02649nas a2200409   4500008004100000245013400041210006900175300001000244490000700254520123100261653002501492653003201517653003101549653001001580653000901590653002201599653003301621653001101654653001101665653000901676653001601685653002401701653003101725653004101756653004501797653006801842653006101910653003001971653002802001653002202029100001402051700001302065700001802078700001402096700001502110856011402125       2006                        eng d00aSimulated computerized adaptive test for patients with shoulder impairments was efficient and produced valid measures of function0 aSimulated computerized adaptive test for patients with shoulder   a290-80 v593 aBACKGROUND 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.10a*Computer Simulation10a*Range of Motion, Articular10aActivities of Daily Living10aAdult10aAged10aAged, 80 and over10aFactor Analysis, Statistical10aFemale10aHumans10aMale10aMiddle Aged10aProspective Studies10aReproducibility of Results10aResearch Support, N.I.H., Extramural10aResearch Support, U.S. Gov't, Non-P.H.S.10aShoulder Dislocation/*physiopathology/psychology/rehabilitation10aShoulder Pain/*physiopathology/psychology/rehabilitation10aShoulder/*physiopathology10aSickness Impact Profile10aTreatment Outcome1 aHart, D L1 aCook, KF1 aMioduski, J E1 aTeal, C R1 aCrane, P K  uhttp://iacat.org/content/simulated-computerized-adaptive-test-patients-shoulder-impairments-was-efficient-and02119nas a2200253   4500008004100000245007900041210006900120300001200189490000700201520113300208653002701341653004601368653005201414653002901466653001101495653005601506653002501562653004101587653004501628653006201673100001501735700001501750856010001765       2005                        eng d00aContemporary measurement techniques for rehabilitation outcomes assessment0 aContemporary measurement techniques for rehabilitation outcomes   a339-3450 v373 aIn this article, we review the limitations of traditional rehabilitation functional outcome instruments currently in use within the rehabilitation field to assess Activity and Participation domains as defined by the International Classification of Function, Disability, and Health. These include a narrow scope of functional outcomes, data incompatibility across instruments, and the precision vs feasibility dilemma. Following this, we illustrate how contemporary measurement techniques, such as item response theory methods combined with computer adaptive testing methodology, can be applied in rehabilitation to design functional outcome instruments that are comprehensive in scope, accurate, allow for compatibility across instruments, and are sensitive to clinically important change without sacrificing their feasibility. Finally, we present some of the pressing challenges that need to be overcome to provide effective dissemination and training assistance to ensure that current and future generations of rehabilitation professionals are familiar with and skilled in the application of contemporary outcomes measurement.10a*Disability Evaluation10aActivities of Daily Living/classification10aDisabled Persons/classification/*rehabilitation10aHealth Status Indicators10aHumans10aOutcome Assessment (Health Care)/*methods/standards10aRecovery of Function10aResearch Support, N.I.H., Extramural10aResearch Support, U.S. Gov't, Non-P.H.S.10aSensitivity and Specificity computerized adaptive testing1 aJette, A M1 aHaley, S M  uhttp://iacat.org/content/contemporary-measurement-techniques-rehabilitation-outcomes-assessment04028nas 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-instrumental01597nas a2200205   4500008004100000245009400041210006900135260001000204300001200214490000800226520086400234653003001098653000901128653003401137653001101171653003501182653004501217100001801262856011101280       2003                        eng d00aTen recommendations for advancing patient-centered outcomes measurement for older persons0 aTen recommendations for advancing patientcentered outcomes measu  cSep 2  a403-4090 v1393 aThe past 50 years have seen great progress in the measurement of patient-based outcomes for older populations. Most of the measures now used were created under the umbrella of a set of assumptions and procedures known as classical test theory. A recent alternative for health status assessment is item response theory. Item response theory is superior to classical test theory because it can eliminate test dependency and achieve more precise measurement through computerized adaptive testing. Computerized adaptive testing reduces test administration times and allows varied and precise estimates of ability. Several key challenges must be met before computerized adaptive testing becomes a productive reality. I discuss these challenges for the health assessment of older persons in the form of 10 "Ds": things we need to deliberate, debate, decide, and do.10a*Health Status Indicators10aAged10aGeriatric Assessment/*methods10aHumans10aPatient-Centered Care/*methods10aResearch Support, U.S. Gov't, Non-P.H.S.1 aMcHorney, C A  uhttp://iacat.org/content/ten-recommendations-advancing-patient-centered-outcomes-measurement-older-persons