PSYCHOMETRIC TESTING

Abstract: In a method for measuring or monitoring throughout any predetermined period the percentage value rating of a self-assessed variable in relation to one or more test individuals, for example each individual's feeling of well-being or quality of life rating during the course of medical treatment, each test individual is supplied with a record card (10) that has a black surface (12) overprinted with a number of separate light silver coloured squares (14) composed of opaque material that can be removed selectively by scraping or scratching. At the end of each day, the test individual scratches away at least part of the opaque silver material of a relevant square (14) to expose the darker underlying area to an extent that is considered to be visually representative of how well or unwell that individual has felt on average during that day. The daily results are recorded on the silver coloured recording squares in a predetermined order and testing is continued for a predetermined period, e.g. 28 days. At the end of that time, the card (10) is processed using an image scanning device (25) connected to a computer system that processes the digitised data generated to measure the proportion or percentage amount of each silver recording square that has been removed, the output being provided in a form selectable by the user. The system described may be adapted for measuring or monitoring other intangible variables or characteristics that are quantifiable in terms of a percentage value rating determined by personal assessment of a test individual.

Description: PSYCHOMETRIC TESTING The present invention relates to the field of psychometric testing, and it is particularly concerned with a method of and means for measuring or monitoring one or more quantifiable variables or characteristics whose values are dependent upon personal assessment. The invention may be used for various purposes, being suited generally to situations where there is a need, in a simple, reliable and convenient way, to collect and collate data, either from a particular individual or from a number of individuals, which represents a personal assessment of a rating value for one or more generally intangible but quantifiable variables or characteristics, measured in some cases in respect of one or more particular time periods. Situations where such assessment data is needed from a range or group of individuals commonly arise, for example in the area of market research or in connection with measurement or monitoring of a quality rating, for instance the quality of some particular performance. However, an especially important area, for which the invention has been initially developed, is in the field of medicine and concerns "feeling of well-being" or "quality of life" testing and measurement, especially for patients undergoing medical treatment or in clinical trials. In recent years, increasing attention has been given to the "quality of life" of patients suffering from many diseases or disabilities, especially serious and potentially fatal or chronic diseases such as cancer, cardiovascular diseases, AIDS, and arthritis for example, and the assessment and evaluation of this "quality of life" characteristic for such patients is becoming widely recognised as being a necessary and important part of evaluating the effects of medical treatment, especially in clinical trials. This subject is extensively discussed for instance by Dr. Lesley Fallowfield in a book entitled "The Quality of Life - The Missing Measurement in Health Care", published (1990) by Souvenir Press (E & A) Limited of London, and there is now a growing realisation that in medical care the need to avoid an unacceptable impairment of the quality of life is often just as important as considerations of the medical effectiveness of the treatment that may be given to patients. There is, therefore, a need to attempt to measure and monitor this characteristic for individual patients, especially during a course of treatment and in clinical trials, but it will be appreciated that "quality of life" is a highly subjective characteristic open to different interpretations by different people, and the overall or global measure of this characteristic is dependent on a range of different parameters or variables whose relative importance depends much on the individuals concerned. Hitherto, quality of life measurements and data have commonly been obtained by providing patients with self- assessment questionnaires containing a number of questions which are directed to various selected parameters that are considered to be relevant for determining an overall quality of life measurement and which are adapted to be answered by the patient in various ways, for example by marking a linear analogue scale or marking certain predetermined responses in a pre-coded categorical scaling system which can provide an assessment rating. Many of these existing questionnaire systems, however, are of unproven validity and reliability, are often rather inconvenient and confusing to the patient, and where monitoring over a period of time is required several separate copies of the questionnaire may be needed. Also, and most importantly, it is often not easy quickly and