TY - JOUR T1 - Computerized adaptive testing for follow-up after discharge from inpatient rehabilitation: II. Participation outcomes JF - Archives of Physical Medicine and Rehabilitation Y1 - 2008 A1 - Haley, S. M. A1 - Gandek, B. A1 - Siebens, H. A1 - Black-Schaffer, R. M. A1 - Sinclair, S. J. A1 - Tao, W. A1 - Coster, W. J. A1 - Ni, P. A1 - Jette, A. M. KW - *Activities of Daily Living KW - *Adaptation, Physiological KW - *Computer Systems KW - *Questionnaires KW - Adult KW - Aged KW - Aged, 80 and over KW - Chi-Square Distribution KW - Factor Analysis, Statistical KW - Female KW - Humans KW - Longitudinal Studies KW - Male KW - Middle Aged KW - Outcome Assessment (Health Care)/*methods KW - Patient Discharge KW - Prospective Studies KW - Rehabilitation/*standards KW - Subacute Care/*standards AB - OBJECTIVES: To measure participation outcomes with a computerized adaptive test (CAT) and compare CAT and traditional fixed-length surveys in terms of score agreement, respondent burden, discriminant validity, and responsiveness. DESIGN: Longitudinal, prospective cohort study of patients interviewed approximately 2 weeks after discharge from inpatient rehabilitation and 3 months later. SETTING: Follow-up interviews conducted in patient's home setting. PARTICIPANTS: Adults (N=94) with diagnoses of neurologic, orthopedic, or medically complex conditions. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Participation domains of mobility, domestic life, and community, social, & civic life, measured using a CAT version of the Participation Measure for Postacute Care (PM-PAC-CAT) and a 53-item fixed-length survey (PM-PAC-53). RESULTS: The PM-PAC-CAT showed substantial agreement with PM-PAC-53 scores (intraclass correlation coefficient, model 3,1, .71-.81). On average, the PM-PAC-CAT was completed in 42% of the time and with only 48% of the items as compared with the PM-PAC-53. Both formats discriminated across functional severity groups. The PM-PAC-CAT had modest reductions in sensitivity and responsiveness to patient-reported change over a 3-month interval as compared with the PM-PAC-53. CONCLUSIONS: Although continued evaluation is warranted, accurate estimates of participation status and responsiveness to change for group-level analyses can be obtained from CAT administrations, with a sizeable reduction in respondent burden. VL - 89 SN - 1532-821X (Electronic)0003-9993 (Linking) N1 - Haley, Stephen MGandek, BarbaraSiebens, HilaryBlack-Schaffer, Randie MSinclair, Samuel JTao, WeiCoster, Wendy JNi, PengshengJette, Alan MK02 HD045354-01A1/HD/NICHD NIH HHS/United StatesK02 HD45354-01/HD/NICHD NIH HHS/United StatesR01 HD043568/HD/NICHD NIH HHS/United StatesR01 HD043568-01/HD/NICHD NIH HHS/United StatesResearch Support, N.I.H., ExtramuralUnited StatesArchives of physical medicine and rehabilitationArch Phys Med Rehabil. 2008 Feb;89(2):275-83. U2 - 2666330 ER - TY - JOUR T1 - Computerized adaptive testing for follow-up after discharge from inpatient rehabilitation: I. Activity outcomes JF - Archives of Physical Medicine and Rehabilitation Y1 - 2006 A1 - Haley, S. M. A1 - Siebens, H. A1 - Coster, W. J. A1 - Tao, W. A1 - Black-Schaffer, R. M. A1 - Gandek, B. A1 - Sinclair, S. J. A1 - Ni, P. KW - *Activities of Daily Living KW - *Adaptation, Physiological KW - *Computer Systems KW - *Questionnaires KW - Adult KW - Aged KW - Aged, 80 and over KW - Chi-Square Distribution KW - Factor Analysis, Statistical KW - Female KW - Humans KW - Longitudinal Studies KW - Male KW - Middle Aged KW - Outcome Assessment (Health Care)/*methods KW - Patient Discharge KW - Prospective Studies KW - Rehabilitation/*standards KW - Subacute Care/*standards AB - OBJECTIVE: To examine score agreement, precision, validity, efficiency, and responsiveness of a computerized adaptive testing (CAT) version of the Activity Measure for Post-Acute Care (AM-PAC-CAT) in a prospective, 3-month follow-up sample of inpatient rehabilitation patients recently discharged home. DESIGN: Longitudinal, prospective 1-group cohort study of patients followed approximately 2 weeks after hospital discharge and then 3 months after the initial home visit. SETTING: Follow-up visits conducted in patients' home setting. PARTICIPANTS: Ninety-four adults who were recently discharged from inpatient rehabilitation, with diagnoses of neurologic, orthopedic, and medically complex conditions. