@article {227,
	title = {An evaluation of patient-reported outcomes found computerized adaptive testing was efficient in assessing stress perception},
	journal = {Journal of Clinical Epidemiology},
	volume = {62},
	number = {3},
	year = {2009},
	note = {Kocalevent, Ruya-DanielaRose, MatthiasBecker, JanineWalter, Otto BFliege, HerbertBjorner, Jakob BKleiber, DieterKlapp, Burghard FEvaluation StudiesUnited StatesJournal of clinical epidemiologyJ Clin Epidemiol. 2009 Mar;62(3):278-87, 287.e1-3. Epub 2008 Jul 18.},
	pages = {278-287},
	edition = {2008/07/22},
	abstract = {OBJECTIVES: This study aimed to develop and evaluate a first computerized adaptive test (CAT) for the measurement of stress perception (Stress-CAT), in terms of the two dimensions: exposure to stress and stress reaction. STUDY DESIGN AND SETTING: Item response theory modeling was performed using a two-parameter model (Generalized Partial Credit Model). The evaluation of the Stress-CAT comprised a simulation study and real clinical application. A total of 1,092 psychosomatic patients (N1) were studied. Two hundred simulees (N2) were generated for a simulated response data set. Then the Stress-CAT was given to n=116 inpatients, (N3) together with established stress questionnaires as validity criteria. RESULTS: The final banks included n=38 stress exposure items and n=31 stress reaction items. In the first simulation study, CAT scores could be estimated with a high measurement precision (SE<0.32; rho>0.90) using 7.0+/-2.3 (M+/-SD) stress reaction items and 11.6+/-1.7 stress exposure items. The second simulation study reanalyzed real patients data (N1) and showed an average use of items of 5.6+/-2.1 for the dimension stress reaction and 10.0+/-4.9 for the dimension stress exposure. Convergent validity showed significantly high correlations. CONCLUSIONS: The Stress-CAT is short and precise, potentially lowering the response burden of patients in clinical decision making.},
	keywords = {*Diagnosis, Computer-Assisted, Adolescent, Adult, Aged, Aged, 80 and over, Confidence Intervals, Female, Humans, Male, Middle Aged, Perception, Quality of Health Care/*standards, Questionnaires, Reproducibility of Results, Sickness Impact Profile, Stress, Psychological/*diagnosis/psychology, Treatment Outcome},
	isbn = {1878-5921 (Electronic)0895-4356 (Linking)},
	author = {Kocalevent, R. D. and Rose, M. and Becker, J. and Walter, O. B. and Fliege, H. and Bjorner, J. B. and Kleiber, D. and Klapp, B. F.}
}
@article {184,
	title = {Simulated computerized adaptive test for patients with shoulder impairments was efficient and produced valid measures of function},
	journal = {Journal of Clinical Epidemiology},
	volume = {59},
	number = {3},
	year = {2006},
	note = {0895-4356 (Print)Journal ArticleValidation Studies},
	pages = {290-8},
	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 (theta(IRT)) and measures generated using the simulated CAT (theta(CAT)). 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 theta(IRT) and theta(CAT) 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 = {*Computer Simulation, *Range of Motion, Articular, Activities of Daily Living, Adult, Aged, Aged, 80 and over, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Prospective Studies, Reproducibility of Results, Research Support, N.I.H., Extramural, Research Support, U.S. Gov{\textquoteright}t, Non-P.H.S., Shoulder Dislocation/*physiopathology/psychology/rehabilitation, Shoulder Pain/*physiopathology/psychology/rehabilitation, Shoulder/*physiopathology, Sickness Impact Profile, Treatment Outcome},
	author = {Hart, D. L. and Cook, K. F. and Mioduski, J. E. and Teal, C. R. and Crane, P. K.}
}
@article {357,
	title = {Measuring physical function in patients with complex medical and postsurgical conditions: a computer adaptive approach},
	journal = {American Journal of Physical Medicine and Rehabilitation},
	volume = {84},
	number = {10},
	year = {2005},
	note = {0894-9115 (Print)Comparative StudyJournal ArticleResearch Support, N.I.H., ExtramuralResearch Support, U.S. Gov{\textquoteright}t, P.H.S.},
	month = {Oct},
	pages = {741-8},
	abstract = {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.},
	keywords = {Activities of Daily Living/*classification, Adult, Aged, Cohort Studies, Continuity of Patient Care, Disability Evaluation, Female, Health Services Research, Humans, Male, Middle Aged, Postoperative Care/*rehabilitation, Prognosis, Recovery of Function, Rehabilitation Centers, Rehabilitation/*standards, Sensitivity and Specificity, Sickness Impact Profile, Treatment Outcome},
	author = {Siebens, H. and Andres, P. L. and Pengsheng, N. and Coster, W. J. and Haley, S. M.}
}
