Computerized Adaptive Testing Using the PROMIS Physical Function Item Bank Reduces Test Burden With Less Ceiling Effects Compared With the Short Musculoskeletal Function Assessment in Orthopaedic Trauma Patients

2014 ◽  
Vol 28 (8) ◽  
pp. 439-443 ◽  
Author(s):  
Man Hung ◽  
Ami R. Stuart ◽  
Thomas F. Higgins ◽  
Charles L. Saltzman ◽  
Erik N. Kubiak
Keyword(s):  
Physical Function ◽  
Computerized Adaptive Testing ◽  
Adaptive Testing ◽  
Item Bank ◽  
Trauma Patients ◽  
Orthopaedic Trauma ◽  
Short Musculoskeletal Function Assessment ◽  
Ceiling Effects ◽  
Musculoskeletal Function ◽  
Function Assessment

Computerized Adaptive Testing for Sleep Disorders: Development of An Item Bank and Validation in A Simulated Study

2020 ◽  
Author(s):  
Menghua She ◽  
Yaling Li ◽  
Dongbo Tu ◽  
Yan Cai
Keyword(s):  
Sleep Disorders ◽  
Computerized Adaptive Testing ◽  
Assessment Tool ◽  
Adaptive Testing ◽  
Item Bank ◽  
Accurate Assessment ◽  
Item Pool ◽  
Psychometric Characteristics ◽  
Predictive Utility ◽  
Item Fit

Abstract Background: As more and more people suffer from sleep disorders, developing an efficient, cheap and accurate assessment tool for screening sleep disorders is becoming more urgent. This study developed a computerized adaptive testing for sleep disorders (CAT-SD). Methods: A large sample of 1,304 participants was recruited to construct the item pool of CAT-SD and to investigate the psychometric characteristics of CAT-SD. More specifically, firstly the analyses of unidimensionality, model fit, item fit, item discrimination parameter and differential item functioning (DIF) were conducted to construct a final item pool which meets the requirements of item response theory (IRT) measurement. In addition, a simulated CAT study with real response data of participants was performed to investigate the psychometric characteristics of CAT-SD, including reliability, validity and predictive utility (sensitivity and specificity). Results: The final unidimensional item bank of the CAT-SD not only had good item fit, high discrimination and no DIF; Moreover, it had acceptable reliability, validity and predictive utility. Conclusions: The CAT-SD could be used as an effective and accurate assessment tool for measuring individuals' severity of the sleep disorders and offers a bran-new perspective for screening of sleep disorders with psychological scales.

scholarly journals Calibration of the food parenting practice (FPP) item bank: tools for improving the measurement of food parenting practices of parents of 5–12-year-old children

2020 ◽  
Vol 17 (1) ◽  
Author(s):  
Louise C. Mâsse ◽  
Teresia M. O’Connor ◽  
Yingyi Lin ◽  
Sheryl O. Hughes ◽  
Claire N. Tugault-Lafleur ◽  
...  
Keyword(s):  
Conceptual Framework ◽  
Parenting Practices ◽  
Computerized Adaptive Testing ◽  
Short Form ◽  
Adaptive Testing ◽  
Item Bank ◽  
Short Version ◽  
Parenting Practice ◽  
Practice Item ◽  
Improve Measurement

Abstract Purpose There has been a call to improve measurement rigour and standardization of food parenting practices measures, as well as aligning the measurement of food parenting practices with the parenting literature. Drawing from an expert-informed conceptual framework assessing three key domains of food parenting practices (autonomy promotion, control, and structure), this study combined factor analytic methods with Item Response Modeling (IRM) methodology to psychometrically validate responses to the Food Parenting Practice item bank. Methods A sample of 799 Canadian parents of 5–12-year-old children completed the Food Parenting Practice item bank (129 items measuring 17 constructs). The factorial structure of the responses to the item bank was assessed with confirmatory factor analysis (CFA), confirmatory bi-factor item analysis, and IRM. Following these analyses, differential Item Functioning (DIF) and Differential Response Functioning (DRF) analyses were then used to test invariance properties by parents’ sex, income and ethnicity. Finally, the efficiency of the item bank was examined using computerized adaptive testing simulations to identify the items to include in a short form. Results Overall, the expert-informed conceptual framework was predominantly supported by the CFA as it retained the same 17 constructs included in the conceptual framework with the exception of the access/availability and permissive constructs which were respectively renamed covert control and accommodating the child to better reflect the content of the final solution. The bi-factor item analyses and IRM analyses revealed that the solution could be simplified to 11 unidimensional constructs and the full item bank included 86-items (empirical reliability from 0.78 to 0.96, except for 1 construct) and the short form had 48 items. Conclusion Overall the food parenting practice item bank has excellent psychometric properties. The item bank includes an expanded version and short version to meet various study needs. This study provides more efficient tools for assessing how food parenting practices influence child dietary behaviours. Next steps are to use the IRM calibrated item bank and draw on computerized adaptive testing methodology to administer the item bank and provide flexibility in item selection.

