Simulated computerized adaptive test for patients with shoulder impairments was efficient and produced valid measures of function
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.
aFocus On Therapeutic Outcomes, Inc., 551 Yopps Cove Road, White Stone, VA 22578, USA
bVeteran's Affairs Measurement Excellence, Training Research & Information Center (METRIC), U.S. Department of Veterans Affairs, Houston, TX, USA
cDepartment of Rehabilitation Medicine, University of Washington, Seattle, WA, USA
dFocus On Therapeutic Outcomes, Inc., Knoxville, TN, USA
eHouston Center for Quality of Care & Utilization Studies, Baylor College of Medicine and Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX, USA
fDepartment of Medicine, Baylor College of Medicine, Houston, TX, USA
gDivision of General Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA
ABSTRACT