@article {231,
	title = {Computerized adaptive testing in back pain: Validation of the CAT-5D-QOL},
	journal = {Spine},
	volume = {33},
	number = {12},
	year = {2008},
	note = {Kopec, Jacek ABadii, MaziarMcKenna, MarioLima, Viviane DSayre, Eric CDvorak, MarcelResearch Support, Non-U.S. Gov{\textquoteright}tValidation StudiesUnited StatesSpineSpine (Phila Pa 1976). 2008 May 20;33(12):1384-90.},
	month = {May 20},
	pages = {1384-90},
	edition = {2008/05/23},
	abstract = {STUDY DESIGN: We have conducted an outcome instrument validation study. OBJECTIVE: Our objective was to develop a computerized adaptive test (CAT) to measure 5 domains of health-related quality of life (HRQL) and assess its feasibility, reliability, validity, and efficiency. SUMMARY OF BACKGROUND DATA: Kopec and colleagues have recently developed item response theory based item banks for 5 domains of HRQL relevant to back pain and suitable for CAT applications. The domains are Daily Activities (DAILY), Walking (WALK), Handling Objects (HAND), Pain or Discomfort (PAIN), and Feelings (FEEL). METHODS: An adaptive algorithm was implemented in a web-based questionnaire administration system. The questionnaire included CAT-5D-QOL (5 scales), Modified Oswestry Disability Index (MODI), Roland-Morris Disability Questionnaire (RMDQ), SF-36 Health Survey, and standard clinical and demographic information. Participants were outpatients treated for mechanical back pain at a referral center in Vancouver, Canada. RESULTS: A total of 215 patients completed the questionnaire and 84 completed a retest. On average, patients answered 5.2 items per CAT-5D-QOL scale. Reliability ranged from 0.83 (FEEL) to 0.92 (PAIN) and was 0.92 for the MODI, RMDQ, and Physical Component Summary (PCS-36). The ceiling effect was 0.5\% for PAIN compared with 2\% for MODI and 5\% for RMQ. The CAT-5D-QOL scales correlated as anticipated with other measures of HRQL and discriminated well according to the level of satisfaction with current symptoms, duration of the last episode, sciatica, and disability compensation. The average relative discrimination index was 0.87 for PAIN, 0.67 for DAILY and 0.62 for WALK, compared with 0.89 for MODI, 0.80 for RMDQ, and 0.59 for PCS-36. CONCLUSION: The CAT-5D-QOL is feasible, reliable, valid, and efficient in patients with back pain. This methodology can be recommended for use in back pain research and should improve outcome assessment, facilitate comparisons across studies, and reduce patient burden.},
	keywords = {*Disability Evaluation, *Health Status Indicators, *Quality of Life, Adult, Aged, Algorithms, Back Pain/*diagnosis/psychology, British Columbia, Diagnosis, Computer-Assisted/*standards, Feasibility Studies, Female, Humans, Internet, Male, Middle Aged, Predictive Value of Tests, Questionnaires/*standards, Reproducibility of Results},
	isbn = {1528-1159 (Electronic)0362-2436 (Linking)},
	author = {Kopec, J. A. and Badii, M. and McKenna, M. and Lima, V. D. and Sayre, E. C. and Dvorak, M.}
}
@article {84,
	title = {Letting the CAT out of the bag: Comparing computer adaptive tests and an 11-item short form of the Roland-Morris Disability Questionnaire},
	journal = {Spine},
	volume = {33},
	number = {12},
	year = {2008},
	note = {Cook, Karon FChoi, Seung WCrane, Paul KDeyo, Richard AJohnson, Kurt LAmtmann, Dagmar5 P60-AR48093/AR/United States NIAMS5U01AR052171-03/AR/United States NIAMSComparative StudyResearch Support, N.I.H., ExtramuralUnited StatesSpineSpine. 2008 May 20;33(12):1378-83.},
	month = {May 20},
	pages = {1378-83},
	edition = {2008/05/23},
	abstract = {STUDY DESIGN: A post hoc simulation of a computer adaptive administration of the items of a modified version of the Roland-Morris Disability Questionnaire. OBJECTIVE: To evaluate the effectiveness of adaptive administration of back pain-related disability items compared with a fixed 11-item short form. SUMMARY OF BACKGROUND DATA: Short form versions of the Roland-Morris Disability Questionnaire have been developed. An alternative to paper-and-pencil short forms is to administer items adaptively so that items are presented based on a person{\textquoteright}s responses to previous items. Theoretically, this allows precise estimation of back pain disability with administration of only a few items. MATERIALS AND METHODS: Data were gathered from 2 previously conducted studies of persons with back pain. An item response theory model was used to calibrate scores based on all items, items of a paper-and-pencil short form, and