Document Detail


Computerized adaptive test for patients with foot or ankle impairments produced valid and responsive measures of function.
MedLine Citation:
PMID:  18709546     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We tested the item response theory (IRT) model assumptions of the original item bank, and evaluated the practical and psychometric adequacy, of a computerized adaptive test (CAT) for patients with foot or ankle impairments seeking rehabilitation in outpatient therapy clinics. METHODS: Data from 10,287 patients with foot or ankle impairments receiving outpatient physical therapy were analyzed. We first examined the unidimensionality, fit, and invariance IRT assumptions of the CAT item bank. Then we evaluated the efficiency of the CAT administration and construct validity and sensitivity of change of the foot/ankle CAT measure of lower-extremity functional status (FS). RESULTS: Results supported unidimensionality, model fit, and invariance of item parameters and patient ability estimates. On average, the CAT used seven items to produce precise estimates of FS that adequately covered the content range with negligible floor and ceiling effects. Patients who were older, had more chronic symptoms, had more surgeries, had more comorbidities, and did not exercise prior to receiving rehabilitation reported worse discharge FS. Seventy-one percent of patients obtained statistically significant change at follow-up. Change of 8 FS units (scale 0-100) represented minimal clinically important improvement. CONCLUSIONS: We concluded that the foot/ankle item bank met IRT assumptions and that the CAT FS measure was precise, valid, and responsive, supporting its use in routine clinical application.
Authors:
Dennis L Hart; Ying-Chih Wang; Paul W Stratford; Jerome E Mioduski
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Publication Detail:
Type:  Journal Article     Date:  2008-08-17
Journal Detail:
Title:  Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation     Volume:  17     ISSN:  0962-9343     ISO Abbreviation:  Qual Life Res     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-09-22     Completed Date:  2009-02-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9210257     Medline TA:  Qual Life Res     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1081-91     Citation Subset:  IM    
Affiliation:
Focus on Therapeutic Outcomes, Inc., 551 Yopps Cove Road, White Stone, VA, 22578-2403, USA. hart@fotoinc.com
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MeSH Terms
Descriptor/Qualifier:
Adaptation, Psychological
Adolescent
Adult
Aged
Ankle Injuries / psychology*,  rehabilitation
Computers*
Disability Evaluation*
Female
Foot Injuries / psychology*,  rehabilitation
Humans
Lower Extremity / pathology
Male
Middle Aged
Models, Theoretical
Outpatients
Pilot Projects
Psychometrics
Quality of Life / psychology*
ROC Curve
Software*
Young Adult

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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