Measuring physical function in patients with complex medical and postsurgical conditions: a computer adaptive approach.

OBJECTIVE: To examine whether the range of disability in the medically complex and postsurgical populations receiving rehabilitation is adequately sampled by the new Activity Measure--Post-Acute Care (AM-PAC), and to assess whether computer adaptive testing (CAT) can derive valid patient scores usin...

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Publicado en:American Journal of Physical Medicine & Rehabilitation Vol. 84; no. 10; pp. 741 - 749
Autores principales: Siebens H, Andres PL, Pengsheng N, Coster WJ, Haley SM
Formato: research tables/charts Journal Article
Publicado: Lippincott Williams & Wilkins Oct2005
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Oct2005
      vid: 84
      iid: 10
      pid: 5086
      pub: Lippincott Williams & Wilkins
      place: Baltimore, Maryland
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        106397088
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        10.1097/01.phm.0000186274.08468.35
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        atl: Measuring physical function in patients with complex medical and postsurgical conditions: a computer adaptive approach.
      aug:
        au:
          Siebens H
          Andres PL
          Pengsheng N
          Coster WJ
          Haley SM
        affil: Department of Physical Medicine and Rehabilitation, University of Virginia, Charlottesville, VA
      sug:
        subj:
          Rehabilitation Standards
          Postoperative Care Rehabilitation
          Outcome Assessment
          Disability Evaluation
          Rehabilitation Centers
          Computerized Adaptive Testing
          Activities of Daily Living Classification
          Clinical Assessment Tools
          Health Services Research
          Recovery
          Sensitivity and Specificity
          Nonexperimental Studies
          Intraclass Correlation Coefficient
          Aged
          Funding Source
          Human
          Aged: 65+ years
      ab: OBJECTIVE: To examine whether the range of disability in the medically complex and postsurgical populations receiving rehabilitation is adequately sampled by the new Activity Measure--Post-Acute Care (AM-PAC), and to assess whether computer adaptive testing (CAT) can derive valid patient scores using fewer questions. DESIGN: Observational study of 158 subjects (mean age 67.2 yrs) receiving skilled rehabilitation services in inpatient (acute rehabilitation hospitals, skilled nursing facility units) and community (home health services, outpatient departments) settings for recent-onset or worsening disability from medical (excluding neurological) and surgical (excluding orthopedic) conditions. Measures were interviewer-administered activity questions (all patients) and physical functioning portion of the SF-36 (outpatients) and standardized chart items (11 Functional Independence Measure (FIM), 19 Standardized Outcome and Assessment Information Set (OASIS) items, and 22 Minimum Data Set (MDS) items). Rasch modeling analyzed all data and the relationship between person ability estimates and average item difficulty. CAT assessed the ability to derive accurate patient scores using a sample of questions. RESULTS: The 163-item activity item pool covered the range of physical movement and personal and instrumental activities. CAT analysis showed comparable scores between estimates using 10 items or the total item pool. CONCLUSION: The AM-PAC can assess a broad range of function in patients with complex medical illness. CAT achieves valid patient scores using fewer questions.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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