accurately to collate and analyse all the data obtained, and this tends to discourage physicians and clinicians from using such systems. Accordingly, a need has ■ '"been recognised for some improvements, taking into account both the convenience and ease of use by the patients and ease of collating and processing the data obtained. Similarly, there is also scope for improvements in existing questionnaire systems used for obtaining and processing personal assessment data for other purposes, such as in the field of market research for example. Broadly, the present invention provides a method of psychometric testing applicable to one or more test individuals for measuring or monitoring one or more intangible but quantifiable variables or characteristics based on a personal self-assessment which is made by the or each said test individual and which can be expressed in terms of a percentage value rating, said method comprising: (a) supplying to the or each test individual, for the particular variable or characteristic concerned, a test record card provided on one face with one or more recording elements composed of opaque material that can be readily removed, completely or partially, by selective scraping or scratching to expose a variable area of an underlying base surface of the card which has optical or light-reflecting properties differing from those of the recording elements, whereby the fractional or percentage amount of each recording element thus removed can be measured by calibrated optical reading means; (b) arranging for the or each test individual to make an assessment of a percentage value rating to be given to the particular variable or characteristic under test and to enter or record this on his or her record card by scraping or scratching a relevant said recording element thereof to remove the fractional or percentage amount of said recording element that is considered by said test individual to be visually representative of said percentage value rating assessment; and subsequently (c) processing the or each record card using optical reading apparatus to measure the proportion or percentage amount of each recording element that has been removed, thereby to obtain and collate the corresponding percentage value ratings for said particular variable or characteristic tested. The test record card recording elements are preferably in the form of an overlay film or layer of the opaque material that may be applied to the respective face of the record card by printing, or by any other suitable means, so as to cover over and conceal selected predefined areas of the underlying base surface of the card. When, as will usually be the case, the card carries a plurality or series of such recording elements, they should each be well defined and located accurately in predetermined positions on the face of the card, preferably in a regular or logical pattern, e.g. a grid pattern. Preferably the recording elements are white or have a light colour of high reflectivity whilst the base surface of the card is very dark coloured or is black, but any other colour combinations may be used so long as they provide a satisfactory optically distinctive tonal contrast. The term "card" as used herein is intended to cover any suitable substrate device, generally of a wafer-like form and presenting a planar surface, that can meet the functional and physical requirements set forth above. In preferred embodiments, the record cards will generally be read using optical reading apparatus in the form of an image scanning device connected to a computer system adapted or programmed to process the digitised image data generated and to provide an output in a convenient form selectable by the user. The invention also includes record cards and the combination of apparatus that provides a unified system for carrying out the method herein disclosed. By way of example, there will now be more specifically described, with reference to the accompanying drawings, a particular embodiment of the invention that has been developed primarily for use in measuring and monitoring the "quality of life" of patients undergoing medical treatment for breast cancer. In the accompanying drawings, FIGURE 1 is a view of the front face of a typical test record card used in this embodiment of the invention; FIGURE 2 is a diagrammatic perspective view of a completed record card in position on a reading table or support plate for reading with a hand-held optical image scanning device; FIGURE 3 is a plan view of the reading table or support plate shown in FIGURE 2; and FIGURE 4 is a section on line IV - IV of FIGURE 3. The test record card of this embodiment is intended to be used to provide a daily record of a patient's quality of life over a four week monitoring period, the patient maintaining the card each day as hereinafter described. In this example, the record card, denoted by the reference numeral 10 in the drawings, is formed of a rectangular piece of stout cardboard which, very conveniently, is of substantially the same size as a conventional standard credit card, i.e. approximately 8.5 x 5.5cm, so that it can easily be carried around by the user. Cards of other sizes can of course be used, but in general for convenience and ease of