressions

The aim of this study was to show that some of the errors made by students when responding to mathematics assessment items can indicate progress in the development of conceptual understanding. By granting partial credit for specific incorrect responses by early secondary students, estimates of the difficulty of demonstrating full and partial knowledge of skills associated with the development of proportional reasoning were determined using Rasch analysis. The errors were confirmed as indicators of progress, and hence partial knowledge, when the thresholds of achievement followed a logical order: The greater the proficiency of the students, the more likely they were to receive a higher score. Consideration of this partial knowledge can enhance the descriptions of the likely behaviours of students at the various levels of learning progressions and this can be informative for teachers in their planning of learning activities.

Student Perceptions of Teaching Quality in Five Countries: A Partial Credit Model Approach to Assess Measurement Invariance

This study examines measurement invariance of student perceptions of teaching quality collected in five countries: Indonesia (n students = 6,331), the Netherlands (n students = 6,738), South Africa (n students = 3,422), South Korea (n students = 6,997) and Spain (n students = 4,676). The administered questionnaire was the My Teacher Questionnaire (MTQ). Student perceived teachers’ teaching quality was estimated using the partial credit model (PCM). Tests for differential item functioning (DIF) were used to assess measurement invariance. Furthermore, if DIF was found, it was explored whether an application of a quasi-international calibration, which estimates country-unique parameters for DIF items, can provide more valid estimates for between-country comparisons. Results indicate the absence of non-uniform DIF, but presence of uniform DIF among most items. This suggests that direct comparisons of raw mean or sum scores between countries is not advisable. Details of the set of invariant items are provided. Furthermore, results suggest that the quasi-international calibration is promising, but also that this approach needs further exploration in the context of student perceptions of teaching quality.

Analisis Pendekatan Saintifik sebagai Indikator Berpikir Ilmiah dalam Pembelajaran Sejarah

This study aims to analyze the extent to which the concept of a scientific approach that is generally accepted for all subjects in the curriculum in Indonesia is be able to become a basis for scientific thinking in history learning. This research is descriptive quantitative research with a survey method that aims to obtain information about the scientific thinking abilities of students in schools. The research subjects consisted of 60 high school students in Indonesia. The data was collected through a written test in the form of a description. Data analysis techniques using Partial Credit Model (PCM) with the help of the Quest program. The findings of the study showed that students who were able to answer questions in category 3 were less than 50%. These data indicate that the scientific approach that applies in general to all subjects in the curriculum in Indonesia has not been able to become the basis for students' scientific thinking skills in history learning. Based on this, the authors recommend four skills in historical learning, namely historical literacy, historical thinking, historical consciousness, and historical reasoning to be the basis for scientific thinking in historical learning. Keywords: Scientific Approach, Scientific Thinking, Historical Literacy, Historical Thinking, Historical Consciousness, and Historical Reasoning Abstrak. Penelitian ini bertujuan untuk menganalisis sejauh mana konsep pendekatan ilmiah yang berlaku umum untuk semua mata pelajaran dalam kurikulum di Indonesia mampu menjadi landasan berpikir ilmiah dalam pembelajaran sejarah. Penelitian ini merupakan penelitian deskriptif kuantitatif dengan metode survey yang bertujuan untuk memperoleh informasi gambaran tentang kemapuan berpikir ilmiah siswa di sekolah. Subjek penelitian terdiri dari 60 siswa Sekolah Menengah Atas di Indonesia. Pengumpulan data dilakukan melalui tes tertulis dalam bentuk uraian. Teknik analisis data menggunakan Partial Credit Model (PCM) dengan bantuan program Quest. Temuan penelitian menunjukkan bahwa peserta didik yang mampu menjawab soal pada kategori 3 kurang dari 50%. Data tersebut mengindikasikan bahwa pendekatan ilmiah yang berlaku secara umum untuk semua mata pelajaran dalam kurikulum di Indonesia belum mampu menjadi landasan keterampilan berpikir ilmiah siswa dalam pembelajaran sejarah. Berdasarkan hal tersebut, penulis merekomendasikan empat keterampilan dalam pembelajaran sejarah yaitu historical literacy, historical thinking, historical consciousness, dan historical reasoning untuk menjadi landasan berpikir ilmiah dalam pembalajaran sejarah. Kata Kunci: Pendekatan Ilmiah, Berpikir Ilmiah, Historical Literacy, Historical Thinking, Historical Consciousness, dan Historical Reasoning.

