Development of a Computerized Adaptive Testing System for Assessing 5 Functions in Patients with Stroke: A Simulation and Validation Study

Gong Hong Lin, Yi Jing Huang, Ya Chen Lee, Shih Chieh Lee, Chia Yeh Chou, Ching Lin Hsieh

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective: The authors aimed to develop and validate the Computerized Adaptive Testing System for Assessing 5 Functions in Patients with Stroke (CAT-5F) based on the Barthel Index (BI), Postural Assessment Scale for Stroke patients (PASS), and Stroke Rehabilitation Assessment of Movement (STREAM) to improve the efficiency of assessment. The purposes of the CAT-5F assessment are to describe patients’ levels of impairments or disabilities in the 5 functions and to serve as an outcome measure in patients with stroke. Design: This is a data-mining study based on data from a previous study using simulation analysis to develop and validate the CAT-5F. Setting: One rehabilitation unit in a medical center in Taiwan served as the setting for this study. Participants: Data were retrieved from totals of 540 (initial assessment) and 309 (discharge assessment) participants with stroke assessed in a previous study. The assessment data (N=540) were from the BI, PASS, and STREAM. Interventions: Not applicable. Main Outcome Measures: The outcome measures for this study were from BI, PASS, and STREAM. Results: The CAT-5F using the optimal stopping rule (limited reliability increased <0.010) had good Rasch reliability across the 5 functions (0.86-0.96) and needed 12.7 items, on average, for the whole administration. The concurrent validity (Pearson product-moment correlation coefficient, r=0.91-0.96) and responsiveness (standardized response mean=0.33-0.91) of the CAT-5F were sufficient in the patients. Conclusion: The CAT-5F has sufficient administrative efficiency, reliability, concurrent validity, and responsiveness to simultaneously assess basic activities of daily living, postural control, upper extremity/lower extremity motor functions, and mobility in patients with stroke.

Original languageEnglish
Pages (from-to)899-907
Number of pages9
JournalArchives of Physical Medicine and Rehabilitation
Volume100
Issue number5
DOIs
Publication statusPublished - May 2019
Externally publishedYes

Keywords

  • Activities of daily living
  • Motor skills
  • Patient outcome assessment
  • Postural balance
  • Rehabilitation
  • Stroke

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation

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