use it is desirable that the length and breadth dimensions should not differ by more than 50% from the above quoted values, i.e they should lie in the ranges of 8.5 ± 4.25cm and 5.5 ± 2.75cm respectively. As may be seen from FIGURE 1, the front face of the record card 10 has a dense black coloured base surface 12 provided by a black paint undercoat bearing a hardened protective coating of varnish, and on this is overprinted a set of 28 silver-coloured squares 14 of equal size arranged in a regular matrix pattern comprising four rows each containing seven squares. Each of these squares 14 constitutes a predefined recording element for use on a single day, different squares 14 being used systematically in a predetermined order for each day of a 28 day monitoring period with the different rows representing the days of each week. Each overprinted silver-coloured recording element or square 14 comprises an overlay film or layer of opaque material that covers and conceals the underlying portion of the black base surface and is produced by a latex based glue/printing ink incorporating an aluminium pigment. This material has a low tack level of adhesion such that for each separate square 14 it can readily be removed, completely or partially, by scraping or scratching, with a blunt tool or coin for example, thereby to expose all or part of the underlying black base surface. The varnish coating of the latter protects the base surface from being abraded when this top overlay covering is being scraped or scratched off. This form of construction of card with a scratch removable covering corresponds to that known and commonly used in connection with lottery tickets for example where the user scratches off an outer covering of material to reveal a number or symbol printed on the surface beneath, and the techniques for producing such overlay coverings are well known in the art. These record cards may quite appropriately be referred to as "scratch cards". It will be appreciated that by virtue of the difference in colours, the silver-coloured recording element squares 14 and the underlying portions of the black base surface 12 have substantially different light reflecting properties, and the fraction or proportion of the total area of the squares which is removed, corresponding to the increased area of the underlying black base surface which is exposed, when the silver coating material of any given square 14 is partially scraped or scratched off can easily be measured by an optical reading device calibrated against a reference standard, e.g. an intact reference card. In use, as previously indicated, the card 10 is maintained by the individual patient concerned who is instructed to scrape or scratch off at the end of each day all or part of the silver covering of the appropriate square 14 relating to that day in such a way that the fraction or proportion of the total area of the covering material removed for that square, and hence the extent to which the underlying black base surface is exposed, reflects the patient's self-assessed feeling of well-being or personal assessment of how "black" the patient has felt, on average, during the day. The fraction or proportion of the recording element square removed thus represents an overall or global measure in this instance of the patients quality of life for that day. At the end of the monitoring period (28 days in this case if the card is fully used), the completed record card is collected and processed to read and analyse the data recorded thereon. Reading the card is most advantageously carried out by use of optical reading apparatus and, although a simple light meter could be employed for this purpose if so desired, the preferred method herein described in connection with this exemplary embodiment involves capturing an image of the card in digitised form by means of an optical image scanner connected to a microcomputer and using the computer, programmed with purpose developed software adapted to analyse the captured image data, to assess what percentage amount of each recording element square 14 has been scraped or scratched off. The data produced may then be further processed by the software to provide an output in a convenient form selected by the user, for example, tabulated daily, weekly or monthly results. In the particular example of the present embodiment, the card reading operation is carried out by placing the card 10 in a locating recess 18 of a reading table or support plate 20 (see FIGURES 2 to 4) and then scanning it with a hand-held image scanner, such as a SCANMAN 32 (Registered Trade Mark) manufactured by Logitech Inc. which is capable of digitising an area of up to 105 x 105mm square. This device, shown at 25 in FIGURE 2, may be used at a resolution of 100 dots per inch and is connected by means of a cable 24 to a microcomputer, for example an Opus PC SX (Registered Trade Mark) computer, via an interface board which is supplied with the image scanner device and which is installed in the computer. As the scanner is moved over the record card, a binary image of the card is captured by the computer. As indicated, the reading table or support plate 20 is designed to hold the record card 10 in a fixed position in the locating recess 18 