@article {357,
	title = {Measuring physical function in patients with complex medical and postsurgical conditions: a computer adaptive approach},
	journal = {American Journal of Physical Medicine and Rehabilitation},
	volume = {84},
	number = {10},
	year = {2005},
	note = {0894-9115 (Print)Comparative StudyJournal ArticleResearch Support, N.I.H., ExtramuralResearch Support, U.S. Gov{\textquoteright}t, P.H.S.},
	month = {Oct},
	pages = {741-8},
	abstract = {OBJECTIVE: To examine whether the range of disability in the medically complex and postsurgical populations receiving rehabilitation is adequately sampled by the new Activity Measure--Post-Acute Care (AM-PAC), and to assess whether computer adaptive testing (CAT) can derive valid patient scores using fewer questions. DESIGN: Observational study of 158 subjects (mean age 67.2 yrs) receiving skilled rehabilitation services in inpatient (acute rehabilitation hospitals, skilled nursing facility units) and community (home health services, outpatient departments) settings for recent-onset or worsening disability from medical (excluding neurological) and surgical (excluding orthopedic) conditions. Measures were interviewer-administered activity questions (all patients) and physical functioning portion of the SF-36 (outpatients) and standardized chart items (11 Functional Independence Measure (FIM), 19 Standardized Outcome and Assessment Information Set (OASIS) items, and 22 Minimum Data Set (MDS) items). Rasch modeling analyzed all data and the relationship between person ability estimates and average item difficulty. CAT assessed the ability to derive accurate patient scores using a sample of questions. RESULTS: The 163-item activity item pool covered the range of physical movement and personal and instrumental activities. CAT analysis showed comparable scores between estimates using 10 items or the total item pool. CONCLUSION: The AM-PAC can assess a broad range of function in patients with complex medical illness. CAT achieves valid patient scores using fewer questions.},
	keywords = {Activities of Daily Living/*classification, Adult, Aged, Cohort Studies, Continuity of Patient Care, Disability Evaluation, Female, Health Services Research, Humans, Male, Middle Aged, Postoperative Care/*rehabilitation, Prognosis, Recovery of Function, Rehabilitation Centers, Rehabilitation/*standards, Sensitivity and Specificity, Sickness Impact Profile, Treatment Outcome},
	author = {Siebens, H. and Andres, P. L. and Pengsheng, N. and Coster, W. J. and Haley, S. M.}
}
@article {168,
	title = {Activity outcome measurement for postacute care},
	journal = {Medical Care},
	volume = {42},
	number = {1 Suppl},
	year = {2004},
	note = {0025-7079Journal ArticleMulticenter Study},
	pages = {I49-161},
	abstract = {BACKGROUND: Efforts to evaluate the effectiveness of a broad range of postacute care services have been hindered by the lack of conceptually sound and comprehensive measures of outcomes. It is critical to determine a common underlying structure before employing current methods of item equating across outcome instruments for future item banking and computer-adaptive testing applications. OBJECTIVE: To investigate the factor structure, reliability, and scale properties of items underlying the Activity domains of the International Classification of Functioning, Disability and Health (ICF) for use in postacute care outcome measurement. METHODS: We developed a 41-item Activity Measure for Postacute Care (AM-PAC) that assessed an individual{\textquoteright}s execution of discrete daily tasks in his or her own environment across major content domains as defined by the ICF. We evaluated the reliability and discriminant validity of the prototype AM-PAC in 477 individuals in active rehabilitation programs across 4 rehabilitation settings using factor analyses, tests of item scaling, internal consistency reliability analyses, Rasch item response theory modeling, residual component analysis, and modified parallel analysis. RESULTS: Results from an initial exploratory factor analysis produced 3 distinct, interpretable factors that accounted for 72\% of the variance: Applied Cognition (44\%), Personal Care \& Instrumental Activities (19\%), and Physical \& Movement Activities (9\%); these 3 activity factors were verified by a confirmatory factor analysis. Scaling assumptions were met for each factor in the total sample and across diagnostic groups. Internal consistency reliability was high for the total sample (Cronbach alpha = 0.92 to 0.94), and for specific diagnostic groups (Cronbach alpha = 0.90 to 0.95). Rasch scaling, residual factor, differential item functioning, and modified parallel analyses supported the unidimensionality and goodness of fit of each unique activity domain. CONCLUSIONS: This 3-factor model of the AM-PAC can form the conceptual basis for common-item equating and computer-adaptive applications, leading to a comprehensive system of outcome instruments for postacute care settings.},
	keywords = {*Self Efficacy, *Sickness Impact Profile, Activities of Daily Living/*classification/psychology, Adult, Aftercare/*standards/statistics \& numerical data, Aged, Boston, Cognition/physiology, Disability Evaluation, Factor Analysis, Statistical, Female, Human, Male, Middle Aged, Movement/physiology, Outcome Assessment (Health Care)/*methods/statistics \& numerical data, Psychometrics, Questionnaires/standards, Rehabilitation/*standards/statistics \& numerical data, Reproducibility of Results, Sensitivity and Specificity, Support, U.S. Gov{\textquoteright}t, Non-P.H.S., Support, U.S. Gov{\textquoteright}t, P.H.S.},
	author = {Haley, S. M. and Coster, W. J. and Andres, P. L. and Ludlow, L. H. and Ni, P. and Bond, T. L. and Sinclair, S. J. and Jette, A. M.}
}
@article {8,
	title = {Computer adaptive testing: a strategy for monitoring stroke rehabilitation across settings},
	journal = {Stroke Rehabilitation},
	volume = {11},
	number = {2},
	year = {2004},
	note = {Andres, Patricia LBlack-Schaffer, Randie MNi, PengshengHaley, Stephen MR01 hd43568/hd/nichdEvaluation StudiesResearch Support, U.S. Gov{\textquoteright}t, Non-P.H.S.Research Support, U.S. Gov{\textquoteright}t, P.H.S.United StatesTopics in stroke rehabilitationTop Stroke Rehabil. 2004 Spring;11(2):33-9.},
	month = {Spring},
	pages = {33-39},
	edition = {2004/05/01},
	abstract = {Current functional assessment instruments in stroke rehabilitation are often setting-specific and lack precision, breadth, and/or feasibility. Computer adaptive testing (CAT) offers a promising potential solution by providing a quick, yet precise, measure of function that can be used across a broad range of patient abilities and in multiple settings. CAT technology yields a precise score by selecting very few relevant items from a large and diverse item pool based on each individual{\textquoteright}s responses. We demonstrate the potential usefulness of a CAT assessment model with a cross-sectional sample of persons with stroke from multiple rehabilitation settings.},
	keywords = {*Computer Simulation, *User-Computer Interface, Adult, Aged, Aged, 80 and over, Cerebrovascular Accident/*rehabilitation, Disabled Persons/*classification, Female, Humans, Male, Middle Aged, Monitoring, Physiologic/methods, Severity of Illness Index, Task Performance and Analysis},
	isbn = {1074-9357 (Print)},
	author = {Andres, P. L. and Black-Schaffer, R. M. and Ni, P. and Haley, S. M.}
}
