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Gepubliceerd in: Quality of Life Research 8/2008

01-10-2008

Computerized adaptive test for patients with foot or ankle impairments produced valid and responsive measures of function

Auteurs: Dennis L. Hart, Ying-Chih Wang, Paul W. Stratford, Jerome E. Mioduski

Gepubliceerd in: Quality of Life Research | Uitgave 8/2008

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Abstract

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.
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Metagegevens
Titel
Computerized adaptive test for patients with foot or ankle impairments produced valid and responsive measures of function
Auteurs
Dennis L. Hart
Ying-Chih Wang
Paul W. Stratford
Jerome E. Mioduski
Publicatiedatum
01-10-2008
Uitgeverij
Springer Netherlands
Gepubliceerd in
Quality of Life Research / Uitgave 8/2008
Print ISSN: 0962-9343
Elektronisch ISSN: 1573-2649
DOI
https://doi.org/10.1007/s11136-008-9381-y

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