Journal of Clinical Epidemiology
Volume 59, Issue 3 , Pages 290-298, March 2006

Simulated computerized adaptive test for patients with shoulder impairments was efficient and produced valid measures of function

  • Dennis L. Hart

      Affiliations

    • Focus On Therapeutic Outcomes, Inc., 551 Yopps Cove Road, White Stone, VA 22578, USA
    • Corresponding Author InformationCorresponding author.
  • ,
  • Karon F. Cook

      Affiliations

    • Veteran's Affairs Measurement Excellence, Training Research & Information Center (METRIC), U.S. Department of Veterans Affairs, Houston, TX, USA
    • Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
  • ,
  • Jerome E. Mioduski

      Affiliations

    • Focus On Therapeutic Outcomes, Inc., Knoxville, TN, USA
  • ,
  • Cayla R. Teal

      Affiliations

    • Houston Center for Quality of Care & Utilization Studies, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
    • Department of Medicine, Baylor College of Medicine, Houston, TX, USA
  • ,
  • Paul K. Crane

      Affiliations

    • Division of General Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA

Accepted 8 August 2005. published online 28 December 2005.

Abstract 

Background and Objective

To test unidimensionality and local independence of a set of shoulder functional status (SFS) items, develop a computerized adaptive test (CAT) of the items using a rating scale item response theory model (RSM), and compare discriminant validity of measures generated using all items (θIRT) and measures generated using the simulated CAT (θCAT).

Study Design and Setting

We performed a secondary analysis of data collected prospectively during rehabilitation of 400 patients with shoulder impairments who completed 60 SFS items.

Results

Factor analytic techniques supported that the 42 SFS items formed a unidimensional scale and were locally independent. Except for five items, which were deleted, the RSM fit the data well. The remaining 37 SFS items were used to generate the CAT. On average, 6 items were needed to estimate precise measures of function using the SFS CAT, compared with all 37 SFS items. The θIRT and θCAT measures were highly correlated (r = .96) and resulted in similar classifications of patients.

Conclusion

The simulated SFS CAT was efficient and produced precise, clinically relevant measures of functional status with good discriminating ability.

Keywords: Computerized adaptive testing, Item response theory, Rehabilitation, Flexilevel Scale of Shoulder Function

To access this article, please choose from the options below

Login to an existing account or Register a new account.

  • Purchase this article for 31.50 USD (You must login/register to purchase this article)

    Online access for 24 hours. The PDF version can be downloaded as your permanent record.

  • Subscribe to this title

    Get unlimited online access to this article and all other articles in this title 24/7 for one year.

  • Claim access now

    For current subscribers with Society Membership or Account Number.

  • Visit SciVerse ScienceDirect to see if you have access via your institution.
 

PII: S0895-4356(05)00298-2

doi:10.1016/j.jclinepi.2005.08.006

Journal of Clinical Epidemiology
Volume 59, Issue 3 , Pages 290-298, March 2006