Development of a computerized adaptive test for assessing activities of daily living in outpatients with stroke

I. Ping Hsueh, Jyun Hong Chen, Chun Hou Wang, Wen Hsuan Hou, Ching Lin Hsieh

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background. An efficient, reliable, and valid measure for assessing activities of daily living (ADL) function is useful to improve the efficiency of patient management and outcome measurement. Objective. The purpose of this study was to construct a computerized adaptive testing (CAT) system for measuring ADL function in outpatients with stroke. Design. Two cohort studies were conducted at 6 hospitals in Taiwan. Methods. A candidate item bank (44 items) was developed, and 643 outpatients were interviewed. An item response theory model was fitted to the data and estimated the item parameters (eg, difficulty and discrimination) for developing the ADL CAT. Another sample of 51 outpatients was interviewed to examine the concurrent validity and efficiency of the CAT. The ADL CAT, as the outcome measure, and the Barthel index (BI) and Frenchay Activities index (FAI) were administered on the second group of participants. Results. Ten items did not satisfy the model's expectations and were deleted. Thirty-four items were included in the final item bank. Two stopping rules (ie, reliability coefficient >.9 and maximum test length of 7 items) were set for the CAT. The participants' ADL scores had an average reliability of.93. The CAT scores were highly associated with those of the full 34 items (Pearson r=.98). The scores of the CAT were closely correlated with those of the combined BI and FAI (r=.82). The time required to complete the CAT was about one fifth of the time used to administer both the BI and FAI. Limitations. The participants were outpatients living in the community. Further studies are needed to cross-validate the results. Conclusions. The results demonstrated that the ADL CAT is quick to administer, reliable, and valid in outpatients with stroke.

Original languageEnglish
Pages (from-to)681-693
Number of pages13
JournalPhysical Therapy
Volume93
Issue number5
DOIs
Publication statusPublished - May 2013

Fingerprint

Activities of Daily Living
Outpatients
Stroke
Taiwan
Cohort Studies
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Development of a computerized adaptive test for assessing activities of daily living in outpatients with stroke. / Hsueh, I. Ping; Chen, Jyun Hong; Wang, Chun Hou; Hou, Wen Hsuan; Hsieh, Ching Lin.

In: Physical Therapy, Vol. 93, No. 5, 05.2013, p. 681-693.

Research output: Contribution to journalArticle

Hsueh, I. Ping ; Chen, Jyun Hong ; Wang, Chun Hou ; Hou, Wen Hsuan ; Hsieh, Ching Lin. / Development of a computerized adaptive test for assessing activities of daily living in outpatients with stroke. In: Physical Therapy. 2013 ; Vol. 93, No. 5. pp. 681-693.
@article{d1bcbbaada0545aa99c7fe1405d1d0ef,
title = "Development of a computerized adaptive test for assessing activities of daily living in outpatients with stroke",
abstract = "Background. An efficient, reliable, and valid measure for assessing activities of daily living (ADL) function is useful to improve the efficiency of patient management and outcome measurement. Objective. The purpose of this study was to construct a computerized adaptive testing (CAT) system for measuring ADL function in outpatients with stroke. Design. Two cohort studies were conducted at 6 hospitals in Taiwan. Methods. A candidate item bank (44 items) was developed, and 643 outpatients were interviewed. An item response theory model was fitted to the data and estimated the item parameters (eg, difficulty and discrimination) for developing the ADL CAT. Another sample of 51 outpatients was interviewed to examine the concurrent validity and efficiency of the CAT. The ADL CAT, as the outcome measure, and the Barthel index (BI) and Frenchay Activities index (FAI) were administered on the second group of participants. Results. Ten items did not satisfy the model's expectations and were deleted. Thirty-four items were included in the final item bank. Two stopping rules (ie, reliability coefficient >.9 and maximum test length of 7 items) were set for the CAT. The participants' ADL scores had an average reliability of.93. The CAT scores were highly associated with those of the full 34 items (Pearson r=.98). The scores of the CAT were closely correlated with those of the combined BI and FAI (r=.82). The time required to complete the CAT was about one fifth of the time used to administer both the BI and FAI. Limitations. The participants were outpatients living in the community. Further studies are needed to cross-validate the results. Conclusions. The results demonstrated that the ADL CAT is quick to administer, reliable, and valid in outpatients with stroke.",
author = "Hsueh, {I. Ping} and Chen, {Jyun Hong} and Wang, {Chun Hou} and Hou, {Wen Hsuan} and Hsieh, {Ching Lin}",
year = "2013",
month = "5",
doi = "10.2522/ptj.20120173",
language = "English",
volume = "93",
pages = "681--693",
journal = "Physical Therapy",
issn = "0031-9023",
publisher = "American Physical Therapy Association",
number = "5",

