Haley Stephen M, Siebens Hilary, Coster Wendy J, Tao Wei, Black-Schaffer Randie M, Gandek Barbara, Sinclair Samuel J, Ni Pengsheng
Health and Disability Research Institute, Boston University, MA 02215, USA.
Arch Phys Med Rehabil. 2006 Aug;87(8):1033-42. doi: 10.1016/j.apmr.2006.04.020.
To examine score agreement, precision, validity, efficiency, and responsiveness of a computerized adaptive testing (CAT) version of the Activity Measure for Post-Acute Care (AM-PAC-CAT) in a prospective, 3-month follow-up sample of inpatient rehabilitation patients recently discharged home.
Longitudinal, prospective 1-group cohort study of patients followed approximately 2 weeks after hospital discharge and then 3 months after the initial home visit.
Follow-up visits conducted in patients' home setting.
Ninety-four adults who were recently discharged from inpatient rehabilitation, with diagnoses of neurologic, orthopedic, and medically complex conditions.
Not applicable.
Summary scores from AM-PAC-CAT, including 3 activity domains of movement and physical, personal care and instrumental, and applied cognition were compared with scores from a traditional fixed-length version of the AM-PAC with 66 items (AM-PAC-66).
AM-PAC-CAT scores were in good agreement (intraclass correlation coefficient model 3,1 range, .77-.86) with scores from the AM-PAC-66. On average, the CAT programs required 43% of the time and 33% of the items compared with the AM-PAC-66. Both formats discriminated across functional severity groups. The standardized response mean (SRM) was greater for the movement and physical fixed form than the CAT; the effect size and SRM of the 2 other AM-PAC domains showed similar sensitivity between CAT and fixed formats. Using patients' own report as an anchor-based measure of change, the CAT and fixed length formats were comparable in responsiveness to patient-reported change over a 3-month interval.
Accurate estimates for functional activity group-level changes can be obtained from CAT administrations, with a considerable reduction in administration time.
在近期出院回家的住院康复患者的前瞻性3个月随访样本中，检验急性后期护理活动测量计算机自适应测试（AM-PAC-CAT）版本的分数一致性、精确性、有效性、效率和反应性。
对患者进行纵向、前瞻性单组队列研究，患者在出院后约2周以及首次家访后3个月接受随访。
在患者家中进行随访。
94名近期从住院康复机构出院的成年人，诊断包括神经、骨科和医学复杂病症。
不适用。
将AM-PAC-CAT的汇总分数，包括运动与身体、个人护理与工具性活动以及应用认知这3个活动领域的分数，与具有66个条目的传统固定长度版本的AM-PAC（AM-PAC-66）的分数进行比较。
AM-PAC-CAT分数与AM-PAC-66的分数具有良好的一致性（组内相关系数模型3,1范围，0.77 - 0.86）。平均而言，与AM-PAC-66相比，CAT程序所需时间减少43%，条目减少33%。两种形式在不同功能严重程度组之间都有区分度。运动与身体固定形式的标准化反应均值（SRM）大于CAT；其他两个AM-PAC领域的效应大小和SRM在CAT和固定形式之间显示出相似的敏感性。以患者自身报告作为基于锚定的变化测量指标，在3个月的时间间隔内，CAT和固定长度形式在对患者报告变化的反应性方面具有可比性。
通过CAT管理可以获得功能活动组水平变化的准确估计，且管理时间大幅减少。
