Computerized Adaptive Testing to Direct Delivery of Hospital-Based Rehabilitation

计算机化自适应测试直接提供医院康复服务

基本信息

  • 批准号:
    9229048
  • 负责人:
  • 金额:
    $ 79.16万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2015
  • 资助国家:
    美国
  • 起止时间:
    2015-04-03 至 2020-02-29
  • 项目状态:
    已结题

项目摘要

 DESCRIPTION (provided by applicant): Over 60% of frail, elderly, and chronically ill patients lose functional capacity during hospitalization. The result is an unnecessarily increased risk of falls, near-term rehospitalizations, and discharges to institutional rather than home settings. Our current clinical care model systemically engenders these often avoidable losses of function due to its unnecessary and ineffective reliance on busy clinicians to detect functional decline and initiate simple, yet effective, treatment plans. There is a critical need to reconceptualize this situation by: 1) minimizing reliance on overburdened clinicians to detect, address, and monitor patients' rehabilitation needs; and 2) immediately initiating resource-appropriate individualized care plans. A non-burdensome assessment strategy capable of accurately profiling patients' evolving functional capabilities and rehabilitation needs is needed. However, no measure currently offers this capability. We propose to develop and evaluate the needed assessment tool by refining the extant item response theory (IRT)-modeled Activity Measure for Post Acute Care (AM-PAC) item banks to create a disease-independent multidimensional computerized adaptive test (MCAT). In addition to enhanced efficiency and precision, MCAT may definitively address threats to measurement validity that arise when an item's or an IRT model's psychometric properties differ across clinically relevant subgroups (as has been reported for the aged, the intensely symptomatic, and ethnic minorities). The benefits of these achievable efforts will be enormous given that the use of this multidimensional approach will radically enhance assessment scope and efficiency without a commensurate increase in clinician burden in a manner that can be easily integrated into current care practices. More specifically, our approach will be to enrich the current AM-PAC banks and administer them to 1500 hospitalized patients. These data, combined with existing AM-PAC data sets, will be used to evaluate differential item functioning, item density across relevant trait ranges, multidimensional IRT model fit, and cut points for score stratification to match physical therapist (PT)-assigned functional stages. The resultant parameter estimates will be used to create a fixed-length short form (SF) and MCAT specified to assign patients to functional stages that link to validated care plans, as well as to detect meaningful change. We will administer the MCAT and SF to 600 hospitalized patients and 300 proxies, 50% verbally and 50% via tablets, who will concurrently be evaluated by experienced PTs. The resultant data will be used to evaluate the MCAT's and SF's validity relative to the gold standard criterion of PT assessment, association with clinical outcomes, robustness to proxy (i.e., caregiver vs. patient) and mode effects, and responsiveness.


项目成果

期刊论文数量(0)
专著数量(0)
科研奖励数量(0)
会议论文数量(0)
专利数量(0)

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Andrea Lynne Cheville其他文献

Andrea Lynne Cheville的其他文献

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{{ truncateString('Andrea Lynne Cheville', 18)}}的其他基金

Achieving Equity through SocioCulturally-informed, Digitally-Enabled Cancer Pain managemeNT” (ASCENT) Clinical Trial
通过社会文化知情、数字化的癌症疼痛管理 NT™ (ASCENT) 临床试验实现公平
  • 批准号:
    10539159
  • 财政年份:
    2022
  • 资助金额:
    $ 79.16万
  • 项目类别:
Project HoPe: Achieving Home Discharge for institutionally-bound Patients with PROMs, AI, and the EHR
HoPe 项目:利用 PROM、AI 和 EHR 使住院患者出院回家
  • 批准号:
    10675460
  • 财政年份:
    2022
  • 资助金额:
    $ 79.16万
  • 项目类别:
Project HoPe: Achieving Home Discharge for institutionally-bound Patients with PROMs, AI, and the EHR
HoPe 项目:利用 PROM、AI 和 EHR 使住院患者出院回家
  • 批准号:
    10456362
  • 财政年份:
    2022
  • 资助金额:
    $ 79.16万
  • 项目类别:
Non-pharmacological Options in postoperative Hospital-based And Rehabilitation pain Management (NOHARM) pragmatic clinical trial
术后医院康复疼痛管理 (NOHARM) 实用临床试验中的非药物选择
  • 批准号:
    10210513
  • 财政年份:
    2019
  • 资助金额:
    $ 79.16万
  • 项目类别:
Non-pharmacological Options in postoperative Hospital-based And Rehabilitation pain Management (NOHARM) pragmatic clinical trial
术后医院康复疼痛管理 (NOHARM) 实用临床试验中的非药物选择
  • 批准号:
    10468778
  • 财政年份:
    2019
  • 资助金额:
    $ 79.16万
  • 项目类别:
Non-pharmacological Options in postoperative Hospital-based And Rehabilitation pain Management (NOHARM) pragmatic clinical trial
术后医院康复疼痛管理 (NOHARM) 实用临床试验中的非药物选择
  • 批准号:
    10263299
  • 财政年份:
    2019
  • 资助金额:
    $ 79.16万
  • 项目类别:
Computerized Adaptive Testing to Direct Delivery of Hospital-Based Rehabilitation
计算机化自适应测试直接提供医院康复服务
  • 批准号:
    9045667
  • 财政年份:
    2015
  • 资助金额:
    $ 79.16万
  • 项目类别:
COllaborative Care to Preserve PErformance in Cancer (COPE) Trial
保持癌症表现的协作护理 (COPE) 试验
  • 批准号:
    8434848
  • 财政年份:
    2012
  • 资助金额:
    $ 79.16万
  • 项目类别:
COllaborative Care to Preserve PErformance in Cancer (COPE) Trial
保持癌症表现的协作护理 (COPE) 试验
  • 批准号:
    8625279
  • 财政年份:
    2012
  • 资助金额:
    $ 79.16万
  • 项目类别:
COllaborative Care to Preserve PErformance in Cancer (COPE) Trial
保持癌症表现的协作护理 (COPE) 试验
  • 批准号:
    8816053
  • 财政年份:
    2012
  • 资助金额:
    $ 79.16万
  • 项目类别:

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