Development of a Computerized Adaptive Test for Assessing Activities of Daily Living in Outpatients With Stroke

2013 ◽  
Vol 93 (5) ◽  
pp. 681-693 ◽  
Author(s):  
I-Ping Hsueh ◽  
Jyun-Hong Chen ◽  
Chun-Hou Wang ◽  
Wen-Hsuan Hou ◽  
Ching-Lin Hsieh
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Computerized Adaptive Testing ◽  
Outcome Measurement ◽  
Theory Model ◽  
Item Bank ◽  
Stopping Rules ◽  
Computerized Adaptive Test ◽  
Maximum Test ◽  
Time Required

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.

scholarly journals Development of a Computerized Adaptive Test for Assessing Balance Function in Patients With Stroke

2010 ◽  
Vol 90 (9) ◽  
pp. 1336-1344 ◽  
Author(s):  
I-Ping Hsueh ◽  
Jyun-Hong Chen ◽  
Chun-Hou Wang ◽  
Cheng-Te Chen ◽  
Ching-Fan Sheu ◽  
...  
Keyword(s):  
Simulation Study ◽  
Computerized Adaptive Testing ◽  
Reliability And Validity ◽  
Field Testing ◽  
Berg Balance Scale ◽  
Theory Model ◽  
Stopping Rules ◽  
Balance Function ◽  
Cross Sectional ◽  
Computerized Adaptive Test

BackgroundAn efficient and precise measure of balance is needed to improve administration efficiency and to reduce the assessment burden for patients.ObjectiveThe purpose of this study was to develop a computerized adaptive testing (CAT) system for assessing balance function in an efficient, reliable, and valid fashion in patients with stroke.DesignTwo cross-sectional prospective studies were conducted.SettingThis study was conducted in the departments of physical medicine and rehabilitation in 6 hospitals.PatientsThe participants were inpatients and outpatients who were receiving rehabilitation.MeasurementsA balance item pool (41 items) was developed on the basis of predefined balance concepts, expert opinions, and field testing. The items were administered by 5 raters to 764 patients. An item response theory model was fit to the data, and the item parameters were estimated. A simulation study was used to determine the performance (eg, reliability, efficiency) of the Balance CAT. The Balance CAT and the Berg Balance Scale (BBS) then were tested on another independent sample of 56 patients to determine the concurrent validity and time needed for administration.ResultsSeven items did not meet the model's expectations and were excluded from further analysis. The remaining 34 items formed the item bank of the Balance CAT. Two stopping rules (ie, reliability coefficient >0.9 or ≤6 items) were set for the CAT. The simulation study showed that the patients' balance scores estimated by the CAT had an average reliability value of .94. The scores obtained from the CAT were closely associated with those of the full item set (Pearson r=.98). The scores of the Balance CAT were highly correlated with those of the BBS (Pearson r=.88). The average time needed to administer the Balance CAT (83 seconds) was only 18% of that of the BBS.LimitationsThe convenience sampling of both samples may limit the generalization of the results. Further psychometric investigation of the Balance CAT is needed.ConclusionThe results provide strong evidence that the Balance CAT is efficient and has reliability and validity for patients with stroke.

Heterogeneous Long-Term Trajectories of Dependency in Older Adults: The PAQUID Cohort, a Population-Based Study over 22 years

2020 ◽  
Vol 75 (12) ◽  
pp. 2396-2403 ◽  
Author(s):  
Arlette Edjolo ◽  
Jean-François Dartigues ◽  
Karine Pérès ◽  
Cécile Proust-Lima
Keyword(s):  
Activities Of Daily Living ◽  
Sex Education ◽  
Successful Aging ◽  
Daily Living ◽  
Functional Decline ◽  
Population Based ◽  
Theory Model ◽  
Factors Associated ◽  
Instrumental Activities ◽  
High Dependency

