03309nas a2200433   4500008004100000020004600041245007700087210006900164250001500233260001100248300001200259490000700271520203200278653002702310653003002337653002102367653001002388653000902398653001502407653003602422653002102458653004402479653002402523653001102547653001102558653001302569653000902582653001602591653003002607653003002637653003102667100001502698700001302713700001502726700001402741700001502755700001402770856009102784       2008                        eng d  a1528-1159 (Electronic)0362-2436 (Linking)00aComputerized adaptive testing in back pain: Validation of the CAT-5D-QOL0 aComputerized adaptive testing in back pain Validation of the CAT  a2008/05/23  cMay 20  a1384-900 v333 aSTUDY 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.10a*Disability Evaluation10a*Health Status Indicators10a*Quality of Life10aAdult10aAged10aAlgorithms10aBack Pain/*diagnosis/psychology10aBritish Columbia10aDiagnosis, Computer-Assisted/*standards10aFeasibility Studies10aFemale10aHumans10aInternet10aMale10aMiddle Aged10aPredictive Value of Tests10aQuestionnaires/*standards10aReproducibility of Results1 aKopec, J A1 aBadii, M1 aMcKenna, M1 aLima, V D1 aSayre, E C1 aDvorak, M  uhttp://iacat.org/content/computerized-adaptive-testing-back-pain-validation-cat-5d-qol03228nas a2200397   4500008004100000020002700041245014200068210006900210250001500279260001100294300001200305490000700317520193600324653002702260653003002287653001002317653000902327653002202336653003602358653001602394653002402410653004402434653001102478653001602489653002602505653003002531653003002561653003102591100001302622700001402635700001502649700001402664700001702678700001502695856012002710       2008                        eng d  a1528-1159 (Electronic)00aLetting the CAT out of the bag: Comparing computer adaptive tests and an 11-item short form of the Roland-Morris Disability Questionnaire0 aLetting the CAT out of the bag Comparing computer adaptive tests  a2008/05/23  cMay 20  a1378-830 v333 aSTUDY 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'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.10a*Disability Evaluation10a*Health Status Indicators10aAdult10aAged10aAged, 80 and over10aBack Pain/*diagnosis/psychology10aCalibration10aComputer Simulation10aDiagnosis, Computer-Assisted/*standards10aHumans10aMiddle Aged10aModels, Psychological10aPredictive Value of Tests10aQuestionnaires/*standards10aReproducibility of Results1 aCook, KF1 aChoi, S W1 aCrane, P K1 aDeyo, R A1 aJohnson, K L1 aAmtmann, D  uhttp://iacat.org/content/letting-cat-out-bag-comparing-computer-adaptive-tests-and-11-item-short-form-roland-morris01828nas a2200229   4500008004100000020004100041245010800082210006900190250001500259300000900274490000600283520101700289653001601306653001501322653005701337653001101394653003001405653001801435100001401453700001401467856011701481       2008                        eng d  a1529-7713 (Print)1529-7713 (Linking)00aStrategies for controlling item exposure in computerized adaptive testing with the partial credit model0 aStrategies for controlling item exposure in computerized adaptiv  a2008/01/09  a1-170 v93 aExposure 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.10a*Algorithms10a*Computers10a*Educational Measurement/statistics & numerical data10aHumans10aQuestionnaires/*standards10aUnited States1 aDavis, LL1 aDodd, B G  uhttp://iacat.org/content/strategies-controlling-item-exposure-computerized-adaptive-testing-partial-credit-model02401nas a2200337   4500008004100000020002200041245010800063210006900171250001500240260000800255300001100263490000700274520139300281653002101674653002101695653001001716653001101726653001801737653001101755653000901766653001601775653003001791653002801821100001801849700001701867700001801884700001401902700001701916700001701933856011301950       2006                        eng d  a0962-9343 (Print)00aMultidimensional computerized adaptive testing of the EORTC QLQ-C30: basic developments and evaluations0 aMultidimensional computerized adaptive testing of the EORTC QLQC  a2006/03/21  cApr  a315-290 v153 aOBJECTIVE: 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.10a*Quality of Life10a*Self Disclosure10aAdult10aFemale10aHealth Status10aHumans10aMale10aMiddle Aged10aQuestionnaires/*standards10aUser-Computer Interface1 aPetersen, M A1 aGroenvold, M1 aAaronson, N K1 aFayers, P1 aSprangers, M1 aBjorner, J B  uhttp://iacat.org/content/multidimensional-computerized-adaptive-testing-eortc-qlq-c30-basic-developments-and04028nas a2200433   4500008004100000245012300041210006900164260000800233300001200241490000700253520252400260653001902784653002902803653005802832653001002890653000902900653002202909653002602931653003302957653001102990653001103001653000903012653001603021653007403037653003003111653003603141653005803177653003103235653004503266653004103311653003203352100001603384700001503400700001603415700001603431700001403447700001203461856012103473       2004                        eng d00aRefining the conceptual basis for rehabilitation outcome measurement: personal care and instrumental activities domain0 aRefining the conceptual basis for rehabilitation outcome measure  cJan  aI62-1720 v423 aBACKGROUND: 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.10a*Self Efficacy10a*Sickness Impact Profile10aActivities of Daily Living/*classification/psychology10aAdult10aAged10aAged, 80 and over10aDisability Evaluation10aFactor Analysis, Statistical10aFemale10aHumans10aMale10aMiddle Aged10aOutcome Assessment (Health Care)/*methods/statistics & numerical data10aQuestionnaires/*standards10aRecovery of Function/physiology10aRehabilitation/*standards/statistics & numerical data10aReproducibility of Results10aResearch Support, U.S. Gov't, Non-P.H.S.10aResearch Support, U.S. Gov't, P.H.S.10aSensitivity and Specificity1 aCoster, W J1 aHaley, S M1 aAndres, P L1 aLudlow, L H1 aBond, T L1 aNi, P S  uhttp://iacat.org/content/refining-conceptual-basis-rehabilitation-outcome-measurement-personal-care-and-instrumental