Literature DB >> 16876547

Computerized adaptive testing for follow-up after discharge from inpatient rehabilitation: I. Activity outcomes.

Stephen M Haley1, Hilary Siebens, Wendy J Coster, Wei Tao, Randie M Black-Schaffer, Barbara Gandek, Samuel J Sinclair, Pengsheng Ni.   

Abstract

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.

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Year:  2006        PMID: 16876547     DOI: 10.1016/j.apmr.2006.04.020

Source DB:  PubMed          Journal:  Arch Phys Med Rehabil        ISSN: 0003-9993            Impact factor:   3.966


  16 in total

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8.  Agreement of patient and physician ratings on mobility and self-care in neurological diseases.

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9.  An exploratory analysis of functional staging using an item response theory approach.

Authors:  Wei Tao; Stephen M Haley; Wendy J Coster; Pengsheng Ni; Alan M Jette
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10.  Creating a computer adaptive test version of the late-life function and disability instrument.

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