02865nas a2200325   4500008004100000020002700041245007400068210006900142250001500211260000800226300001100234490000700245520188300252653003202135653003202167653002502199653002302224653004802247653001102295653001102306653000902317653001602326653001902342653002702361100001502388700001502403700001002418700001202428856009902440       2008                        eng d  a1537-7385 (Electronic)00aAdaptive short forms for outpatient rehabilitation outcome assessment0 aAdaptive short forms for outpatient rehabilitation outcome asses  a2008/09/23  cOct  a842-520 v873 aOBJECTIVE: To develop outpatient Adaptive Short Forms for the Activity Measure for Post-Acute Care item bank for use in outpatient therapy settings. DESIGN: A convenience sample of 11,809 adults with spine, lower limb, upper limb, and miscellaneous orthopedic impairments who received outpatient rehabilitation in 1 of 127 outpatient rehabilitation clinics in the United States. We identified optimal items for use in developing outpatient Adaptive Short Forms based on the Basic Mobility and Daily Activities domains of the Activity Measure for Post-Acute Care item bank. Patient scores were derived from the Activity Measure for Post-Acute Care computerized adaptive testing program. Items were selected for inclusion on the Adaptive Short Forms based on functional content, range of item coverage, measurement precision, item exposure rate, and data collection burden. RESULTS: Two outpatient Adaptive Short Forms were developed: (1) an 18-item Basic Mobility Adaptive Short Form and (2) a 15-item Daily Activities Adaptive Short Form, derived from the same item bank used to develop the Activity Measure for Post-Acute Care computerized adaptive testing program. Both Adaptive Short Forms achieved acceptable psychometric properties. CONCLUSIONS: In outpatient postacute care settings where computerized adaptive testing outcome applications are currently not feasible, item response theory-derived Adaptive Short Forms provide the efficient capability to monitor patients' functional outcomes. The development of Adaptive Short Form functional outcome instruments linked by a common, calibrated item bank has the potential to create a bridge to outcome monitoring across postacute care settings and can facilitate the eventual transformation from Adaptive Short Forms to computerized adaptive testing applications easier and more acceptable to the rehabilitation community.10a*Activities of Daily Living10a*Ambulatory Care Facilities10a*Mobility Limitation10a*Treatment Outcome10aDisabled Persons/psychology/*rehabilitation10aFemale10aHumans10aMale10aMiddle Aged10aQuestionnaires10aRehabilitation Centers1 aJette, A M1 aHaley, S M1 aNi, P1 aMoed, R  uhttp://www.iacat.org/content/adaptive-short-forms-outpatient-rehabilitation-outcome-assessment03123nas a2200385   4500008004100000020002200041245012900063210006900192250001500261260000800276300001000284490000700294520188400301653002502185653002702210653001502237653001002252653002102262653002802283653003802311653001102349653001102360653001102371653000902382653004602391653002702437653003002464653003202494100001502526700001602541700001602557700001502573700002502588856012402613       2005                        eng d  a0003-9993 (Print)00aAssessing mobility in children using a computer adaptive testing version of the pediatric evaluation of disability inventory0 aAssessing mobility in children using a computer adaptive testing  a2005/05/17  cMay  a932-90 v863 aOBJECTIVE: To assess score agreement, validity, precision, and response burden of a prototype computerized adaptive testing (CAT) version of the Mobility Functional Skills Scale (Mob-CAT) of the Pediatric Evaluation of Disability Inventory (PEDI) as compared with the full 59-item version (Mob-59). DESIGN: Computer simulation analysis of cross-sectional and longitudinal retrospective data; and cross-sectional prospective study. SETTING: Pediatric rehabilitation hospital, including inpatient acute rehabilitation, day school program, outpatient clinics, community-based day care, preschool, and children's homes. PARTICIPANTS: Four hundred sixty-nine children with disabilities and 412 children with no disabilities (analytic sample); 41 children without disabilities and 39 with disabilities (cross-validation sample). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Summary scores from a prototype Mob-CAT application and versions using 15-, 10-, and 5-item stopping rules; scores from the Mob-59; and number of items and time (in seconds) to administer assessments. RESULTS: Mob-CAT scores from both computer simulations (intraclass correlation coefficient [ICC] range, .94-.99) and field administrations (ICC=.98) were in high agreement with scores from the Mob-59. Using computer simulations of retrospective data, discriminant validity, and sensitivity to change of the Mob-CAT closely approximated that of the Mob-59, especially when using the 15- and 10-item stopping rule versions of the Mob-CAT. The Mob-CAT used no more than 15% of the items for any single administration, and required 20% of the time needed to administer the Mob-59. CONCLUSIONS: Comparable score estimates for the PEDI mobility scale can be obtained from CAT administrations, with losses in validity and precision for shorter forms, but with a considerable reduction in administration time.10a*Computer Simulation10a*Disability Evaluation10aAdolescent10aChild10aChild, Preschool10aCross-Sectional Studies10aDisabled Children/*rehabilitation10aFemale10aHumans10aInfant10aMale10aOutcome Assessment (Health Care)/*methods10aRehabilitation Centers10aRehabilitation/*standards10aSensitivity and Specificity1 aHaley, S M1 aRaczek, A E1 aCoster, W J1 aDumas, H M1 aFragala-Pinkham, M A  uhttp://www.iacat.org/content/assessing-mobility-children-using-computer-adaptive-testing-version-pediatric-evaluation-002902nas a2200409   4500008004100000245012300041210006900164260000800233300001000241490000700251520159700258653004701855653001001902653000901912653001901921653003101940653002601971653001101997653002902008653001102037653000902048653001602057653003902073653001402112653002502126653002702151653003002178653003202208653002802240653002202268100001502290700001602305700001702321700001602338700001502354856012302369       2005                        eng d00aMeasuring physical function in patients with complex medical and postsurgical conditions: a computer adaptive approach0 aMeasuring physical function in patients with complex medical and  cOct  a741-80 v843 aOBJECTIVE: 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.10aActivities of Daily Living/*classification10aAdult10aAged10aCohort Studies10aContinuity of Patient Care10aDisability Evaluation10aFemale10aHealth Services Research10aHumans10aMale10aMiddle Aged10aPostoperative Care/*rehabilitation10aPrognosis10aRecovery of Function10aRehabilitation Centers10aRehabilitation/*standards10aSensitivity and Specificity10aSickness Impact Profile10aTreatment Outcome1 aSiebens, H1 aAndres, P L1 aPengsheng, N1 aCoster, W J1 aHaley, S M  uhttp://www.iacat.org/content/measuring-physical-function-patients-complex-medical-and-postsurgical-conditions-computer