Diversity Accountability Index for Journals (DAI-J): Increasing awareness and establishing accountability across psychology journals

To increase awareness and establish accountability, we propose that journals rate themselves using this table with an emerging list of accountability benchmarks. Recommendations are derived from Buchanan, Perez, Prinstein, & Thurston's 2021 paper, Upending Racism in Psychological Science: Strategies to Change How Our Science is Conducted, Reported, Reviewed, and Disseminated. Benchmarks were based on Centola et al., 2018, which showed 25% as the tipping point for shifting majority opinion on social norms. In order to over-correct for racism that has permeated our science, we suggest partial credit (score of 1) for journals that meet the 25% threshold and full credit (score of 2) for journals that go well above this threshold (i.e., 33% or one third of their publications). In the present table, “Most” refers to 70-100% of published articles, “Some” refers to 30-50% of published articles, and “Few” refers to 0-10% of published articles. Buchanan, N. T., Perez, M., Prinstein, M. J., & Thurston, I. (invited resubmission). Upending Racism in Psychological Science: Strategies to Change How Our Science is Conducted, Reported, Reviewed, and Disseminated. American Psychologist. (PsyArXiv Public Access: https://psyarxiv.com/6nk4x)

Examining Chemistry Students’ Perceptions Toward Multiple-Choice Assessment Tools that Vary in Feedback and Partial Credit

Multiple-choice testing with dichotomous scoring is one of the most common assessment methods utilized in undergraduate education. Determining students’ perceptions toward different types of multiple-choice testing formats is important for effective assessment. The present study compared two alternative multiple-choice testing formats used in a second-year required chemistry course: (1) The Immediate Feedback Assessment Technique (IFAT®) and (2) Personal Point Allocation (PPA). Both testing methods allow for partial credit but only the IFAT® provides immediate feedback on students’ responses. Both survey and interview data indicated that, overall, most students preferred IFAT® to the PPA testing method. These positive ratings were related to potential increase in reward, ease of use, and confidence. IFAT® was also perceived to be less stress producing, and anxiety provoking than PPA. Interview data supported these findings but also indicated individual differences in preference for each of these two methods. Additionally, students’ feedback on strategies used for either testing method and suggestions on how to improve the methods are discussed.

Diversity Accountability Index for Journals (DAI-J): Increasing awareness and establishing accountability across psychology journals

To increase awareness and establish accountability, we propose that journals rate themselves using this table with an emerging list of accountability benchmarks. Recommendations are derived from Buchanan, Perez, Prinstein, & Thurston's 2021 paper, Upending Racism in Psychological Science: Strategies to Change How Our Science is Conducted, Reported, Reviewed, and Disseminated. Benchmarks were based on Centola et al., 2018, which showed 25% as the tipping point for shifting majority opinion on social norms. In order to over-correct for racism that has permeated our science, we suggest partial credit (score of 1) for journals that meet the 25% threshold and full credit (score of 2) for journals that go well above this threshold (i.e., 33% or one third of their publications). In the present table, “Most” refers to 70-100% of published articles, “Some” refers to 30-50% of published articles, and “Few” refers to 0-10% of published articles. See: Buchanan, N. T., Perez, M., Prinstein, M., & Thurston, I. (invited resubmission). Upending Racism in Psychological Science: Strategies to Change How Our Science is Conducted, Reported, Reviewed, and Disseminated. American Psychologist. PsyArXiv. https://psyarxiv.com/6nk4x