Computerised adaptive testing accurately predicts CLEFT-Q scores by selecting fewer, more patient-focused questions

Abstract

Background: The International Consortium for Health Outcome Measurement (ICHOM) has recently agreed upon a core outcome set for the comprehensive appraisal of cleft care, which puts a greater emphasis on patient-reported outcome measures (PROMs) and, in particular, the CLEFT-Q. The CLEFT-Q comprises 12 scales with a total of 110 items, aimed to be answered by children as young as 8 years old. Objective: In this study, we aimed to use computerised adaptive testing (CAT) to reduce the number of items needed to predict results for each CLEFT-Q scale. Method: We used an open-source CAT simulation package to run item responses over each of the full-length scales and its CAT counterpart at varying degrees of precision, estimated by standard error (SE). The mean number of items needed to achieve a given SE was recorded for Conflicts of Interest: The CLEFT-Q is owned by McMaster University and The Hospital for Sick Children, and it was developed by Anne Klassen and Karen Wong Riff. The CLEFT-Q can be used free of charge for non-profit purposes (e.g. by clinicians, researchers and students). The other authors declare no potential conflicts of interest with regard to the research, authorship and publication of this article.

Deeper Understanding of Appearance in Orofacial Clefts: A Structural Equation Model of the CLEFT-Q Appearance Scales

“…For example, if we know that Nose scores and Nostrils scores correlate, and that a respondent has attained a high score in the Nose scale, it may be more appropriate to start a Nostril scale CAT with a question targeted towards respondents with a higher Nostrils score. Future work will determine whether the accuracy and efficiency of the CLEFT-Q CAT scales 17 could be improved with multidimensional item response theory.…”

Impact of Completing CLEFT-Q Scales That Ask About Appearance on Children and Young Adults: An International Study

“…Timing of administration of the CLEFT-Q is crucial; in routine clinical practice, for example, detailed questions about facial appearance could be asked when the surgical window is opening up. In addition, to reduce patient burden, a computer adaptive testing (CAT) version of the 12 CLEFT-Q scales has been developed (Harrison et al, 2019). In the CAT version, the number of questions that participants needed to answer was reduced to an average of 43 items while maintaining a 97% correlation between scores obtained with CAT and full-length scales.…”

Comparison of Corresponding Scores From the Cleft Hearing Appearance and Speech Questionnaire (CHASQ) and CLEFT-Q in Swedish Patients With Cleft Lip and/or Palate

“…If the instrument had been administered electronically, scales could have been automatically presented to patients depending on age and diagnosis. Computerized adaptive testing (CAT) has been evaluated with CLEFT-Q ( Harrison et al, 2019 ). The study showed that 97% accuracy of final result could be obtained by using only 43 items (39.2%) of the 110 items in the full scale.…”