whilst the scanner 25 is moved across its upper surface. Guiderails 22 are provided at opposite sides to guide the movement of the scanner 25, and the main bed 23 of the support plate itself is formed by a sheet or panel of opaque white Perspex (Regd. Trade Mark) having a depression cut towards one end of its top surface in order to provide the locating recess 18. The dimensions of the depression or recess 18 are such that it can receive the record card 10 and keep it in position during scanning with the top surface of the card flush with the top surface of the main bed 23, as shown in FIGURE 2. A circular hole 27 is drilled through the plate in the centre of the recess 18, as shown in FIGURES 3 and 4, to facilitate removal of the card, and an upstanding end wall 28 at one end provides an end stop for the scanner. As the scanner 25 works by emitting light and measuring its reflection, it is important that the light reflected by the support comes only from its upper surface. It is therefore very desirable that the bed 23 of the support should be constructed, as described, from a material which is both white and opaque. Typically, the computer to which the scanner is connected will have an 80386 processor running for example at 20 MHz and will have a colour VGA interface and monitor, 40 Mbyte hard disk, and at least 1 Mbyte main memory. It will also be connected to a suitable printer, e.g. an ink jet printer or laser printer. The image scanning device will generally be provided with its own image capture software by the manufacturer and this will be used in conjunction with the requisite purpose-developed software for analysing and processing the data. Software Operation For a better understanding of the way in which the data may be processed, there now follows a more detailed outline description of the typical operation of one particular form of software used in connection with the present embodiment. The computer program is run by first typing its name which brings up a first screen display that prompts the user to check and confirm that the scanner 25 is set up correctly. Then, once the user has confirmed that the scanner is correctly configured, a main menu is presented containing the following items: 1. Scan a card and store the image 2. Analyse an image you have stored 3. Analyse several images 4. List image files 5. List result files 6. Print out a result file 7. Stop this package running and return to DOS On selecting menu item 1, this makes use of the image capture software supplied to scan the image and store it on the hard disk of the computer. The user is prompted for the name of the file in which to store the image, and the image capture software is passed control information which specifies how the scanner 25 is to be used and provides the name of the file in which the digitised image of the card is to be stored. Provided there is no error condition detected, the "scan button" on the scanner device is held down and the card is scanned to produce the image thereof. The scanned image is displayed on the screen for checking, and if acceptable the user presses the "enter key" to return to the main menu. Otherwise, the card can be re- scanned by pressing a particular function key. The scanned image is stored in TIF file format. Selecting item 2 from the main menu enables the stored image to be analysed. In order to analyse an image, the user first specifies the file name of the image to be processed. The default image corresponding with the last record card scanned may be selected by simply typing "return" when the file name is requested, but if the default image is not required then the appropriate file name is entered at the keyboard. The first stage in the analysis of the card image is the establishment of the positions of the four edges of the card. The scanned background is recorded as a light colour whereas the card itself is recorded as a dark colour. The position of an edge therefore corresponds to a transition from light to dark and candidate pixels for the location of an edge of the card is determined by examining the contents of the rows or columns of the image matrix. This examination starts at the top, bottom, left or right of the image as appropriate and for a given row or column is terminated once an edge is found. All candidate edge pixels are then tested to see if they are close to another edge pixel and distant candidates are rejected as noise. The position of the card edge is then determined from a linear least squares fit to the remaining edge candidates. Any candidates which are distant from this fitted line can also be rejected and the regression repeated. Once the equations of the four edges of the card are known, the coordinates of the corners of the card are calculated from the intersections of these boundary lines. The locations of the recording elements or squares 14 representing the scratch areas are then deduced from simple geometry, and the fraction of each recording element or square removed is calculated. If the opaque overlay or covering material above a pixel of the image has been removed, then the pixel will be "dark" otherwise the pixel will be "light". As the analysis is performed, the scanned image is displayed on the screen and the