%0 Journal Article %J Health and Quality of Life Outcomes %D 2009 %T Reduction in patient burdens with graphical computerized adaptive testing on the ADL scale: tool development and simulation %A Chien, T. W. %A Wu, H. M. %A Wang, W-C. %A Castillo, R. V. %A Chou, W. %K *Activities of Daily Living %K *Computer Graphics %K *Computer Simulation %K *Diagnosis, Computer-Assisted %K Female %K Humans %K Male %K Point-of-Care Systems %K Reproducibility of Results %K Stroke/*rehabilitation %K Taiwan %K United States %X BACKGROUND: The aim of this study was to verify the effectiveness and efficacy of saving time and reducing burden for patients, nurses, and even occupational therapists through computer adaptive testing (CAT). METHODS: Based on an item bank of the Barthel Index (BI) and the Frenchay Activities Index (FAI) for assessing comprehensive activities of daily living (ADL) function in stroke patients, we developed a visual basic application (VBA)-Excel CAT module, and (1) investigated whether the averaged test length via CAT is shorter than that of the traditional all-item-answered non-adaptive testing (NAT) approach through simulation, (2) illustrated the CAT multimedia on a tablet PC showing data collection and response errors of ADL clinical functional measures in stroke patients, and (3) demonstrated the quality control of endorsing scale with fit statistics to detect responding errors, which will be further immediately reconfirmed by technicians once patient ends the CAT assessment. RESULTS: The results show that endorsed items could be shorter on CAT (M = 13.42) than on NAT (M = 23) at 41.64% efficiency in test length. However, averaged ability estimations reveal insignificant differences between CAT and NAT. CONCLUSION: This study found that mobile nursing services, placed at the bedsides of patients could, through the programmed VBA-Excel CAT module, reduce the burden to patients and save time, more so than the traditional NAT paper-and-pencil testing appraisals. %B Health and Quality of Life Outcomes %7 2009/05/07 %V 7 %P 39 %@ 1477-7525 (Electronic)1477-7525 (Linking) %G eng %M 19416521 %2 2688502 %0 Journal Article %J Journal of Applied Measurement %D 2008 %T Strategies for controlling item exposure in computerized adaptive testing with the partial credit model %A Davis, L. L. %A Dodd, B. G. %K *Algorithms %K *Computers %K *Educational Measurement/statistics & numerical data %K Humans %K Questionnaires/*standards %K United States %X Exposure 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. %B Journal of Applied Measurement %7 2008/01/09 %V 9 %P 1-17 %@ 1529-7713 (Print)1529-7713 (Linking) %G eng %M 18180546 %0 Journal Article %J Quality of Life Research %D 2007 %T Patient-reported outcomes measurement and management with innovative methodologies and technologies %A Chang, C-H. %K *Health Status %K *Outcome Assessment (Health Care) %K *Quality of Life %K *Software %K Computer Systems/*trends %K Health Insurance Portability and Accountability Act %K Humans %K Patient Satisfaction %K Questionnaires %K United States %X Successful integration of modern psychometrics and advanced informatics in patient-reported outcomes (PRO) measurement and management can potentially maximize the value of health outcomes research and optimize the delivery of quality patient care. Unlike the traditional labor-intensive paper-and-pencil data collection method, item response theory-based computerized adaptive testing methodologies coupled with novel technologies provide an integrated environment to collect, analyze and present ready-to-use PRO data for informed and shared decision-making. This article describes the needs, challenges and solutions for accurate, efficient and cost-effective PRO data acquisition and dissemination means in order to provide critical and timely PRO information necessary to actively support and enhance routine patient care in busy clinical settings. %B Quality of Life Research %7 2007/05/29 %V 16 Suppl 1 %P 157-66 %@ 0962-9343 (Print)0962-9343 (Linking) %G eng %M 17530448 %0 Journal Article %J Medical Care %D 2007 %T Psychometric evaluation and calibration of health-related quality of life item banks: plans for the Patient-Reported Outcomes Measurement Information System (PROMIS) %A Reeve, B. B. %A Hays, R. D. %A Bjorner, J. B. %A Cook, K. F. %A Crane, P. K. %A Teresi, J. A. %A Thissen, D. %A Revicki, D. A. %A Weiss, D. J. %A Hambleton, R. K. %A Liu, H. %A Gershon, R. C. %A Reise, S. P. %A Lai, J. S. %A Cella, D. %K *Health Status %K *Information Systems %K *Quality of Life %K *Self Disclosure %K Adolescent %K Adult %K Aged %K Calibration %K Databases as Topic %K Evaluation Studies as Topic %K Female %K Humans %K Male %K Middle Aged %K Outcome Assessment (Health Care)/*methods %K Psychometrics %K Questionnaires/standards %K United States %X BACKGROUND: The construction and evaluation of item banks to measure unidimensional constructs of health-related quality of life (HRQOL) is a fundamental objective of the Patient-Reported Outcomes Measurement Information System (PROMIS) project. OBJECTIVES: Item banks will be used as the foundation for developing short-form instruments and enabling computerized adaptive testing. The PROMIS Steering