several computer adaptive tests (CATs). RESULTS: Correlations between each CAT condition and scores based on a 23-item version of the Roland-Morris Disability Questionnaire ranged from 0.93 to 0.98. Compared with an 11-item short form, an 11-item CAT produced scores that were significantly more highly correlated with scores based on the 23-item scale. CATs with even fewer items also produced scores that were highly correlated with scores based on all items. For example, scores from a 5-item CAT had a correlation of 0.93 with full scale scores. Seven- and 9-item CATs correlated at 0.95 and 0.97, respectively. A CAT with a standard-error-based stopping rule produced scores that correlated at 0.95 with full scale scores. CONCLUSION: A CAT-based back pain-related disability measure may be a valuable tool for use in clinical and research contexts. Use of CAT for other common measures in back pain research, such as other functional scales or measures of psychological distress, may offer similar advantages.},
	keywords = {*Disability Evaluation, *Health Status Indicators, Adult, Aged, Aged, 80 and over, Back Pain/*diagnosis/psychology, Calibration, Computer Simulation, Diagnosis, Computer-Assisted/*standards, Humans, Middle Aged, Models, Psychological, Predictive Value of Tests, Questionnaires/*standards, Reproducibility of Results},
	isbn = {1528-1159 (Electronic)},
	author = {Cook, K. F. and Choi, S. W. and Crane, P. K. and Deyo, R. A. and Johnson, K. L. and Amtmann, D.}
}
@article {95,
	title = {Strategies for controlling item exposure in computerized adaptive testing with the partial credit model},
	journal = {Journal of Applied Measurement},
	volume = {9},
	number = {1},
	year = {2008},
	note = {Davis, Laurie LaughlinDodd, Barbara GUnited StatesJournal of applied measurementJ Appl Meas. 2008;9(1):1-17.},
	pages = {1-17},
	edition = {2008/01/09},
	abstract = {Exposure control research with polytomous item pools has determined that randomization procedures can be very effective for controlling test security in computerized adaptive testing (CAT). The current study investigated the performance of four procedures for controlling item exposure in a CAT under the partial credit model. In addition to a no exposure control baseline condition, the Kingsbury-Zara, modified-within-.10-logits, Sympson-Hetter, and conditional Sympson-Hetter procedures were implemented to control exposure rates. The Kingsbury-Zara and the modified-within-.10-logits procedures were implemented with 3 and 6 item candidate conditions. The results show that the Kingsbury-Zara and modified-within-.10-logits procedures with 6 item candidates performed as well as the conditional Sympson-Hetter in terms of exposure rates, overlap rates, and pool utilization. These two procedures are strongly recommended for use with partial credit CATs due to their simplicity and strength of their results.},
	keywords = {*Algorithms, *Computers, *Educational Measurement/statistics \& numerical data, Humans, Questionnaires/*standards, United States},
	isbn = {1529-7713 (Print)1529-7713 (Linking)},
	author = {Davis, L. L. and Dodd, B. G.}
}
@article {311,
	title = {Multidimensional computerized adaptive testing of the EORTC QLQ-C30: basic developments and evaluations},
	journal = {Quality of Life Research},
	volume = {15},
	number = {3},
	year = {2006},
	note = {Petersen, Morten AaGroenvold, MogensAaronson, NeilFayers, PeterSprangers, MirjamBjorner, Jakob BEuropean Organisation for Research and Treatment of Cancer Quality of Life GroupResearch Support, Non-U.S. Gov{\textquoteright}tNetherlandsQuality of life research : an international journal of quality of life aspects of treatment, care and rehabilitationQual Life Res. 2006 Apr;15(3):315-29.},
	month = {Apr},
	pages = {315-29},
	edition = {2006/03/21},
	abstract = {OBJECTIVE: Self-report questionnaires are widely used to measure health-related quality of life (HRQOL). Ideally, such questionnaires should be adapted to the individual patient and at the same time scores should be directly comparable across patients. This may be achieved using computerized adaptive testing (CAT). Usually, CAT is carried out for a single domain at a time. However, many HRQOL domains are highly correlated. Multidimensional CAT may utilize these correlations to improve measurement efficiency. We investigated the possible advantages and difficulties of multidimensional CAT. STUDY DESIGN AND SETTING: We evaluated multidimensional CAT of three scales from the EORTC QLQ-C30: