UMass Chan Medical School Faculty Publications


Evaluation of a role functioning computer adaptive test (RF-CAT)

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date


Document Type



Adolescent; Adult; Aged; Aged, 80 and over; Chronic Disease; *Computers; Cross-Sectional Studies; Diagnosis, Computer-Assisted; Female; *Health Status Indicators; Humans; Male; Middle Aged; Patient Acceptance of Health Care; Psychometrics; *Quality of Life; Questionnaires; Reproducibility of Results; Self Report; *Sick Role; Sickness Impact Profile; Young Adult


Health Services Research | Medicine and Health | Sociology


OBJECTIVES: To evaluate the validity and participants' acceptance of an online assessment of role function using computer adaptive test (RF-CAT).

METHODS: The RF-CAT and a set of established quality of life instruments were administered in a cross-sectional study in a panel sample (n = 444) recruited from the general population with over-selection of participants with selected self-report chronic conditions (n = 225). The efficiency, score accuracy, validity, and acceptability of the RF-CAT were evaluated and compared to existing measures.

RESULTS: The RF-CAT with a stopping rule of six items with content balancing used 25 of the available bank items and was completed on average in 66 s. RF-CAT and the legacy tools scores were highly correlated (.64-.84) and successfully discriminated across known groups. The RF-CAT produced a more precise assessment over a wider range than the SF-36 Role Physical scale. Patients' evaluations of the RF-CAT system were positive overall, with no differences in ratings observed between the CAT and static assessments.

CONCLUSIONS: The RF-CAT was feasible, more precise than the static SF-36 RP and equally acceptable to participants as legacy measures. In empirical tests of validity, the better performance of the CAT was not uniformly statistically significant. Further research exploring the relationship between gained precision and discriminant power of the CAT assessment is needed.


Role function, Computer adaptive test, Patient-reported outcome, Health-related quality of life

DOI of Published Version



Anatchkova M, Rose M, Ware J, Bjorner JB. Evaluation of a role functioning computer adaptive test (RF-CAT). Qual Life Res. 2013 Jun;22(5):1085-92. doi:10.1007/s11136-012-0215-6.

Related Resources

Link to Article in PubMed

Journal/Book/Conference Title

Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation

PubMed ID