Computerized adaptive test for patients with foot or ankle impairments produced valid and responsive measures of function.

Objective: We tested the item response theory (IRT) model assumptions of the original item bank, and evaluated the practical and psychometric adequacy, of a computerized adaptive test (CAT) for patients with foot or ankle impairments seeking rehabilitation in outpatient therapy clinics.Methods: Data...

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Publicado en:Quality of Life Research Vol. 17; no. 8; pp. 1081 - 1092
Autores principales: Hart DL, Wang YC, Stratford PW, Mioduski JE, Hart, Dennis L, Wang, Ying-Chih, Stratford, Paul W, Mioduski, Jerome E
Formato: research Journal Article
Publicado: Springer Nature Oct2008
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2008
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      pub: Springer Nature
      place: New York, New York
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        atl: Computerized adaptive test for patients with foot or ankle impairments produced valid and responsive measures of function.
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        au:
          Hart DL
          Wang YC
          Stratford PW
          Mioduski JE
          Hart, Dennis L
          Wang, Ying-Chih
          Stratford, Paul W
          Mioduski, Jerome E
        affil: Focus on Therapeutic Outcomes, Inc., 551 Yopps Cove Road, White Stone, VA, 22578-2403, USA
      sug:
        subj:
          Ankle Injuries Psychosocial Factors
          Computers and Computerization
          Disability Evaluation
          Foot Injuries Psychosocial Factors
          Quality of Life Psychosocial Factors
          Software
          Adaptation, Psychological
          Adolescence
          Adult
          Aged
          Ankle Injuries Rehabilitation
          Female
          Foot Injuries Rehabilitation
          Lower Extremity Pathology
          Male
          Middle Age
          Models, Theoretical
          Outpatients
          Pilot Studies
          Psychometrics
          ROC Curve
          Human
          Adolescent: 13-18 years
          Adult: 19-44 years
          Aged: 65+ years
          Middle Aged: 45-64 years
          Female
          Male
      ab: Objective: We tested the item response theory (IRT) model assumptions of the original item bank, and evaluated the practical and psychometric adequacy, of a computerized adaptive test (CAT) for patients with foot or ankle impairments seeking rehabilitation in outpatient therapy clinics.Methods: Data from 10,287 patients with foot or ankle impairments receiving outpatient physical therapy were analyzed. We first examined the unidimensionality, fit, and invariance IRT assumptions of the CAT item bank. Then we evaluated the efficiency of the CAT administration and construct validity and sensitivity of change of the foot/ankle CAT measure of lower-extremity functional status (FS).Results: Results supported unidimensionality, model fit, and invariance of item parameters and patient ability estimates. On average, the CAT used seven items to produce precise estimates of FS that adequately covered the content range with negligible floor and ceiling effects. Patients who were older, had more chronic symptoms, had more surgeries, had more comorbidities, and did not exercise prior to receiving rehabilitation reported worse discharge FS. Seventy-one percent of patients obtained statistically significant change at follow-up. Change of 8 FS units (scale 0-100) represented minimal clinically important improvement.Conclusions: We concluded that the foot/ankle item bank met IRT assumptions and that the CAT FS measure was precise, valid, and responsive, supporting its use in routine clinical application.
      pubtype: Academic Journal
      doctype:
        research
        Journal Article
      ougenre: Article
    language: English
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