Subjective morbidity following radial free flap reconstruction in head and neck tumour patients

2019 ◽  
Vol 133 (03) ◽  
pp. 230-235 ◽  
Author(s):  
A Minkara ◽  
M R Simmons ◽  
A Goodale ◽  
Y J Patil
Keyword(s):  
Free Flap ◽  
Short Form ◽  
Donor Site ◽  
Radial Forearm Free Flap ◽  
Short Musculoskeletal Function Assessment ◽  
Neck Tumour ◽  
Radial Forearm ◽  
Musculoskeletal Function ◽  
Assessment Questionnaire ◽  
Function Assessment

AbstractObjectiveEvaluation of post-operative donor site disability remains unaddressed in radial forearm free flap cases. This study aimed to assess donor site dysfunction following radial forearm free flap harvest using validated general, disease-specific and site-specific disability questionnaires.MethodsIn this retrospective case series of 24 patients at a tertiary academic medical centre, patients were assessed using the Short Form 36 Health Survey, Short Musculoskeletal Function Assessment questionnaire, and Disabilities of the Arm, Shoulder and Hand questionnaire. One-sample z-tests were performed, comparing means of the cohort to controls.ResultsCompared to population controls, the cohort had higher mean scores for the Disabilities of the Arm, Shoulder and Hand questionnaire (18.22 vs 10.1, p < 0.01), and Short Musculoskeletal Function Assessment questionnaire bothersome index (21.44 vs 13.77, p = 0.04), and a lower mean score for the Short Form 36 Health Survey physical component (38.88 vs 50, p < 0.01), indicating a greater disability for the cohort compared to controls.ConclusionRadial forearm free flap harvest causes significant long-term donor site disability in head and neck tumour patients. The Disabilities of the Arm, Shoulder and Hand questionnaire is a concise tool for measuring this dysfunction.

scholarly journals Computerized Adaptive Testing for Patient Reported Outcomes in Ankle Fracture Surgery

2018 ◽  
Vol 39 (10) ◽  
pp. 1192-1198 ◽  
Author(s):  
Elizabeth B. Gausden ◽  
Ashley Levack ◽  
Benedict U. Nwachukwu ◽  
Danielle Sin ◽  
David S. Wellman ◽  
...  
Keyword(s):  
Ankle Fracture ◽  
Patient Reported Outcomes ◽  
Computerized Adaptive Testing ◽  
Adaptive Testing ◽  
Ceiling Effect ◽  
Significant Difference ◽  
Patient Reported ◽  
Ceiling Effects ◽  
Clinically Significant ◽  
Fracture Surgery

Background: Advantages of using computerized adaptive testing (CAT) include decreased survey-burden, diminished floor and ceiling effect, and improved ability to detect the minimal clinical significant difference (MCID) among patients. The goal of this study was to compare the legacy patient-reported outcome measures (PROMs) to the Patient-Reported Outcomes Measurement Information System (PROMIS) scores in terms of ability to detect clinically significant changes in patients who have undergone surgery for ankle fractures. Methods: Patients who underwent osteosynthesis for an unstable ankle fracture between 2013-2016 and completed legacy outcome scores (Foot and Ankle Outcome Score [FAOS], Olerud and Molander Ankle Score [OMAS], and Weber Score) along with the PROMIS Physical Function (PF) and PROMIS Lower Extremity (LE) CATs postoperatively were included. Correlation between the scores at 3-month, 6-month, and 1-year intervals, as well as floor and ceiling effects, in addition to MCIDs were calculated for each instrument. A total of 132 patients were included in the study. Results: There was no observed floor or ceiling effect in either the PROMIS PF or the PROMIS LE scores. Clinically significant changes in the PROMIS LE score were detected in patients between 6-month and 12-month postoperative visits ( P = .0006), whereas the reported OMAS score and Weber scores did not identify a clinically significant difference between patients at their 6-month and 12-month visit. Conclusion: The results of this study indicate that the PROMIS LE was superior for evaluating patients following ankle fracture surgery in terms of lower floor and ceiling effects and greater ability to distinguish clinically significant changes in patients between time points following surgery. Level of Evidence: Level III, comparative study.