Abstract Background A critical step toward successful aging is to identify opportunities for prevention of functional decline. Our aim was to describe the heterogeneity in trajectories of dependency preceding death in elders and to identify factors associated with this heterogeneity. Methods The study relied on 3,238 participants of the prospective population-based PAQUID cohort aged 65+ at baseline in 1988. Dependency was defined from an 11-item scale of basic and instrumental activities of daily living (ADL: bathing, dressing, toileting, continence, eating, and transferring; instrumental activities of daily living (IADL): telephoning, shopping, using transport, handling medication, and managing finances) collected over 22 years. Heterogeneous trajectories were estimated using a longitudinal item response theory model including latent classes. Results Five distinct profiles of functional dependency were identified over the two last decades of life: persistently high (12%), moderate (26%), persistently low (40%), and accelerated high dependency (15%), and no dependency (8%). Main factors associated with heterogeneity included age at death, sex, education, initial cognition (Mini-Mental State Examination [MMSE] score and dementia), initial disability, and poly-medication. Conclusions In the two last decades of life, more than 9 elders in 10 were characterized as functional decliners. On average, around half of the elders died with no or mild dependency, while 27% live several years with a high level of limitations and would need assistance in activities of daily living, at least for 2–4 years preceding death. The identified factors associated with these trajectories are important to understand functional heterogeneity in elders and to propose interventions to postpone or prevent “chronic” disability.

scholarly journals Evaluation of an Item Bank for a Computerized Adaptive Test of Activity in Children With Cerebral Palsy

2009 ◽  
Vol 89 (6) ◽  
pp. 589-600 ◽  
Author(s):  
Stephen M. Haley ◽  
Maria A. Fragala-Pinkham ◽  
Helene M. Dumas ◽  
Pengsheng Ni ◽  
George E. Gorton ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Computer Simulations ◽  
Computerized Adaptive Testing ◽  
Item Bank ◽  
Activity Level ◽  
Convenience Sample ◽  
Computerized Adaptive Test ◽  
Adaptive Test ◽  
Children With Cerebral Palsy ◽  
Stop Rules

Background: Contemporary clinical assessments of activity are needed across the age span for children with cerebral palsy (CP). Computerized adaptive testing (CAT) has the potential to efficiently administer items for children across wide age spans and functional levels. Objective: The objective of this study was to examine the psychometric properties of a new item bank and simulated computerized adaptive test to assess activity level abilities in children with CP. Design: This was a cross-sectional item calibration study. Methods: The convenience sample consisted of 308 children and youth with CP, aged 2 to 20 years (X=10.7, SD=4.0), recruited from 4 pediatric hospitals. We collected parent-report data on an initial set of 45 activity items. Using an Item Response Theory (IRT) approach, we compared estimated scores from the activity item bank with concurrent instruments, examined discriminate validity, and developed computer simulations of a CAT algorithm with multiple stop rules to evaluate scale coverage, score agreement with CAT algorithms, and discriminant and concurrent validity. Results: Confirmatory factor analysis supported scale unidimensionality, local item dependence, and invariance. Scores from the computer simulations of the prototype CATs with varying stop rules were consistent with scores from the full item bank (r=.93–.98). The activity summary scores discriminated across levels of upper-extremity and gross motor severity and were correlated with the Pediatric Outcomes Data Collection Instrument (PODCI) physical function and sports subscale (r=.86), the Functional Independence Measure for Children (Wee-FIM) (r=.79), and the Pediatric Quality of Life Inventory–Cerebral Palsy version (r=.74). Limitations: The sample size was small for such IRT item banks and CAT development studies. Another limitation was oversampling of children with CP at higher functioning levels. Conclusions: The new activity item bank appears to have promise for use in a CAT application for the assessment of activity abilities in children with CP across a wide age range and different levels of motor severity.

