TY - JOUR T1 - Assessing self-care and social function using a computer adaptive testing version of the pediatric evaluation of disability inventory JF - Archives of Physical Medicine and Rehabilitation Y1 - 2008 A1 - Coster, W. J. A1 - Haley, S. M. A1 - Ni, P. A1 - Dumas, H. M. A1 - Fragala-Pinkham, M. A. KW - *Disability Evaluation KW - *Social Adjustment KW - Activities of Daily Living KW - Adolescent KW - Age Factors KW - Child KW - Child, Preschool KW - Computer Simulation KW - Cross-Over Studies KW - Disabled Children/*rehabilitation KW - Female KW - Follow-Up Studies KW - Humans KW - Infant KW - Male KW - Outcome Assessment (Health Care) KW - Reference Values KW - Reproducibility of Results KW - Retrospective Studies KW - Risk Factors KW - Self Care/*standards/trends KW - Sex Factors KW - Sickness Impact Profile AB - OBJECTIVE: To examine score agreement, validity, precision, and response burden of a prototype computer adaptive testing (CAT) version of the self-care and social function scales of the Pediatric Evaluation of Disability Inventory compared with the full-length version of these scales. DESIGN: Computer simulation analysis of cross-sectional and longitudinal retrospective data; 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: Children with disabilities (n=469) and 412 children with no disabilities (analytic sample); 38 children with disabilities and 35 children without disabilities (cross-validation sample). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Summary scores from prototype CAT applications of each scale using 15-, 10-, and 5-item stopping rules; scores from the full-length self-care and social function scales; time (in seconds) to complete assessments and respondent ratings of burden. RESULTS: Scores from both computer simulations and field administration of the prototype CATs were highly consistent with scores from full-length administration (r range, .94-.99). Using computer simulation of retrospective data, discriminant validity, and sensitivity to change of the CATs closely approximated that of the full-length scales, especially when the 15- and 10-item stopping rules were applied. In the cross-validation study the time to administer both CATs was 4 minutes, compared with over 16 minutes to complete the full-length scales. CONCLUSIONS: Self-care and social function score estimates from CAT administration are highly comparable with those obtained from full-length scale administration, with small losses in validity and precision and substantial decreases in administration time. VL - 89 SN - 1532-821X (Electronic)0003-9993 (Linking) N1 - Coster, Wendy JHaley, Stephen MNi, PengshengDumas, Helene MFragala-Pinkham, Maria AK02 HD45354-01A1/HD/NICHD NIH HHS/United StatesR41 HD052318-01A1/HD/NICHD NIH HHS/United StatesR43 HD42388-01/HD/NICHD NIH HHS/United StatesComparative StudyResearch Support, N.I.H., ExtramuralUnited StatesArchives of physical medicine and rehabilitationArch Phys Med Rehabil. 2008 Apr;89(4):622-9. U2 - 2666276 ER - TY - JOUR T1 - Measuring physical functioning in children with spinal impairments with computerized adaptive testing JF - Journal of Pediatric Orthopedics Y1 - 2008 A1 - Mulcahey, M. J. A1 - Haley, S. M. A1 - Duffy, T. A1 - Pengsheng, N. A1 - Betz, R. R. KW - *Disability Evaluation KW - Adolescent KW - Child KW - Child, Preschool KW - Computer Simulation KW - Cross-Sectional Studies KW - Disabled Children/*rehabilitation KW - Female KW - Humans KW - Infant KW - Kyphosis/*diagnosis/rehabilitation KW - Male KW - Prospective Studies KW - Reproducibility of Results KW - Scoliosis/*diagnosis/rehabilitation AB - BACKGROUND: The purpose of this study was to assess the utility of measuring current physical functioning status of children with scoliosis and kyphosis by applying computerized adaptive testing (CAT) methods. Computerized adaptive testing uses a computer interface to administer the most optimal items based on previous responses, reducing the number of items needed to obtain a scoring estimate. METHODS: This was a prospective study of 77 subjects (0.6-19.8 years) who were seen by a spine surgeon during a routine clinic visit for progress spine deformity. Using a multidimensional version of the Pediatric Evaluation of Disability Inventory CAT program (PEDI-MCAT), we evaluated content range, accuracy and efficiency, known-group validity, concurrent validity with the Pediatric Outcomes Data Collection Instrument, and test-retest reliability in a subsample (n = 16) within a 2-week interval. RESULTS: We found the PEDI-MCAT to have sufficient item coverage in both self-care and mobility content for this sample, although most patients tended to score at the higher ends of both scales. Both the accuracy of PEDI-MCAT scores as compared with a fixed format of the PEDI (r = 0.98 for both mobility and self-care) and test-retest reliability were very high [self-care: intraclass correlation (3,1) = 0.98, mobility: intraclass correlation (3,1) = 0.99]. The PEDI-MCAT took an average of 2.9 minutes for the parents to complete. The PEDI-MCAT detected expected differences between patient groups, and scores on the PEDI-MCAT correlated in expected directions with scores from the Pediatric Outcomes Data Collection Instrument domains. CONCLUSIONS: Use of the PEDI-MCAT to assess the physical functioning status, as perceived by parents of children with complex spinal impairments, seems to be feasible and achieves accurate and efficient estimates of self-care and mobility function. Additional item development will be needed at the higher functioning end of the scale to avoid ceiling effects for older children. LEVEL OF EVIDENCE: This is a level II prospective study designed to establish the utility of computer adaptive testing as an evaluation method in a busy pediatric spine practice. VL - 28 SN - 0271-6798 (Print)0271-6798 (Linking) N1 - Mulcahey, M JHaley, Stephen MDuffy, TheresaPengsheng, NiBetz, Randal RK02 HD045354-01A1/HD/NICHD NIH HHS/United StatesUnited StatesJournal of pediatric orthopedicsJ Pediatr Orthop. 2008 Apr-May;28(3):330-5. U2 - 2696932 ER - TY - JOUR T1 - Assessing mobility in children using a computer adaptive testing version of the pediatric evaluation of disability inventory JF - Archives of Physical Medicine and Rehabilitation Y1 - 2005 A1 - Haley, S. M. A1 - Raczek, A. E. A1 - Coster, W. J. A1 - Dumas, H. M. A1 - Fragala-Pinkham, M. A. KW - *Computer Simulation KW - *Disability Evaluation KW - Adolescent KW - Child KW - Child, Preschool KW - Cross-Sectional Studies KW - Disabled Children/*rehabilitation KW - Female KW - Humans KW - Infant KW - Male KW - Outcome Assessment (Health Care)/*methods KW - Rehabilitation Centers KW - Rehabilitation/*standards KW - Sensitivity and Specificity AB - OBJECTIVE: 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. VL - 86 SN - 0003-9993 (Print) N1 - Haley, Stephen MRaczek, Anastasia ECoster, Wendy JDumas, Helene MFragala-Pinkham, Maria AK02 hd45354-01a1/hd/nichdR43 hd42388-01/hd/nichdResearch Support, N.I.H., ExtramuralResearch Support, U.S. Gov't, P.H.S.United StatesArchives of physical medicine and rehabilitationArch Phys Med Rehabil. 2005 May;86(5):932-9. ER -