Item Banks, Item Linking and Computer-Adaptive Tests

2007 ◽  
pp. 189-205
Keyword(s):  
Adaptive Tests ◽  
Item Banks ◽  
Computer Adaptive Tests

scholarly journals Patient-Reported Outcomes Demonstrate The Value Of Non-Operative And Operative Orthopedic Treatments And Predict The Odds Of Improvement With Surgery

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000
Author(s):  
Andrew Haskell ◽  
Todd S. Kim
Keyword(s):  
Pain Intensity ◽  
Patient Reported Outcomes ◽  
Pain Interference ◽  
Surgical Patients ◽  
Final Visit ◽  
Adaptive Tests ◽  
Item Banks ◽  
Patient Reported ◽  
Computer Adaptive Tests ◽  
Better Than

Category: Outcomes Measurement Introduction/Purpose: The importance of patient reported outcomes (PROs) has become increasingly recognized as an important tool to measure our clinical value. The National Institute of Health (NIH) created the Patient-Reported Outcomes Measurement Information System (PROMIS), a series of validated item banks, to help clinicians and researches measure key clinical domains. The PROMIS computer adaptive tests (CAT) may be administered with minimal resources or administrative burden. This study describes the results of administering computer adaptive tests (CAT) to every patient in a high volume Orthopedic Surgery practice. We test the hypotheses that both non-operative treatment and operative treatments improve PRO scores. Furthermore, we test the hypothesis that preoperative scores in these domains may be used to predict chances of improvement after surgery. Methods: The PROMIS CAT was administered prospectively for all patients as part of standard clinic intake and recorded in the patient’s electronic medical record (EMR) at each clinic visit. The PROMIS item banks are normalized to mean 50±10 for the US population. De-identified data was retrospectively extracted from the EMR including PROMIS scores, demographic information, as well as surgery specific information. As of this submission, 1688 PROMIS CATs from March 2015 to September 2016 have been analyzed. Data for initial and final clinic visits, as well as for the final preoperative visit for patients who had surgery, are compared using Wilcoxon Matched Pairs Test for paired samples and Mann-Whitney U Test for unpaired samples. Linear regression is used to assess the association of initial values to change in value after treatment. The effect of stratified initial clinic domain value on odds of improving with surgery is assessed using Analysis of Variance. Results: Non-surgical and surgical patients present with similar pain intensity (49.6±7.9 vs. 49.4±7.8). Surgical patients do not improve prior to surgery, but both improve by their final visit (45.7±7.5, 43.7±8.8, p<0.05). Non-surgical and surgical patients present with similar pain interference (60.0±8.4 vs. 60.3±8.9). Surgical patients do not improve prior to surgery, but both improve by their final visit (56.9±8.8, 54.3±9.4, p<0.05). For surgical patients, change in pain intensity and pain interference correlate with initial values (R2 0.32 and 0.27, p<0.05). The percentage whose pain intensity improves after surgery when initial value is over one SD worse than mean is 96%, within one SD worse than mean is 81%, within one SD better than mean is 56%, and over one SD better than mean is 40% (p<0.05). Conclusion: Both non-operative and operative orthopedic treatments improve patient reported pain intensity and pain interference. For patients that have surgery, patients that present with more severe symptoms tend to improve more with surgery. Furthermore, the odds of improving after surgery can be calculated based on preoperative PRO scores. This may allow surgeons to counsel patients about the potential benefits of surgery with personalized precision that is currently unavailable. Measuring PROs using PROMIS CATs demonstrates the value of both non-operative and operative Orthopedic Surgery care for our patients. Preoperative PRO scores may predict the odds of successful surgical intervention.

Screening for mental disorders in heart failure patients using computer-adaptive tests

2013 ◽  
Vol 23 (5) ◽  
pp. 1609-1618 ◽  
Author(s):  
H. Felix Fischer ◽  
Cassandra Klug ◽  
Koosje Roeper ◽  
Eva Blozik ◽  
Frank Edelmann ◽  
...  
Keyword(s):  
Heart Failure ◽  
Mental Disorders ◽  
Adaptive Tests ◽  
Heart Failure Patients ◽  
Computer Adaptive Tests

Pediatric PROMIS Computer Adaptive Tests Are Highly Correlated With Adult PROMIS Computer Adaptive Tests in Pediatric Sports Medicine Patients

2020 ◽  
Vol 48 (14) ◽  
pp. 3620-3625
Author(s):  
David N. Bernstein ◽  
Sreten Franovic ◽  
D. Grace Smith ◽  
Luke Hessburg ◽  
Nikhil Yedulla ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Depressive Symptoms ◽  
Physical Function ◽  
Upper Extremity ◽  
Sports Medicine ◽  
Pain Interference ◽  
Adaptive Tests ◽  
Care Research ◽  
Patient Reported ◽  
Computer Adaptive Tests

