Article

Computerized adaptive tests (CATs) promise efficient outcomes data
collection with little loss of measurement precision.
The shoulder CAT has not
been assessed for administrative efficiency, nor have prospective studies been
completed to evaluate the sensitivity to change or the responsiveness of
CAT-based functional status (CAT-FS) measures. OBJECTIVE: The purpose of this
study was to evaluate the efficiency and responsiveness of the shoulder CAT.
DESIGN: This was a secondary analysis of prospectively collected data.
METHODS:Data were analyzed from patients with shoulder impairments who received
outpatient rehabilitation in 518 clinics in 30 US states. Over the testing time,
30,987 patients completed the shoulder CAT at intake, and of these, 13,805
completed the CAT at discharge (45% completion rate). The efficiency of routine
CAT administration was evaluated, and the sensitivity to change and
responsiveness of CAT-FS measures were assessed. RESULTS: On average, patients
took about 1.5 minutes (SD <2 minutes) to answer 6 CAT items (SD=2), which
produced precise estimates of CAT-FS measures that adequately covered the content
range and had negligible floor and minimal ceiling effects. Ninety-four percent
of the patients had CAT-FS scores between 20 and 80, where upper-level 95%
confidence interval (CI) standard errors were between 3.2 and 4.6 (out of 100).
Of patients with both intake and discharge data, 79% had CAT-FS change scores
greater than minimal detectable change, and 76% had changes greater than minimal
clinically important improvement. LIMITATIONS: Because this study was a secondary
analysis, the results may have been affected by patient selection bias. Future
studies would benefit from more complete data. CONCLUSIONS: The results indicate
the shoulder CAT was efficient and support the precision, sensitivity, and
responsiveness of CAT-FS measures.

Langue : ANGLAIS