Committee selected 5 HRQOL domains for initial focus: physical functioning, fatigue, pain, emotional distress, and social role participation. This report provides an overview of the methods used in the PROMIS item analyses and proposed calibration of item banks. ANALYSES: Analyses include evaluation of data quality (eg, logic and range checking, spread of response distribution within an item), descriptive statistics (eg, frequencies, means), item response theory model assumptions (unidimensionality, local independence, monotonicity), model fit, differential item functioning, and item calibration for banking. RECOMMENDATIONS: Summarized are key analytic issues; recommendations are provided for future evaluations of item banks in HRQOL assessment. %B Medical Care %7 2007/04/20 %V 45 %P S22-31 %8 May %@ 0025-7079 (Print) %G eng %M 17443115 %0 Journal Article %J Journal of Applied Measurement %D 2003 %T Developing an initial physical function item bank from existing sources %A Bode, R. K. %A Cella, D. %A Lai, J. S. %A Heinemann, A. W. %K *Databases %K *Sickness Impact Profile %K Adaptation, Psychological %K Data Collection %K Humans %K Neoplasms/*physiopathology/psychology/therapy %K Psychometrics %K Quality of Life/*psychology %K Research Support, U.S. Gov't, P.H.S. %K United States %X The objective of this article is to illustrate incremental item banking using health-related quality of life data collected from two samples of patients receiving cancer treatment. The kinds of decisions one faces in establishing an item bank for computerized adaptive testing are also illustrated. Pre-calibration procedures include: identifying common items across databases; creating a new database with data from each pool; reverse-scoring "negative" items; identifying rating scales used in items; identifying pivot points in each rating scale; pivot anchoring items at comparable rating scale categories; and identifying items in each instrument that measure the construct of interest. A series of calibrations were conducted in which a small proportion of new items were added to the common core and misfitting items were identified and deleted until an initial item bank has been developed. %B Journal of Applied Measurement %V 4 %P 124-36 %G eng %M 12748405 %0 Journal Article %J Medical Care %D 2000 %T Item response theory and health outcomes measurement in the 21st century %A Hays, R. D. %A Morales, L. S. %A Reise, S. P. %K *Models, Statistical %K Activities of Daily Living %K Data Interpretation, Statistical %K Health Services Research/*methods %K Health Surveys %K Human %K Mathematical Computing %K Outcome Assessment (Health Care)/*methods %K Research Design %K Support, Non-U.S. Gov't %K Support, U.S. Gov't, P.H.S. %K United States %X Item response theory (IRT) has a number of potential advantages over classical test theory in assessing self-reported health outcomes. IRT models yield invariant item and latent trait estimates (within a linear transformation), standard errors conditional on trait level, and trait estimates anchored to item content. IRT also facilitates evaluation of differential item functioning, inclusion of items with different response formats in the same scale, and assessment of person fit and is ideally suited for implementing computer adaptive testing. Finally, IRT methods can be helpful in developing better health outcome measures and in assessing change over time. These issues are reviewed, along with a discussion of some of the methodological and practical challenges in applying IRT methods. %B Medical Care %V 38 %P II28-II42 %G eng %M 10982088 %0 Journal Article %J Recruitment, Retention, and Restructuring Report %D 1996 %T Dispelling myths about the new NCLEX exam %A Johnson, S. H. %K *Educational Measurement %K *Licensure %K Humans %K Nursing Staff %K Personnel Selection %K United States %X The new computerized NCLEX system is working well. Most new candidates, employers, and board of nursing representatives like the computerized adaptive testing system and the fast report of results. But, among the candidates themselves some myths have grown which cause them needless anxiety. %B Recruitment, Retention, and Restructuring Report %V 9 %P 6-7 %8 Jan-Feb %G eng %M 8715107 %0 Journal Article %J Nursing Management %D 1993 %T Moving in a new direction: Computerized adaptive testing (CAT) %A Jones-Dickson, C. %A Dorsey, D. %A Campbell-Warnock, J. %A Fields, F. %K *Computers %K Accreditation/methods %K Educational Measurement/*methods %K Licensure, Nursing %K United States %B Nursing Management %7 1993/01/01 %V 24 %P 80, 82 %8 Jan %@ 0744-6314 (Print) %G eng %M 8418441 %0 Journal Article %J Issues %D 1990 %T Future directions for the National Council: the Computerized Adaptive Testing Project %A Bouchard, J. %K *Computers %K *Licensure %K Educational Measurement/*methods %K Societies, Nursing %K United States %B Issues %V 11 %P 1, 3, 5 %G eng %M 2074153 %0 Journal Article %J Issues %D 1990 %T National Council Computerized Adaptive Testing Project Review--committee perspective %A Haynes, B. %K *Computers %K *Licensure %K Educational Measurement/*methods %K Feasibility Studies %K Societies, Nursing %K United States %B Issues %V 11 %P 3 %G eng %M 2074156