Activities of Daily Living Item Bank

2018 ◽  
Author(s):  
Chih-Ying Li ◽  
Sergio Romero ◽  
Heather S. Bonilha ◽  
Kit N. Simpson ◽  
Annie N. Simpson ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Item Bank

scholarly journals Development and calibration of an item bank for the assessment of activities of daily living in cardiovascular patients using Rasch analysis

2013 ◽  
Vol 11 (1) ◽  
pp. 133 ◽  
Author(s):  
Harald Baumeister ◽  
Birgit Abberger ◽  
Anne Haschke ◽  
Maren Boecker ◽  
Juergen Bengel ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Rasch Analysis ◽  
Item Bank ◽  
Cardiovascular Patients

scholarly journals Hierarchical Structure in Activities of Daily Living and Long-Term Disability Trajectories in the Elderly Chinese Population: A 20-Year Cohort Study

2021 ◽  
Author(s):  
Yaofeng Han ◽  
Jihui Xue ◽  
Wei Pei ◽  
Ya Fang
Keyword(s):  
Activities Of Daily Living ◽  
Hierarchical Structure ◽  
Urban Areas ◽  
Daily Living ◽  
Chinese Population ◽  
The Elderly ◽  
Theory Model ◽  
Demographic Characteristics ◽  
Elderly Chinese ◽  
The Hierarchical Structure

Abstract Background: The global burden of disability is rising. Understanding the hierarchical structure of activities of daily living (ADL) and the disability trajectory of elderly people is pivotal to developing early interventions. Purpose: We aimed to determine the hierarchical structure of the ability to perform ADL and further describe the disability trajectory of the elderly before death. Methods: A longitudinal item response theory model (LIRT) was constructed from 28 345 elderly participants in the Chinese Longitudinal Healthy Longevity Survey, in which ADL were measured by the Katz scale for up to 20 years from 1998 to 2018, until the participants' death. The disability values estimated from the LIRT were fitted to a mixed-effects model to examine how the disability trajectories varied with different demographic characteristics. Results: The difficulty parameters showed that ADL losses began with bathing-partial (B=-1.396, SE=0.003), then toileting-partial, bathing-total, dressing-partial, transferring-partial, dressing-total, feeding-partial, continence-partial, toileting-total, feeding-total, transferring-total, and ended with continence-total (a=3.647, SE=0.013). Disability trajectories varied with sex (β=0.041, SE=0.001), place of residence (β=0.010, SE=0.001), and marital status (β=0.144, SE=0.001). Females, people who lived in urban areas, and those who lived without a spouse had poorer disability status. Conclusion: Losses in the ability to perform ADL have a hierarchical structure. Demographic characteristics affect disability trajectories among the elderly Chinese population.

Activities of Daily Living Item Bank--Cardiovascular Patient Version

2013 ◽  
Author(s):  
Harald Baumeister ◽  
Birgit Abberger ◽  
Anne Haschke ◽  
Maren Boecker ◽  
Juergen Bengel ◽  
...  
Keyword(s):  
Activities Of Daily Living ◽  
Daily Living ◽  
Item Bank ◽  
Patient Version ◽  
Cardiovascular Patient

Detecting Disabilities in Older Patients With Cancer: Comparison Between Comprehensive Geriatric Assessment and Vulnerable Elders Survey-13

2010 ◽  
Vol 28 (12) ◽  
pp. 2046-2050 ◽  
Author(s):  
Andrea Luciani ◽  
Gilda Ascione ◽  
Cecilia Bertuzzi ◽  
Desirè Marussi ◽  
Carla Codecà ◽  
...  
Keyword(s):  
Elderly Patients ◽  
Activities Of Daily Living ◽  
Geriatric Assessment ◽  
Comprehensive Geriatric Assessment ◽  
Daily Living ◽  
Older Patients ◽  
Reliability And Validity ◽  
Patients With Cancer ◽  
Age Related ◽  
Time Required

