Item Response Theory and Computerized Adaptive Testing: Implications for Outcomes Measurement in Rehabilitation
Department of Quantitative Health Sciences
Outcome Assessment (Health Care); Rehabilitation
Biostatistics | Epidemiology | Health Services Research
Objective: To evaluate computerized adaptive testing (CAT) measures of rehabilitation outcomes.
Study Design: Physical functioning questions were calibrated via item response theory (IRT) and administered with CAT software.
Subjects: 485 adults interviewed during postacute care rehabilitation (simulation study) and 26 adults who completed CAT and personal interviews (CAT pilot study).
Main Outcome Measures: Patient acceptance and respondent burden, reliability, and discriminant validity.
Results: In the simulation study, CAT-based estimates correlated highly (r=.93 and r=.98) with criteria, minimized ceiling and floor effects, and reduced respondent burden while achieving high reliability. Pilot study patients preferred self-administered CAT surveys, and CAT scores discriminated well across severity levels.
Conclusions: CAT software has considerable potential to improve physical functioning measurement in rehabilitation settings.
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Citation: Ware JE, Gandek B, Sinclair SJ, Bjorner JB. Item Response Theory and Computerized Adaptive Testing: Implications for Outcomes Assesment in Rehabilitation. Rehabilitation Psychology. 2005;50(1):71-78.
Ware, John E. Jr.; Gandek, Barbara; Sinclair, Samuel J.; and Bjorner, Jakob B., "Item Response Theory and Computerized Adaptive Testing: Implications for Outcomes Measurement in Rehabilitation" (2005). Quantitative Health Sciences Publications and Presentations. 610.