Hung Man, Stuart Ami R, Higgins Thomas F, Saltzman Charles L, Kubiak Erik N
Departmant of Orthopaedic Surgery Operations, University of Utah, Salt Lake City, UT.
J Orthop Trauma. 2014 Aug;28(8):439-43. doi: 10.1097/BOT.0000000000000059.
Patient-reported outcomes are important to assess effectiveness of clinical interventions. For orthopaedic trauma patients, the short Musculoskeletal Function Assessment (sMFA) is a commonly used questionnaire. Recently, the Patient-Reported Outcome Measurement Information System (PROMIS) PF Function Computer Adaptive Test (PF CAT) was developed using item response theory to efficiently administer questions from a calibrated bank of 124 PF questions using computerized adaptive testing. In this study, we compared the sMFA versus the PROMIS PF CAT for trauma patients.
Orthopaedic trauma patients completed the sMFA and the PROMIS PF CAT on a tablet wirelessly connected to the PROMIS Assessment Center. The time for each test administration was recorded. A 1-parameter item response theory model was used to examine the psychometric properties of the instruments, including precision and floor/ceiling effects.
One hundred fifty-three orthopaedic trauma patients participated in the study. Mean test administration time for PROMIS PF CAT was 44 seconds versus 599 seconds for sMFA (P < 0.05). Both instruments showed extremely high item reliability (Cronbach alpha = 0.98). In terms of instrument coverage, neither instrument showed any floor effect; however, the sMFA revealed 14.4% ceiling effect, whereas the PROMIS PF CAT had no appreciable ceiling effect.
Administered by electronic means, the PROMIS PF CAT required less than one-tenth the amount of time for patients to complete than the sMFA while achieving equally high reliability and less ceiling effects. The PROMIS PF CAT is a very attractive and innovative method for assessing patient-reported outcomes with minimal burden to patients.
患者报告的结果对于评估临床干预措施的有效性很重要。对于骨科创伤患者，简短肌肉骨骼功能评估（sMFA）是一种常用的问卷。最近，患者报告结果测量信息系统（PROMIS）PF功能计算机自适应测试（PF CAT）利用项目反应理论开发，通过计算机化自适应测试有效地从124个PF校准题库中提出问题。在本研究中，我们比较了创伤患者的sMFA和PROMIS PF CAT。
骨科创伤患者在无线连接到PROMIS评估中心的平板电脑上完成sMFA和PROMIS PF CAT。记录每次测试的用时。使用单参数项目反应理论模型检查这些工具的心理测量特性，包括精度和地板/天花板效应。
153名骨科创伤患者参与了研究。PROMIS PF CAT的平均测试用时为44秒，而sMFA为599秒（P < 0.05）。两种工具均显示出极高的项目可靠性（克朗巴哈系数α = 0.98）。在工具覆盖范围方面，两种工具均未显示任何地板效应；然而，sMFA显示出14.4%的天花板效应，而PROMIS PF CAT没有明显的天花板效应。
通过电子方式实施时，PROMIS PF CAT让患者完成测试所需的时间不到sMFA的十分之一，同时具有同样高的可靠性且天花板效应更小。PROMIS PF CAT是一种非常有吸引力且创新的方法，可在给患者带来最小负担的情况下评估患者报告的结果。