display shows the progress of the analysis square by square so that any mis¬ registration of the computer calculated recording elements or scratch areas and the true recording elements or scratch areas can be seen. The final stage of the analysis is to display the percentage of the area of each recording element square removed for each of the 28 squares on the card, together with weekly and four-weekly averages. The resulting analysis is then stored in a result file for future reference. Item 3 of the menu is an option for analysing several images sequentially, but it operates in a similar way to option 2. The file names of all the images to be processed, however, are entered before the processing commences. Items 4 and 5 of the main menu are provided merely for giving lists or directories of the names of the image files that are available and the names of the result files which are available. Item 6 of the main menu is used for printing out a result. This option will print out the result file on the printer, and by way of example a sample printout is given below: ANALYSIS OF SCANNED CARD FILE C:\IMAGES\TEST100.TIF Lowest value found: 20 (on day 7) Highest value found: 100 Gross mean: 55.35 (weeks 1-4 = 34.71 51.28 69 66.42) Results as on card: 43, 47, 29, 46, 25, 33, 20, 29, 31, 24, 46, 62, 76, 91, 74, 99, 100, 90, 52, 33, 35, 28, 53, 38, 73, 80, 95, 98 Item 7 on the main menu is merely for exiting from the program and returning to the operating system. As will be appreciated, the system described is easy to use by all persons concerned, and is capable of being readily understood by the individual patient. Although the system has been described in terms of measuring an overall or global quality of life characteristic, it may also be used for a number of variables which form part of this characteristic, e.g. anxiety, depression and appetite. Either a series of separate cards can be employed for monitoring these different variables, or a number of different variables could be recorded on a single card using, for example, different rows of recording elements or 5 "scratch" squares with the computer reading system programmed accordingly. Colour combinations other than black and silver may of course also be used for the base surface and the recording elements respectively, so long as there is sufficient contrast to provide a readily readable 10 image, and particularly where a number of different variables are to be recorded different colour coding of at least the recording elements may be desirable for clearly identifying and distinguishing them. 1 -~ A~-- ~ [ In a further modification, if desired the opaque overlay covering of each recording element on the record card may be printed initially so as to be subdivided or broken-up into a number or series of closely-adjacent separate sub-elements or discrete segments that can be 20 scraped or scratched off selectively. In certain circum¬ stances, this arrangement may perhaps help the user to control removal of the correct fractional amount of the total covered area that is wanted for any given recording element. 25 The record cards may also carry additional information, either printed on the front or on the reverse side, and this information may be either textual or in the form of a bar code that can also be read by the optical 30 reading apparatus. In particular, for the cards 10 of the "quality of life" measurement and monitoring system specifically described herein for this exemplary embodiment of the invention, the back of the cards are conveniently printed with markings for recording the patient's 35 identification number and date of commencing the monitoring period. In connection with "quality of life" monitoring, the detailed record and analysis of the results obtained can be particularly useful for assessing progression of a patient's disease and/or treatment, and this can facilitate tailoring management of the patient to attempt to maintain as high quality of life as possible. Many other modifications may of course be made within the scope of the invention, and the system described can readily be adapted to suit other situations, for example in the field of market research as already mentioned, since it need not be limited to monitoring the assessment by a single individual of one or more variables over a particular time period or series of time periods. In particular, where data is required from a number of different individuals, each making their own personal assessment of a particular variable or set of variables relating to a given subject or product for example, each individual may be provided with his own card and after carrying out a test the different cards, duly completed, are then all read by the same computer scanning system and the data obtained can be processed collectively. As will be seen, the invention provides a number of different aspects and, in general, it embraces all novel and inventive features and aspects herein disclosed, either explicitly or implicitly and either singly or in combination with one another. Moreover, the scope of the invention is not to be construed as being limited by the illustrative examples or by the terms and expressions used herein merely in a descriptive or explanatory sense.

