TY - JOUR T1 - Simulated computerized adaptive test for patients with shoulder impairments was efficient and produced valid measures of function JF - Journal of Clinical Epidemiology Y1 - 2006 A1 - Hart, D. L. A1 - Cook, K. F. A1 - Mioduski, J. E. A1 - Teal, C. R. A1 - Crane, P. K. KW - *Computer Simulation KW - *Range of Motion, Articular KW - Activities of Daily Living KW - Adult KW - Aged KW - Aged, 80 and over KW - Factor Analysis, Statistical KW - Female KW - Humans KW - Male KW - Middle Aged KW - Prospective Studies KW - Reproducibility of Results KW - Research Support, N.I.H., Extramural KW - Research Support, U.S. Gov't, Non-P.H.S. KW - Shoulder Dislocation/*physiopathology/psychology/rehabilitation KW - Shoulder Pain/*physiopathology/psychology/rehabilitation KW - Shoulder/*physiopathology KW - Sickness Impact Profile KW - Treatment Outcome AB - 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 (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. VL - 59 N1 - 0895-4356 (Print)Journal ArticleValidation Studies ER - TY - JOUR T1 - Simulated computerized adaptive tests for measuring functional status were efficient with good discriminant validity in patients with hip, knee, or foot/ankle impairments JF - Journal of Clinical Epidemiology Y1 - 2005 A1 - Hart, D. L. A1 - Mioduski, J. E. A1 - Stratford, P. W. KW - *Health Status Indicators KW - Activities of Daily Living KW - Adolescent KW - Adult KW - Aged KW - Aged, 80 and over KW - Ankle Joint/physiopathology KW - Diagnosis, Computer-Assisted/*methods KW - Female KW - Hip Joint/physiopathology KW - Humans KW - Joint Diseases/physiopathology/*rehabilitation KW - Knee Joint/physiopathology KW - Lower Extremity/*physiopathology KW - Male KW - Middle Aged KW - Research Support, N.I.H., Extramural KW - Research Support, U.S. Gov't, P.H.S. KW - Retrospective Studies AB - BACKGROUND 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. VL - 58 N1 - 0895-4356 (Print)Journal ArticleMulticenter StudyValidation Studies ER -