PurposeComprehensive geriatric assessment (CGA) is a multidimensional method used by geriatricians and oncologists to detect and evaluate multiple age-related problems and to plan and coordinate interventions. Because its main drawback is the time required, efforts have been made to evaluate screening instruments suitable for preliminarily assessing elderly patients. The main aim of this study was to establish the accuracy of the Vulnerable Elders Survey-13 (VES-13) in predicting the presence of abnormalities revealed by CGA.Patients and MethodsPatients age ≥ 70 years with a histologically or cytologically confirmed diagnosis of a solid or hematologic tumor underwent both CGA and a VES-13 assessment, and the reliability and validity of VES-13 were analyzed.ResultsFifty-three percent of the 419 elderly patients with cancer (mean age, 76.8 years) were vulnerable on VES-13; the rates of disabilities on CGA and activities of daily living (ADLs)/instrumental activities of daily living (IADLs) scales were 30% and 25%, respectively. The sensitivity and specificity of VES-13 were 87% and 62%, respectively, versus CGA and 90% and 70%, respectively, versus ADL/IADL scales.ConclusionsOn the basis of our data, VES-13 is highly predictive of impaired functional status and can thus be considered a useful preliminary means of assessing older patients with cancer before undertaking a full CGA.

scholarly journals A Direct Performance Test for Assessing Activities of Daily Living in Patients with Mild Degenerative Dementia: The Development of the ETAM and Preliminary Results

2015 ◽  
Vol 5 (1) ◽  
pp. 74-84 ◽  
Author(s):  
Anke Schmiedeberg-Sohn ◽  
Elmar Graessel ◽  
Katharina Luttenberger
Keyword(s):  
Pilot Study ◽  
Activities Of Daily Living ◽  
Daily Living ◽  
Performance Test ◽  
Item Analysis ◽  
Geriatric Depression Scale ◽  
Depression Scale ◽  
International Classification Of Functioning ◽  
Mild Dementia ◽  
Time Required

Background: There are currently only a few performance tests that assess the capacity to perform activities of daily living. These measures frequently require a long time to administer, are strongly cognition oriented, or have not been adequately validated. Methods: The Erlangen Test of Activities of Daily Living in Mild Dementia (ETAM) was developed in a 4-phase process that was based on the International Classification of Functioning, Disability, and Health (ICF). A pilot study was conducted on 30 subjects with mild dementia with a mean age of 80 years. The subjects' mean score on the MMSE was 21.5. Twenty-one of the 30 subjects were women. Results: Ten items were developed and tested in the pilot study. The mean time required to complete the test was 26 min. The item analysis showed difficulties that ranged primarily from r = 0.28 to r = 0.79. The ETAM had a moderate correlation with the MMSE (rMMSE = 0.310) and a low correlation with the Geriatric Depression Scale-15 (GDS-15; rGDS-15 = 0.149). Conclusion: The preliminary version of the ETAM is quick and easy to use and has predominantly satisfactory item characteristics. There still is the need to revise the items ‘giving directions' and ‘making tea' with regard to standardisation.

scholarly journals Development of a Computer Adaptive Test for Depression Based on the Dutch-Flemish Version of the PROMIS Item Bank

2017 ◽  
Vol 40 (1) ◽  
pp. 79-105 ◽  
Author(s):  
Gerard Flens ◽  
Niels Smits ◽  
Caroline B. Terwee ◽  
Joost Dekker ◽  
Irma Huijbrechts ◽  
...  
Keyword(s):  
Computerized Adaptive Testing ◽  
Population Sample ◽  
Item Bank ◽  
Stopping Rules ◽  
Measurement Information ◽  
Computer Adaptive Test ◽  
Patient Reported ◽  
Original Item ◽  
Final Item ◽  
Measurement Information System

We developed a Dutch-Flemish version of the patient-reported outcomes measurement information system (PROMIS) adult V1.0 item bank for depression as input for computerized adaptive testing (CAT). As item bank, we used the Dutch-Flemish translation of the original PROMIS item bank (28 items) and additionally translated 28 U.S. depression items that failed to make the final U.S. item bank. Through psychometric analysis of a combined clinical and general population sample ( N = 2,010), 8 added items were removed. With the final item bank, we performed several CAT simulations to assess the efficiency of the extended (48 items) and the original item bank (28 items), using various stopping rules. Both item banks resulted in highly efficient and precise measurement of depression and showed high similarity between the CAT simulation scores and the full item bank scores. We discuss the implications of using each item bank and stopping rule for further CAT development.

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