Claims: CLAIMS 1. A method of psychometric testing applicable to one or more test individuals for measuring or monitoring one or more intangible variables or characteristics that are quantifiable by a personal assessment thereof which is made by the or each said test individual and which can be expressed in terms of a percentage value rating, said method comprising: (a) supplying to the or each test individual, for the particular variable or characteristic concerned, a test record card provided on one face with one or more recording elements composed of opaque material that can be readily removed, completely or partially, by selective scraping or scratching to expose a variable area of an underlying base surface of the card which has optical or light-reflecting properties differing from those of the recording elements, whereby the fractional or percentage amount of each recording element thus removed can be measured by calibrated optical reading means; (b) arranging for the or each test individual to make an assessment of a percentage value rating to be given to the particular variable or characteristic under test and to enter or record this on his or her record card by scraping or scratching a relevant said recording element thereof to remove the fractional or percentage amount of said recording element that is considered by said test individual to be visually representative of said percentage value rating assessment; and subsequently (c) processing the or each record card using optical reading apparatus to measure the proportion or percentage amount of each recording element that has been removed, thereby to obtain and collate the corresponding percentage value ratings for said particular variable or characteristic tested. 2. A method as claimed in Claim 1 wherein the opaque material of the or each recording element of said test record card is in the form of an overlay film or layer applied to the respective face of the record card, by printing or other means, so as to cover over and conceal selected predefined areas of the underlying base surface of the card. 3. A method as claimed in any of the preceding claims wherein the or each recording element on the record card and the underlying base surface of the card are coloured differently to provide an optically distinctive tonal contrast. 4. A method as claimed in Claim 3 wherein the or each said recording element is white or has a relatively light colour while the base surface of the record card is dark coloured or is black so as to provide an optically readable difference in reflectivity. 5. A method as claimed in any of the preceding claims wherein said test record card has a plurality or series of said recording elements that are each well defined and located accurately in predetermined positions on the face of the card. 6. A method as claimed in Claim 5, wherein the recording elements on said record card are of a regular geometric shape arranged in a grid pattern. 7. A method as claimed in Claim 5 or 6 further characterised by the fact that step (b) is repeated periodically with the test individual concerned using a different recording element on each occasion to enter or record the respective percentage value rating assessment made. 8. A method as claimed in Claim 7 wherein step (b) is repeated daily and the recording elements on said test record card are arranged in one or more groups of seven corresponding to a predetermined number of weeks representative of the maximum overall period over which the testing may be carried out. 9. A method as claimed in any of the preceding claims wherein the or each record card used has a wafer like form with a length of 8.5cm and a breadth of 5.5cm, or length and breadth dimensions which do not differ by more than 50% from the above quoted values, i.e. a length within the range of 8.5 ± 4.25cm and a breadth within the range of 5.5 ± 2.75cm. 10. A method as claimed in any of the preceding claims wherein the or each record card is read using optical reading apparatus in the form of an image scanning device connector to a computer system adapted or programmed to process the digitised image data generated and to provide an output in a form selectable by the user. 11. A method as claimed in any of the preceding claims, applied to "Quality of Life" measuring or monitoring of a patient or groups of patients undergoing medical treatment. 12. A method of measuring or monitoring an individual's feeling of well-being or quality of life during the course of medical treatment, as determined by a personal self- assessment made by the individual concerned, said method comprising providing the test individual with a card having on one face thereof a number of recording elements composed of opaque material printed on the underlying surface of the card and optically distinguishable from the latter, the test individual then making at regular intervals an assessment of his feeling of well-being or quality of life and recording this by scratching away a certain fraction or percentage amount of the opaque material on a relevant said recording element on the card so that the extent to which the opaque material is removed provides an optically readable effect representative of the value rating assessed by the individual for the preceding period, the recording elements being used successively in a predetermined order throughout the period that the test is continued, and the record card then being processed using optical reading apparatus to measure the proportion or percentage amount of each recording element that has been removed. 13. Apparatus for carrying out the method of any of the preceding claims, said apparatus comprising in combination an image scanning device connected to a computer system and one or more said test record cards. 14. A test record card for use in the method claimed in Claim 11 or 12, characterised in that there are a plurality of said recording elements arranged in one or more rows, each row containing seven elements, one for each day of the week, comprised of a scratch-removable light or silver coloured opaque material printed over a black or dark coloured underlying surface of the card.

Inventors: BAUM MICHAEL, DANCE DAVID ROGER, BAUM, MICHAEL, DANCE, DAVID, ROGER
Applicants: BAUM MICHAEL, DANCE DAVID ROGER, BAUM, MICHAEL, DANCE, DAVID, ROGER
Application year: 1993
Main classification: G09B7
IPC codes: G09B3, G09B7, G09B23