}

TY - JOUR

T1 - Development of a computerized adaptive test for assessing activities of daily living in outpatients with stroke

AU - Hsueh, I. Ping

AU - Chen, Jyun Hong

AU - Wang, Chun Hou

AU - Hou, Wen Hsuan

AU - Hsieh, Ching Lin

PY - 2013/5

Y1 - 2013/5

N2 - Background. An efficient, reliable, and valid measure for assessing activities of daily living (ADL) function is useful to improve the efficiency of patient management and outcome measurement. Objective. The purpose of this study was to construct a computerized adaptive testing (CAT) system for measuring ADL function in outpatients with stroke. Design. Two cohort studies were conducted at 6 hospitals in Taiwan. Methods. A candidate item bank (44 items) was developed, and 643 outpatients were interviewed. An item response theory model was fitted to the data and estimated the item parameters (eg, difficulty and discrimination) for developing the ADL CAT. Another sample of 51 outpatients was interviewed to examine the concurrent validity and efficiency of the CAT. The ADL CAT, as the outcome measure, and the Barthel index (BI) and Frenchay Activities index (FAI) were administered on the second group of participants. Results. Ten items did not satisfy the model's expectations and were deleted. Thirty-four items were included in the final item bank. Two stopping rules (ie, reliability coefficient >.9 and maximum test length of 7 items) were set for the CAT. The participants' ADL scores had an average reliability of.93. The CAT scores were highly associated with those of the full 34 items (Pearson r=.98). The scores of the CAT were closely correlated with those of the combined BI and FAI (r=.82). The time required to complete the CAT was about one fifth of the time used to administer both the BI and FAI. Limitations. The participants were outpatients living in the community. Further studies are needed to cross-validate the results. Conclusions. The results demonstrated that the ADL CAT is quick to administer, reliable, and valid in outpatients with stroke.

AB - Background. An efficient, reliable, and valid measure for assessing activities of daily living (ADL) function is useful to improve the efficiency of patient management and outcome measurement. Objective. The purpose of this study was to construct a computerized adaptive testing (CAT) system for measuring ADL function in outpatients with stroke. Design. Two cohort studies were conducted at 6 hospitals in Taiwan. Methods. A candidate item bank (44 items) was developed, and 643 outpatients were interviewed. An item response theory model was fitted to the data and estimated the item parameters (eg, difficulty and discrimination) for developing the ADL CAT. Another sample of 51 outpatients was interviewed to examine the concurrent validity and efficiency of the CAT. The ADL CAT, as the outcome measure, and the Barthel index (BI) and Frenchay Activities index (FAI) were administered on the second group of participants. Results. Ten items did not satisfy the model's expectations and were deleted. Thirty-four items were included in the final item bank. Two stopping rules (ie, reliability coefficient >.9 and maximum test length of 7 items) were set for the CAT. The participants' ADL scores had an average reliability of.93. The CAT scores were highly associated with those of the full 34 items (Pearson r=.98). The scores of the CAT were closely correlated with those of the combined BI and FAI (r=.82). The time required to complete the CAT was about one fifth of the time used to administer both the BI and FAI. Limitations. The participants were outpatients living in the community. Further studies are needed to cross-validate the results. Conclusions. The results demonstrated that the ADL CAT is quick to administer, reliable, and valid in outpatients with stroke.

UR - http://www.scopus.com/inward/record.url?scp=84877089070&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84877089070&partnerID=8YFLogxK

U2 - 10.2522/ptj.20120173

DO - 10.2522/ptj.20120173

M3 - Article

VL - 93

SP - 681

EP - 693

JO - Physical Therapy

JF - Physical Therapy

SN - 0031-9023

IS - 5

ER -