scholarly journals Implications for post critical illness trial design: sub-phenotyping trajectories of functional recovery among sepsis survivors

Critical Care ◽  
2020 ◽  
Vol 24 (1) ◽  
Author(s):  
Zudin A. Puthucheary ◽  
Jochen S. Gensichen ◽  
Aylin S. Cakiroglu ◽  
Richard Cashmore ◽  
Lara Edbrooke ◽  
...  
Keyword(s):  
Critical Illness ◽  
Physical Function ◽  
Functional Recovery ◽  
Complete Recovery ◽  
Population Heterogeneity ◽  
Physical Component Score ◽  
Sf 36 ◽  
Ceiling Effects ◽  
Sepsis Survivors ◽  
Function Assessment

Abstract Background Patients who survive critical illness suffer from a significant physical disability. The impact of rehabilitation strategies on health-related quality of life is inconsistent, with population heterogeneity cited as one potential confounder. This secondary analysis aimed to (1) examine trajectories of functional recovery in critically ill patients to delineate sub-phenotypes and (2) to assess differences between these cohorts in both clinical characteristics and clinimetric properties of physical function assessment tools. Methods Two hundred ninety-one adult sepsis survivors were followed-up for 24 months by telephone interviews. Physical function was assessed using the Physical Component Score (PCS) of the Short Form-36 Questionnaire (SF-36) and Activities of Daily Living and the Extra Short Musculoskeletal Function Assessment (XSFMA-F/B). Longitudinal trajectories were clustered by factor analysis. Logistical regression analyses were applied to patient characteristics potentially determining cluster allocation. Responsiveness, floor and ceiling effects and concurrent validity were assessed within clusters. Results One hundred fifty-nine patients completed 24 months of follow-up, presenting overall low PCS scores. Two distinct sub-cohorts were identified, exhibiting complete recovery or persistent impairment. A third sub-cohort could not be classified into either trajectory. Age, education level and number of co-morbidities were independent determinants of poor recovery (AUROC 0.743 ((95%CI 0.659–0.826), p < 0.001). Those with complete recovery trajectories demonstrated high levels of ceiling effects in physical function (PF) (15%), role physical (RP) (45%) and body pain (BP) (57%) domains of the SF-36. Those with persistent impairment demonstrated high levels of floor effects in the same domains: PF (21%), RP (71%) and BP (12%). The PF domain demonstrated high responsiveness between ICU discharge and at 6 months and was predictive of a persistent impairment trajectory (AUROC 0.859 (95%CI 0.804–0.914), p < 0.001). Conclusions Within sepsis survivors, two distinct recovery trajectories of physical recovery were demonstrated. Older patients with more co-morbidities and lower educational achievements were more likely to have a persistent physical impairment trajectory. In regard to trajectory prediction, the PF score of the SF-36 was more responsive than the PCS and could be considered for primary outcomes. Future trials should consider adaptive trial designs that can deal with non-responders or sub-cohort specific outcome measures more effectively.

Subjective morbidity following fibular free flap reconstruction in head and neck cancer patients

2018 ◽  
Vol 132 (8) ◽  
pp. 729-733
Author(s):  
D M Sparkman ◽  
M R Simmons ◽  
Y J Patil
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Cancer Patients ◽  
Lower Limb ◽  
Short Form ◽  
Flap Reconstruction ◽  
Free Flap Reconstruction ◽  
Short Musculoskeletal Function Assessment ◽  
Musculoskeletal Function ◽  
Function Assessment

AbstractObjectiveThis study aimed to evaluate the presence of subjective post-operative donor site morbidity after fibula free flap reconstruction in head and neck cancer patients, utilising three validated instruments: the 36-item Short Form Health Survey, the Short Musculoskeletal Function Assessment questionnaire and the Lower Limb Core Scale.MethodsIn this retrospective study, all head and neck cancer patients who underwent fibula free flap reconstruction between January 2009 and July 2014 were identified. All questionnaires and their respective subcomponents were scored.ResultsTwenty-one cases were included. Patients were found to have a higher Short Musculoskeletal Function Assessment bothersome index (22.42 vs 13.77, p = 0.03), a lower Short Form 36 Health Survey Physical Component Summary score (42.44 vs 50, p < 0.01) and a decreased Lower Limb Core Scale score (47.08 vs 90.52, p < 0.01), compared to US population norms. The Short Form 36 Health Survey Mental Component Summary scores and Short Musculoskeletal Function Assessment function index failed to demonstrate significant differences. Gender affected overall disability.ConclusionIn this study, significant long-term disability was demonstrated after fibular flap reconstruction, as measured by the Lower Limb Core Scale.

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