Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA. ; Division of Public Health, University of Utah, Salt Lake City, Utah, USA. ; Division of Epidemiology, University of Utah, Salt Lake City, Utah, USA. ; Huntsman Cancer Institute, University Medical Center, Salt Lake City, Utah, USA.
Department of Orthopaedics, University of Utah, Salt Lake City, Utah, USA. ; Department of Computer & Electrical Engineering, University of Utah, Salt Lake City, Utah, USA.
Orthop J Sports Med. 2014 Dec 19;2(12):2325967114562191. doi: 10.1177/2325967114562191. eCollection 2014 Dec.
The applicability and validity of many patient-reported outcome measures in the high-functioning population are not well understood.
To compare the psychometric properties of the modified Harris Hip Score (mHHS), the Hip Outcome Score activities of daily living subscale (HOS-ADL) and sports (HOS-sports), and the Lower Extremity Computerized Adaptive Test (LE CAT). The hypotheses was that all instruments would perform well but that the LE CAT would show superiority psychometrically because a combination of CAT and a large item bank allows for a high degree of measurement precision.
Cohort study (diagnosis); Level of evidence, 2.
Data were collected from 472 advanced-age, active participants from the Huntsman World Senior Games in 2012. Validity evidences were examined through item fit, dimensionality, monotonicity, local independence, differential item functioning, person raw score to measure correlation, and instrument coverage (ie, ceiling and floor effects), and reliability evidences were examined through Cronbach alpha and person separation index.
All instruments demonstrated good item fit, unidimensionality, monotonicity, local independence, and person raw score to measure correlations. The HOS-ADL had high ceiling effects of 36.02%, and the mHHS had ceiling effects of 27.54%. The LE CAT had ceiling effects of 8.47%, and the HOS-sports had no ceiling effects. None of the instruments had any floor effects. The mHHS had a very low Cronbach alpha of 0.41 and an extremely low person separation index of 0.08. Reliabilities for the LE CAT were excellent and for the HOS-ADL and HOS-sports were good.
The LE CAT showed better psychometric properties overall than the HOS-ADL, HOS-sports, and mHHS for the senior population. The mHHS demonstrated pronounced ceiling effects and poor reliabilities that should be of concern. The high ceiling effects for the HOS-ADL were also of concern. The LE CAT was superior in all psychometric aspects examined in this study. Future research should investigate the LE CAT for wider use in different populations.
许多患者报告的结局测量在高功能人群中的适用性和有效性尚不清楚。
比较改良 Harris 髋关节评分（mHHS）、髋关节结局评分活动日常生活量表（HOS-ADL）和运动量表（HOS-sports）以及下肢计算机自适应测试（LE CAT）的心理测量特性。假设所有仪器都将表现良好，但 LE CAT 在心理测量上具有优势，因为 CAT 与大型项目库的结合允许高度的测量精度。
队列研究（诊断）；证据水平，2 级。
2012 年，从 Huntsman 世界老年运动会的 472 名高龄、活跃参与者中收集数据。通过项目拟合、维度、单调性、局部独立性、差异项目功能、人员原始分数与测量相关以及仪器覆盖率（即天花板和地板效应）来检验有效性证据，并通过 Cronbach 阿尔法和人员分离指数来检验可靠性证据。
所有仪器的项目拟合、单维性、单调性、局部独立性和人员原始分数与测量相关都很好。HOS-ADL 的天花板效应高达 36.02%，mHHS 的天花板效应为 27.54%。LE CAT 的天花板效应为 8.47%，HOS-sports 没有天花板效应。没有任何仪器有地板效应。mHHS 的 Cronbach 阿尔法非常低，仅为 0.41，人员分离指数极低，仅为 0.08。LE CAT 的可靠性非常好，HOS-ADL 和 HOS-sports 的可靠性也很好。
LE CAT 总体上显示出比 HOS-ADL、HOS-sports 和 mHHS 更好的心理测量特性，用于老年人群。mHHS 表现出明显的天花板效应和较差的可靠性，这应该引起关注。HOS-ADL 的高天花板效应也值得关注。LE CAT 在本研究中检查的所有心理测量方面都具有优势。未来的研究应该在不同人群中进一步研究 LE CAT 的广泛应用。
