An evaluation of a patient-reported outcomes found computerized adaptive testing was efficient in assessing osteoarthritis impact

UMMS Affiliation

Department of Quantitative Health Sciences

Publication Date


Document Type



*Adaptation, Psychological; *Disability Evaluation; Humans; Osteoarthritis; Quality of Life; Questionnaires; Sickness Impact Profile; Treatment Outcome; User-Computer Interface


Biostatistics | Epidemiology | Health Services Research


BACKGROUND AND OBJECTIVES: Evaluate a patient-reported outcomes questionnaire that uses computerized adaptive testing (CAT) to measure the impact of osteoarthritis (OA) on functioning and well-being.

MATERIALS AND METHODS: OA patients completed 37 questions about the impact of OA on physical, social and role functioning, emotional well-being, and vitality. Questionnaire responses were calibrated and scored using item response theory, and two scores were estimated: a Total-OA score based on patients' responses to all 37 questions, and a simulated CAT-OA score where the computer selected and scored the five most informative questions for each patient. Agreement between Total-OA and CAT-OA scores was assessed using correlations. Discriminant validity of Total-OA and CAT-OA scores was assessed with analysis of variance. Criterion measures included OA pain and severity, patient global assessment, and missed work days.

RESULTS: Simulated CAT-OA and Total-OA scores correlated highly (r = 0.96). Both Total-OA and simulated CAT-OA scores discriminated significantly between patients differing on the criterion measures. F-statistics across criterion measures ranged from 39.0 (P < .001) to 225.1 (P < .001) for the Total-OA score, and from 40.5 (P < .001) to 221.5 (P < .001) for the simulated CAT-OA score.

CONCLUSIONS: CAT methods produce valid and precise estimates of the impact of OA on functioning and well-being with significant reduction in response burden.

DOI of Published Version



J Clin Epidemiol. 2006 Jul;59(7):715-23. Link to article on publisher's site

Journal/Book/Conference Title

Journal of clinical epidemiology

PubMed ID


Related Resources

Link to Article in PubMed