02107nas a2200229 4500008004100000245013800041210006900179300001400248490000700262520127000269653003101539653003401570653002501604653001701629653001901646653002401665100001401689700001801703700001701721700001901738856012001757 2006 eng d00aSimulated computerized adaptive test for patients with lumbar spine impairments was efficient and produced valid measures of function0 aSimulated computerized adaptive test for patients with lumbar sp a947–9560 v593 aObjective: To equate physical functioning (PF) items with Back Pain Functional Scale (BPFS) items, develop a computerized adaptive test (CAT) designed to assess lumbar spine functional status (LFS) in people with lumbar spine impairments, and compare discriminant validity of LFS measures (qIRT) generated using all items analyzed with a rating scale Item Response Theory model (RSM) and measures generated using the simulated CAT (qCAT). Methods: We performed a secondary analysis of retrospective intake rehabilitation data. Results: Unidimensionality and local independence of 25 BPFS and PF items were supported. Differential item functioning was negligible for levels of symptom acuity, gender, age, and surgical history. The RSM fit the data well. A lumbar spine specific CAT was developed that was 72% more efficient than using all 25 items to estimate LFS measures. qIRT and qCAT measures did not discriminate patients by symptom acuity, age, or gender, but discriminated patients by surgical history in similar clinically logical ways. qCAT measures were as precise as qIRT measures. Conclusion: A body part specific simulated CAT developed from an LFS item bank was efficient and produced precise measures of LFS without eroding discriminant validity.10aBack Pain Functional Scale10acomputerized adaptive testing10aItem Response Theory10aLumbar spine10aRehabilitation10aTrue-score equating1 aHart, D L1 aMioduski, J E1 aWerneke, M W1 aStratford, P W uhttp://iacat.org/content/simulated-computerized-adaptive-test-patients-lumbar-spine-impairments-was-efficient-and-002649nas 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-and02068nas a2200217 4500008004500000245013400045210006900179300001200248490000700260520127300267653003401540653004201574653002501616653001901641100001401660700001301674700001801687700001401705700001501719856011601734 2006 Engldsh 00aSimulated computerized adaptive test for patients with shoulder impairments was efficient and produced valid measures of function0 aSimulated computerized adaptive test for patients with shoulder  a290-2980 v593 a

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 (qIRT) and measures generated using the simulated CAT (qCAT).
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 on were needed to estimate precise measures of function using the SFS CAT, compared with all 37 SFS items. The qIRT and qCAT measures were highly correlated (r 5 .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. 

10acomputerized adaptive testing10aFlexilevel Scale of Shoulder Function10aItem Response Theory10aRehabilitation1 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-and-002716nas a2200373 4500008004100000245017500041210006900216300001100285490000700296520137800303653003001681653003101711653001501742653001001757653000901767653002201776653003201798653004201830653001101872653003001883653001101913653005101924653003101975653003702006653000902043653001602052653004102068653004102109653002602150100001402176700001802190700001902208856011502227 2005 eng d00aSimulated computerized adaptive tests for measuring functional status were efficient with good discriminant validity in patients with hip, knee, or foot/ankle impairments0 aSimulated computerized adaptive tests for measuring functional s a629-380 v583 aBACKGROUND AND OBJECTIVE: To develop computerized adaptive tests (CATs) designed to assess lower extremity functional status (FS) in people with lower extremity impairments using items from the Lower Extremity Functional Scale and compare discriminant validity of FS measures generated using all items analyzed with a rating scale Item Response Theory model (theta(IRT)) and measures generated using the simulated CATs (theta(CAT)). METHODS: Secondary analysis of retrospective intake rehabilitation data. RESULTS: Unidimensionality of items was strong, and local independence of items was adequate. Differential item functioning (DIF) affected item calibration related to body part, that is, hip, knee, or foot/ankle, but DIF did not affect item calibration for symptom acuity, gender, age, or surgical history. Therefore, patients were separated into three body part specific groups. The rating scale model fit all three data sets well. Three body part specific CATs were developed: each was 70% more efficient than using all LEFS items to estimate FS measures. theta(IRT) and theta(CAT) measures discriminated patients by symptom acuity, age, and surgical history in similar ways. theta(CAT) measures were as precise as theta(IRT) measures. CONCLUSION: Body part-specific simulated CATs were efficient and produced precise measures of FS with good discriminant validity.10a*Health Status Indicators10aActivities of Daily Living10aAdolescent10aAdult10aAged10aAged, 80 and over10aAnkle Joint/physiopathology10aDiagnosis, Computer-Assisted/*methods10aFemale10aHip Joint/physiopathology10aHumans10aJoint Diseases/physiopathology/*rehabilitation10aKnee Joint/physiopathology10aLower Extremity/*physiopathology10aMale10aMiddle Aged10aResearch Support, N.I.H., Extramural10aResearch Support, U.S. Gov't, P.H.S.10aRetrospective Studies1 aHart, D L1 aMioduski, J E1 aStratford, P W uhttp://iacat.org/content/simulated-computerized-adaptive-tests-measuring-functional-status-were-efficient-good02890nas a2200349 4500008004100000245008300041210006900124260000800193300001100201490000700212520176600219653003001985653002802015653001502043653001002058653000902068653002202077653001102099653001902110653001102129653000902140653001602149653006202165653006102227653003302288653003602321653003102357653002602388100001402414700001602428856009602444 2002 eng d00aDevelopment of an index of physical functional health status in rehabilitation0 aDevelopment of an index of physical functional health status in  cMay a655-650 v833 aOBJECTIVE: To describe (1) the development of an index of physical functional health status (FHS) and (2) its hierarchical structure, unidimensionality, reproducibility of item calibrations, and practical application. DESIGN: Rasch analysis of existing data sets. SETTING: A total of 715 acute, orthopedic outpatient centers and 62 long-term care facilities in 41 states participating with Focus On Therapeutic Outcomes, Inc. PATIENTS: A convenience sample of 92,343 patients (40% male; mean age +/- standard deviation [SD], 48+/-17y; range, 14-99y) seeking rehabilitation between 1993 and 1999. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Patients completed self-report health status surveys at admission and discharge. The Medical Outcomes Study 36-Item Short-Form Health Survey's physical functioning scale (PF-10) is the foundation of the physical FHS. The Oswestry Low Back Pain Disability Questionnaire, Neck Disability Index, Lysholm Knee Questionnaire, items pertinent to patients with upper-extremity impairments, and items pertinent to patients with more involved neuromusculoskeletal impairments were cocalibrated into the PF-10. RESULTS: The final FHS item bank contained 36 items (patient separation, 2.3; root mean square measurement error, 5.9; mean square +/- SD infit, 0.9+/-0.5; outfit, 0.9+/-0.9). Analyses supported empirical item hierarchy, unidimensionality, reproducibility of item calibrations, and content and construct validity of the FHS-36. CONCLUSIONS: Results support the reliability and validity of FHS-36 measures in the present sample. Analyses show the potential for a dynamic, computer-controlled, adaptive survey for FHS assessment applicable for group analysis and clinical decision making for individual patients.10a*Health Status Indicators10a*Rehabilitation Centers10aAdolescent10aAdult10aAged10aAged, 80 and over10aFemale10aHealth Surveys10aHumans10aMale10aMiddle Aged10aMusculoskeletal Diseases/*physiopathology/*rehabilitation10aNervous System Diseases/*physiopathology/*rehabilitation10aPhysical Fitness/*physiology10aRecovery of Function/physiology10aReproducibility of Results10aRetrospective Studies1 aHart, D L1 aWright, B D uhttp://iacat.org/content/development-index-physical-functional-health-status-rehabilitation