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Summary scores from AM-PAC-CAT, including 3 activity domains of movement and physical, personal care and instrumental, and applied cognition were compared with scores from a traditional fixed-length version of the AM-PAC with 66 items (AM-PAC-66). RESULTS: AM-PAC-CAT scores were in good agreement (intraclass correlation coefficient model 3,1 range, .77-.86) with scores from the AM-PAC-66. On average, the CAT programs required 43% of the time and 33% of the items compared with the AM-PAC-66. Both formats discriminated across functional severity groups. The standardized response mean (SRM) was greater for the movement and physical fixed form than the CAT; the effect size and SRM of the 2 other AM-PAC domains showed similar sensitivity between CAT and fixed formats. Using patients' own report as an anchor-based measure of change, the CAT and fixed length formats were comparable in responsiveness to patient-reported change over a 3-month interval. CONCLUSIONS: Accurate estimates for functional activity group-level changes can be obtained from CAT administrations, with a considerable reduction in administration time. VL - 87 SN - 0003-9993 (Print) N1 - Haley, Stephen MSiebens, HilaryCoster, Wendy JTao, WeiBlack-Schaffer, Randie MGandek, BarbaraSinclair, Samuel JNi, PengshengK0245354-01/phsR01 hd043568/hd/nichdResearch Support, N.I.H., ExtramuralUnited StatesArchives of physical medicine and rehabilitationArch Phys Med Rehabil. 2006 Aug;87(8):1033-42. ER - TY - JOUR T1 - Score comparability of short forms and computerized adaptive testing: Simulation study with the activity measure for post-acute care JF - Archives of Physical Medicine and Rehabilitation Y1 - 2004 A1 - Haley, S. M. A1 - Coster, W. J. A1 - Andres, P. L. A1 - Kosinski, M. A1 - Ni, P. KW - Boston KW - Factor Analysis, Statistical KW - Humans KW - Outcome Assessment (Health Care)/*methods KW - Prospective Studies KW - Questionnaires/standards KW - Rehabilitation/*standards KW - Subacute Care/*standards AB - OBJECTIVE: To compare simulated short-form and computerized adaptive testing (CAT) scores to scores obtained from complete item sets for each of the 3 domains of the Activity Measure for Post-Acute Care (AM-PAC). DESIGN: Prospective study. SETTING: Six postacute health care networks in the greater Boston metropolitan area, including inpatient acute rehabilitation, transitional care units, home care, and outpatient services. PARTICIPANTS: A convenience sample of 485 adult volunteers who were receiving skilled rehabilitation services. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Inpatient and community-based short forms and CAT applications were developed for each of 3 activity domains (physical & mobility, personal care & instrumental, applied cognition) using item pools constructed from new items and items from existing postacute care instruments. RESULTS: Simulated CAT scores correlated highly with score estimates from the total item pool in each domain (4- and 6-item CAT r range,.90-.95; 10-item CAT r range,.96-.98). Scores on the 10-item short forms constructed for inpatient and community settings also provided good estimates of the AM-PAC item pool scores for the physical & movement and personal care & instrumental domains, but were less consistent in the applied cognition domain. Confidence intervals around individual scores were greater in the short forms than for the CATs. CONCLUSIONS: Accurate scoring estimates for AM-PAC domains can be obtained with either the setting-specific short forms or the CATs. The strong relationship between CAT and item pool scores can be attributed to the CAT's ability to select specific items to match individual responses. The CAT may have additional advantages over short forms in practicality, efficiency, and the potential for providing more precise scoring estimates for individuals. VL - 85 SN - 0003-9993 (Print) N1 - Haley, Stephen MCoster, Wendy JAndres, Patricia LKosinski, MarkNi, PengshengR01 hd43568/hd/nichdComparative StudyMulticenter StudyResearch Support, U.S. Gov't, Non-P.H.S.Research Support, U.S. Gov't, P.H.S.United StatesArchives of physical medicine and rehabilitationArch Phys Med Rehabil. 2004 Apr;85(4):661-6. ER -