Background: The Patient-Reported Outcomes Measurement Information System (PROMIS) is a powerful set of patient-reported outcome measures (PROMs) that are gaining popularity throughout orthopaedic surgery. The use of both adult and pediatric PROMIS questionnaires in orthopaedic sports medicine limits the value of the PROMIS in routine sports medicine clinical care, research, and quality improvement. Because orthopaedic sports medicine surgeons see patients across a wide age range, simplifying the collection of PROMIS computer adaptive tests (CATs) to a single set of questionnaires, regardless of age, is of notable value. Purpose/Hypothesis: The purpose was to determine the strength of the correlation between the pediatric and adult PROMIS questionnaires. We hypothesized that there would be a high correlation between the adult and pediatric versions for each PROMIS domain, thereby justifying the use of only the adult version for most sports medicine providers, regardless of patient age. Study Design: Cohort study (Diagnosis); Level of evidence, 2. Methods: Between December 2018 and December 2019, all pediatric sports medicine patients presenting to a single, academic, orthopaedic sports medicine clinic were asked to participate in the present study with their parents’ consent. Patients were asked to complete a set of adult PROMIS domains (Physical Function and/or Upper Extremity, Pain Interference, and Depression) as well as a set of pediatric PROMIS domains (Mobility and/or Upper Extremity, Pain Interference, and Depressive Symptoms). Concurrent validity was assessed using Pearson correlation coefficients ( r). Ceiling and floor effects were determined. Results: A total of 188 patients met our inclusion criteria. The correlation between the adult and pediatric PROMIS Upper Extremity, Physical Function and Mobility, Pain Interference, and Depression and Depressive Symptoms forms were high-moderate ( r = 0.68; P < .01), high-moderate ( r = 0.69; P < .01), high ( r = 0.78; P < .01), and high ( r = 0.85; P < .01), respectively. Both adult and pediatric depression-related PROMIS domains demonstrated notable floor effects (adult: 38%; pediatric: 24%). The pediatric PROMIS Upper Extremity domain demonstrated a ceiling effect (20%). Conclusion: Adult PROMIS CATs may be used in an orthopaedic sports medicine clinic for both adult and pediatric patients. Our findings will help decrease the amount of resources needed for the implementation and use of PROMs for patient care, research, and quality improvement in orthopaedic sports medicine clinics.

Relationship Between PROMIS Computer Adaptive Tests and Legacy Hip Measures Among Patients Presenting to a Tertiary Care Hip Preservation Center

2019 ◽  
Vol 47 (4) ◽  
pp. 876-884 ◽  
Author(s):  
Robert C. Kollmorgen ◽  
Carolyn A. Hutyra ◽  
Cindy Green ◽  
Brian Lewis ◽  
Steven A. Olson ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Strong Correlation ◽  
Social Roles ◽  
Tertiary Care ◽  
Patient Reported Outcome Measures ◽  
Patient Reported Outcome ◽  
Adaptive Tests ◽  
Patient Reported ◽  
Ceiling Effects ◽  
Computer Adaptive Tests

Background: Legacy hip outcome measures may be burdensome to patients and sometimes yield floor or ceiling effects. Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive tests (CATs) allow for low-burden data capture and limited ceiling and floor effects. Purpose/Hypothesis: The purpose of this study was to determine whether the PROMIS CAT domains demonstrate correlation against commonly used legacy patient-reported outcome measures in a population of patients presenting to a tertiary care hip preservation center. The authors hypothesized the following: (1) PROMIS CAT scores based on physical function (PF), pain interference (PIF), pain behavior, and pain intensity would show strong correlation with the following legacy scores: modified Harris Hip Score (mHHS), International Hip Outcome Tool–12 (iHOT-12), Hip Outcome Score (HOS) Sports and Activities of Daily Living subscales, and Veterans RAND–6D (VR-6D) utility measure. (2) The mental and physical health portions of the VR-6D legacy measure would show weak correlation with mental- and psychosocial-specific PROMIS elements—depression, anxiety, fatigue, sleep, and ability to participate in social roles and activities. (3) All PROMIS measures would exhibit fewer floor and ceiling effects than legacy scores. Study Design: Cohort study (diagnosis); Level of evidence, 3. Methods: Prospective data were collected on 125 patients in the hip preservation clinics. Enrollees completed legacy scores (visual analog scale for pain, mHHS, iHOT-12, HOS, and VR-6D) and PROMIS CAT questionnaires (PF, PIF, pain behavior, anxiety, depression, sleep, social roles and activities, pain intensity, fatigue). Spearman rank correlations were calculated, with rs values of 0 to 0.3 indicating negligible correlation; 0.3 to 0.5, weak correlation; 0.5 to 0.7, moderately strong correlation; and >0.7, strong correlation. Floor and ceiling effects were evaluated. Results: As anticipated, the PF-CAT yielded strong correlations with the iHOT-12, mHHS, HOS–Sports, HOS–Activities of Daily Living, and VR-6D, with rs values of 0.76, 0.71, 0.81, 0.87, and 0.71, respectively. The PIF-CAT was the only pain score to show moderately strong to strong correlation with all 14 patient-reported outcome measures. A strong correlation was observed between the VR-6D and the social roles and activities CAT ( rs = 0.73). The depression CAT had a significant floor effect at 19%. No additional floor or ceiling effect was present for any other legacy or PROMIS measure. Conclusion: The PF-CAT shows strong correlation with legacy patient-reported outcome scores among patients presenting to a tertiary care hip preservation center. The PIF-CAT also correlates strongly with legacy and PROMIS measures evaluating physical and mental well-being. PROMIS measures are less burdensome and demonstrate no floor or ceiling effects, making them a potential alternative to legacy patient-reported outcome measures for the hip.