the physical functioning, emotional functioning, and fatigue scales. Analyses utilised a database with 2958 European cancer patients. RESULTS: It was possible to obtain scores for the three domains with five to seven items administered using multidimensional CAT that were very close to the scores obtained using all 12 items and with no or little loss of measurement precision. CONCLUSION: The findings suggest that multidimensional CAT may significantly improve measurement precision and efficiency and encourage further research into multidimensional CAT. Particularly, the estimation of the model underlying the multidimensional CAT and the conceptual aspects need further investigations.},
	keywords = {*Quality of Life, *Self Disclosure, Adult, Female, Health Status, Humans, Male, Middle Aged, Questionnaires/*standards, User-Computer Interface},
	isbn = {0962-9343 (Print)},
	author = {Petersen, M. A. and Groenvold, M. and Aaronson, N. K. and Fayers, P. and Sprangers, M. and Bjorner, J. B.}
}
@article {87,
	title = {Refining the conceptual basis for rehabilitation outcome measurement: personal care and instrumental activities domain},
	journal = {Medical Care},
	volume = {42},
	number = {1 Suppl},
	year = {2004},
	note = {0025-7079Journal Article},
	month = {Jan},
	pages = {I62-172},
	abstract = {BACKGROUND: Rehabilitation outcome measures routinely include content on performance of daily activities; however, the conceptual basis for item selection is rarely specified. These instruments differ significantly in format, number, and specificity of daily activity items and in the measurement dimensions and type of scale used to specify levels of performance. We propose that a requirement for upper limb and hand skills underlies many activities of daily living (ADL) and instrumental activities of daily living (IADL) items in current instruments, and that items selected based on this definition can be placed along a single functional continuum. OBJECTIVE: To examine the dimensional structure and content coverage of a Personal Care and Instrumental Activities item set and to examine the comparability of items from existing instruments and a set of new items as measures of this domain. METHODS: Participants (N = 477) from 3 different disability groups and 4 settings representing the continuum of postacute rehabilitation care were administered the newly developed Activity Measure for Post-Acute Care (AM-PAC), the SF-8, and an additional setting-specific measure: FIM (in-patient rehabilitation); MDS (skilled nursing facility); MDS-PAC (postacute settings); OASIS (home care); or PF-10 (outpatient clinic). Rasch (partial-credit model) analyses were conducted on a set of 62 items covering the Personal Care and Instrumental domain to examine item fit, item functioning, and category difficulty estimates and unidimensionality. RESULTS: After removing 6 misfitting items, the remaining 56 items fit acceptably along the hypothesized continuum. Analyses yielded different difficulty estimates for the maximum score (eg, "Independent performance") for items with comparable content from different instruments. Items showed little differential item functioning across age, diagnosis, or severity groups, and 92\% of the participants fit the model. CONCLUSIONS: ADL and IADL items from existing rehabilitation outcomes instruments that depend on skilled upper limb and hand use can be located along a single continuum, along with the new personal care and instrumental items of the AM-PAC addressing gaps in content. Results support the validity of the proposed definition of the Personal Care and Instrumental Activities dimension of function as a guide for future development of rehabilitation outcome instruments, such as linked, setting-specific short forms and computerized adaptive testing approaches.},
	keywords = {*Self Efficacy, *Sickness Impact Profile, Activities of Daily Living/*classification/psychology, Adult, Aged, Aged, 80 and over, Disability Evaluation, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Outcome Assessment (Health Care)/*methods/statistics \& numerical data, Questionnaires/*standards, Recovery of Function/physiology, Rehabilitation/*standards/statistics \& numerical data, Reproducibility of Results, Research Support, U.S. Gov{\textquoteright}t, Non-P.H.S., Research Support, U.S. Gov{\textquoteright}t, P.H.S., Sensitivity and Specificity},
	author = {Coster, W. J. and Haley, S. M. and Andres, P. L. and Ludlow, L. H. and Bond, T. L. and Ni, P. S.}
}
