Harrison Conrad J, Geerards Daan, Ottenhof Maarten J, Klassen Anne F, Riff Karen W Y Wong, Swan Marc C, Pusic Andrea L, Sidey-Gibbons Chris J
Department of Plastic Surgery, John Radcliffe Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Patient-Reported Outcomes, Value & Experience (PROVE) Centre, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
Patient-Reported Outcomes, Value & Experience (PROVE) Centre, Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA; Department of Surgery, Harvard Medical School, Boston, Massachusetts, USA; Department of Plastic and Reconstructive Surgery, Catharina Hospital, Eindhoven, the Netherlands.
J Plast Reconstr Aesthet Surg. 2019 Nov;72(11):1819-1824. doi: 10.1016/j.bjps.2019.05.039. Epub 2019 Jun 11.
The International Consortium for Health Outcome Measurement (ICHOM) has recently agreed upon a core outcome set for the comprehensive appraisal of cleft care, which puts a greater emphasis on patient-reported outcome measures (PROMs) and, in particular, the CLEFT-Q. The CLEFT-Q comprises 12 scales with a total of 110 items, aimed to be answered by children as young as 8 years old.
In this study, we aimed to use computerised adaptive testing (CAT) to reduce the number of items needed to predict results for each CLEFT-Q scale.
We used an open-source CAT simulation package to run item responses over each of the full-length scales and its CAT counterpart at varying degrees of precision, estimated by standard error (SE). The mean number of items needed to achieve a given SE was recorded for each scale's CAT, and the correlations between results from the full-length scales and those predicted by the CAT versions were calculated.
Using CATs for each of the 12 CLEFT-Q scales, we reduced the number of questions that participants needed to answer, that is, from 110 to a mean of 43.1 (range 34-60, SE < 0.55) while maintaining a 97% correlation between scores obtained with CAT and full-length scales.
CAT is likely to play a fundamental role in the uptake of PROMs into clinical practice given the high degree of accuracy achievable with substantially fewer items.
国际健康结局测量联盟（ICHOM）最近已就全面评估腭裂护理的核心结局集达成一致，该核心结局集更加强调患者报告结局测量指标（PROMs），尤其是腭裂问卷（CLEFT-Q）。CLEFT-Q由12个分量表组成，共110个条目，旨在供8岁及以上儿童作答。
在本研究中，我们旨在使用计算机自适应测试（CAT）来减少预测每个CLEFT-Q分量表结果所需的条目数量。
我们使用一个开源CAT模拟软件包，在全长分量表及其CAT对应版本上以不同精度运行条目反应，精度由标准误（SE）估计。记录每个分量表的CAT达到给定SE所需的平均条目数，并计算全长分量表结果与CAT版本预测结果之间的相关性。
对CLEFT-Q的12个分量表均使用CAT，我们减少了参与者需要回答的问题数量（即从110个减少到平均43.1个，范围为34 - 60个，SE < 0.55），同时保持CAT得分与全长分量表得分之间97%的相关性。
鉴于使用大幅减少的条目数量即可实现高度准确性，CAT可能在将PROMs应用于临床实践中发挥重要作用。