scholarly journals The use of computer adaptive tests in outcome assessments following upper limb trauma

2018 ◽  
Vol 100-B (6) ◽  
pp. 693-702 ◽  
Author(s):  
P. Jayakumar ◽  
C. L. Overbeek ◽  
A-M. Vranceanu ◽  
M. Williams ◽  
S. Lamb ◽  
...  
Keyword(s):  
Outcome Measures ◽  
Upper Limb ◽  
Methodological Quality ◽  
Outcome Measurement ◽  
Health Measurement ◽  
Adaptive Tests ◽  
Number Of Patients ◽  
Patient Reported ◽  
Ceiling Effects ◽  
Computer Adaptive Tests

Aims Outcome measures quantifying aspects of health in a precise, efficient, and user-friendly manner are in demand. Computer adaptive tests (CATs) may overcome the limitations of established fixed scales and be more adept at measuring outcomes in trauma. The primary objective of this review was to gain a comprehensive understanding of the psychometric properties of CATs compared with fixed-length scales in the assessment of outcome in patients who have suffered trauma of the upper limb. Study designs, outcome measures and methodological quality are defined, along with trends in investigation. Materials and Methods A search of multiple electronic databases was undertaken on 1 January 2017 with terms related to “CATs”, “orthopaedics”, “trauma”, and “anatomical regions”. Studies involving adults suffering trauma to the upper limb, and undergoing any intervention, were eligible. Those involving the measurement of outcome with any CATs were included. Identification, screening, and eligibility were undertaken, followed by the extraction of data and quality assessment using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria. The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and reg istered (PROSPERO: CRD42016053886). Results A total of 31 studies reported trauma conditions alone, or in combination with non-traumatic conditions using CATs. Most were cross-sectional with varying level of evidence, number of patients, type of study, range of conditions and methodological quality. CATs correlated well with fixed scales and had minimal or no floor-ceiling effects. They required significantly fewer questions and/or less time for completion. Patient-Reported Outcomes Measurement Information System (PROMIS) CATs were the most frequently used, and the use of CATs is increasing. Conclusion Early studies show valid and reliable outcome measurement with CATs performing as well as, if not better than, established fixed scales. Superior properties such as floor-ceiling effects and ease of use support their use in the assessment of outcome after trauma. As CATs are being increasingly used in patient outcomes research, further psychometric evaluation, especially involving longitudinal studies and groups of patients with specific injuries are required to inform clinical practice using these contemporary measures. Cite this article: Bone Joint J 2018;100-B:693–702.

TRENDS IN COMPUTER-BASED SECOND LANGUAGE ASSESSMENT

2005 ◽  
Vol 25 ◽  
pp. 228-242 ◽  
Author(s):  
Joan Jamieson
Keyword(s):  
Second Language ◽  
Language Processing ◽  
Corpus Linguistics ◽  
Large Scale ◽  
Language Testing ◽  
Language Assessment ◽  
Adaptive Tests ◽  
Technological Advances ◽  
Computer Based ◽  
Computer Adaptive Tests

In the last 20 years, several authors have described the possible changes that computers may effect in language testing. Since ARAL's last review of general language testing trends (Clapham, 2000), authors in the Cambridge Language Assessment Series have offered various visions of how computer technology could alter the testing of second language skills. This chapter reflects these perspectives as it charts the paths recently taken in the field. Initial steps were made in the conversion of existing item types and constructs already known from paper-and- pencil testing into formats suitable for computer delivery. This conversion was closely followed by the introduction of computer-adaptive tests, which aim to make more, and perhaps, better, use of computer capabilities to tailor tests more closely to individual abilities and interests. Movement toward greater use of computers in assessment has been coupled with an assumption that computer-based tests should be better than their traditional predecessors, and some related steps have been taken. Corpus linguistics has provided tools to create more authentic assessments; the quest for authenticity has also motivated inclusion of more complex tasks and constructs. Both these innovations have begun to be incorporated into computer-based language tests. Natural language processing has also provided some tools for computerized scoring of essays, particularly relevant in large-scale language testing programs. Although computer use has not revolutionized all aspects of language testing, recent efforts have produced some of the research, technological advances, and improved pedagogical understanding needed to support progress.

Sign in / Sign up

Export Citation Format

Share Document