Reduction in patient burdens with graphical computerized adaptive testing on the ADL scale: tool development and simulation

Chien, Tsair Wei; Wu, Hing Man; Wang, Wen Chung; Castillo, R.; Chou, Willy

doi:10.1186/1477-7525-7-39

Cited by 33 publications

(60 citation statements)

References 12 publications

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“…As a result, the test length of CAT was about 58% that of NAT, a little higher than in previous studies with about half the test length [1,9-11]. …”

Section: Discussioncontrasting

confidence: 53%

A Web-Based Computerized Adaptive Testing (CAT) to Assess Patient Perception in Hospitalization

Chien¹,

Wang²,

Huang³

et al. 2011

J Med Internet Res

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Background Many hospitals have adopted mobile nursing carts that can be easily rolled up to a patient’s bedside to access charts and help nurses perform their rounds. However, few papers have reported data regarding the use of wireless computers on wheels (COW) at patients’ bedsides to collect questionnaire-based information of their perception of hospitalization on discharge from the hospital.Objective The purpose of this study was to evaluate the relative efficiency of computerized adaptive testing (CAT) and the precision of CAT-based measures of perceptions of hospitalized patients, as compared with those of nonadaptive testing (NAT). An Excel module of our CAT multicategory assessment is provided as an example.Method A total of 200 patients who were discharged from the hospital responded to the CAT-based 18-item inpatient perception questionnaire on COW. The numbers of question administrated were recorded and the responses were calibrated using the Rasch model. They were compared with those from NAT to show the advantage of CAT over NAT.Results Patient measures derived from CAT and NAT were highly correlated (r = 0.98) and their measurement precisions were not statistically different (P = .14). CAT required fewer questions than NAT (an efficiency gain of 42%), suggesting a reduced burden for patients. There were no significant differences between groups in terms of gender and other demographic characteristics.Conclusions CAT-based administration of surveys of patient perception substantially reduced patient burden without compromising the precision of measuring patients’ perceptions of hospitalization. The Excel module of animation-CAT on the wireless COW that we developed is recommended for use in hospitals.

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“…As a result, the test length of CAT was about 58% that of NAT, a little higher than in previous studies with about half the test length [1,9-11]. …”

Section: Discussioncontrasting

confidence: 53%

A Web-Based Computerized Adaptive Testing (CAT) to Assess Patient Perception in Hospitalization

Chien¹,

Wang²,

Huang³

et al. 2011

J Med Internet Res

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“…This advantage was previously demonstrated in a simulation study of the Activities of Daily Living CAT, which found that the CAT provided similar results to a static version while reducing the number of items administered by 50%. 31 Results from other studies indicate that scores similar to those obtained with full-length item banks (ranging in length from 18 -585 items) can be achieved through much shorter CATs when measuring functional status, [32][33][34] mental health status, 21,27,35,36 or the impact of conditions, such as headache, 23,37 diabetes, 30 chronic pain, 28 and asthma. 29 Most actual CAT applications used between 5 and 7 items to measure 1 construct.…”

Section: Respondent Burdenmentioning

confidence: 86%

Short and Precise Patient Self-Assessment of Heart Failure Symptoms Using a Computerized Adaptive Test

Rose

Anatchkova

Fletcher

et al. 2012

Circ: Heart Failure

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Background— Assessment of dyspnea, fatigue, and physical disability is fundamental to the monitoring of patients with heart failure (HF). A plethora of patient-reported measures exist, but most are too burdensome or imprecise to be useful in clinical practice. New techniques used for computer adaptive tests (CATs) may be able to address these problems. The purpose of this study was to build a CAT for patients with HF. Methods and Results— Item banks of 74 queries (“items”) were developed to assess self-reported physical disability, fatigue, and dyspnea. All queries were administered to 658 adults with HF to build 3 item banks. The resulting HF-CAT was administered to 100 patients with ancillary HF (New York Heart Association I, 11%; II, 53%; III and IV, 36%). In addition, the physical function and vitality domains of the SF-36 Health Survey questionnaire, an established shortness-of-breath scale, and the Minnesota Living with Heart Failure Questionnaire were applied. The HF-CAT assessment took 3:09±1:52 minutes to complete and score. All HF-CAT scales demonstrated good construct validity through high correlations with the corresponding SF-36 Health Survey physical function ( r =−0.87), vitality ( r =−0.85), and shortness-of-breath ( r =0.84) scales. Simulation studies showed a more precise measurement of all HF-CAT scales over a larger range than comparable static tools. The HF-CAT scales identified significant differences between patients classified by the New York Heart Association symptom criteria, similar to the Minnesota Living with Heart Failure Questionnaire. Conclusions— A new CAT for patients with HF was built using modern psychometric methods. Initial results demonstrate its potential to increase the feasibility and precision of patient self-assessments of symptoms of HF with minimized respondent burden. Clinical Trial Registration— URL: http://www.projectreporter.nih.gov . Unique identifier: 1R43HL083622-01.

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“…Many studies [39–43] have reported that item response theory (IRT)-based computer adaptive testing (CAT) has the advantages of both long-form and short-form questionnaires [44–46] in precision and efficiency. Many employees already own mobile phones.…”

Section: Discussionmentioning

confidence: 99%

Development of a Microsoft Excel tool for one-parameter Rasch model of continuous items: an application to a safety attitude survey

Chien

Shao²,

Kuo

2017

BMC Med Res Methodol

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BackgroundMany continuous item responses (CIRs) are encountered in healthcare settings, but no one uses item response theory’s (IRT) probabilistic modeling to present graphical presentations for interpreting CIR results. A computer module that is programmed to deal with CIRs is required.To present a computer module, validate it, and verify its usefulness in dealing with CIR data, and then to apply the model to real healthcare data in order to show how the CIR that can be applied to healthcare settings with an example regarding a safety attitude survey.MethodsUsing Microsoft Excel VBA (Visual Basic for Applications), we designed a computer module that minimizes the residuals and calculates model’s expected scores according to person responses across items. Rasch models based on a Wright map and on KIDMAP were demonstrated to interpret results of the safety attitude survey.ResultsThe author-made CIR module yielded OUTFIT mean square (MNSQ) and person measures equivalent to those yielded by professional Rasch Winsteps software. The probabilistic modeling of the CIR module provides messages that are much more valuable to users and show the CIR advantage over classic test theory.ConclusionsBecause of advances in computer technology, healthcare users who are familiar to MS Excel can easily apply the study CIR module to deal with continuous variables to benefit comparisons of data with a logistic distribution and model fit statistics.Electronic supplementary materialThe online version of this article (doi:10.1186/s12874-016-0276-2) contains supplementary material, which is available to authorized users.

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Reduction in patient burdens with graphical computerized adaptive testing on the ADL scale: tool development and simulation

Abstract: Background: The aim of this study was to verify the effectiveness and efficacy of saving time and reducing burden for patients, nurses, and even occupational therapists through computer adaptive testing (CAT).

Cited by 33 publications

References 12 publications

A Web-Based Computerized Adaptive Testing (CAT) to Assess Patient Perception in Hospitalization

A Web-Based Computerized Adaptive Testing (CAT) to Assess Patient Perception in Hospitalization

Short and Precise Patient Self-Assessment of Heart Failure Symptoms Using a Computerized Adaptive Test

Development of a Microsoft Excel tool for one-parameter Rasch model of continuous items: an application to a safety attitude survey

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