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
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
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DOI：
10.1097/bot.0000000000000059
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发表时间：
2014-08-01
影响因子：
2.3
通讯作者：
Kubiak, Erik N.
中科院分区：
文献类型：
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作者：
Hung, Man;Stuart, Ami R.;Kubiak, Erik N.
目的：患者报告的结果对于评估临床干预措施的有效性非常重要。对于骨科创伤患者，简短的肌肉骨骼功能评估（sMFA）是常用的问卷。最近，使用项目反应理论开发了患者报告结果测量信息系统 (PROMIS) PF 功能计算机自适应测试 (PF CAT)，以使用计算机自适应测试有效管理 124 个 PF 问题校准库中的问题。在本研究中，我们对创伤患者的 sMFA 与 PROMIS PF CAT 进行了比较。方法：骨科创伤患者在无线连接到 PROMIS 评估中心的平板电脑上完成了 sMFA 和 PROMIS PF CAT。记录每次测试的时间。使用一参数项目反应理论模型来检查仪器的心理测量特性，包括精度和地板/天花板效应。结果：153 名骨科创伤患者参与了这项研究。 PROMIS PF CAT 的平均测试管理时间为 44 秒，而 sMFA 的平均测试管理时间为 599 秒 (P < 0.05)。两种仪器都显示出极高的项目可靠性（Cronbach alpha = 0.98）。从仪器覆盖范围来看，两种仪器均未出现地板效应；然而，sMFA 显示了 14.4% 的天花板效应，而 PROMIS PF CAT 没有明显的天花板效应。结论：通过电子方式管理，PROMIS PF CAT 所需的患者完成时间不到 sMFA 的十分之一，同时实现了同样高的可靠性和较小的天花板效应。 PROMIS PF CAT 是一种非常有吸引力的创新方法，用于评估患者报告的结果，同时对患者的负担最小。
Purpose: Patient-reported outcomes are important to assess effectiveness of clinical interventions. For orthopaedic trauma patients, the short Musculoskeletal Function Assessment (sMFA) is a commonly used questionnaire. Recently, the Patient-Reported Outcome Measurement Information System (PROMIS) PF Function Computer Adaptive Test (PF CAT) was developed using item response theory to efficiently administer questions from a calibrated bank of 124 PF questions using computerized adaptive testing. In this study, we compared the sMFA versus the PROMIS PF CAT for trauma patients.Methods: Orthopaedic trauma patients completed the sMFA and the PROMIS PF CAT on a tablet wirelessly connected to the PROMIS Assessment Center. The time for each test administration was recorded. A 1-parameter item response theory model was used to examine the psychometric properties of the instruments, including precision and floor/ceiling effects.Results: One hundred fifty-three orthopaedic trauma patients participated in the study. Mean test administration time for PROMIS PF CAT was 44 seconds versus 599 seconds for sMFA (P < 0.05). Both instruments showed extremely high item reliability (Cronbach alpha = 0.98). In terms of instrument coverage, neither instrument showed any floor effect; however, the sMFA revealed 14.4% ceiling effect, whereas the PROMIS PF CAT had no appreciable ceiling effect.Conclusions: Administered by electronic means, the PROMIS PF CAT required less than one-tenth the amount of time for patients to complete than the sMFA while achieving equally high reliability and less ceiling effects. The PROMIS PF CAT is a very attractive and innovative method for assessing patient-reported outcomes with minimal burden to patients.