Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK.
Clinical Trials Unit, Warwick Medical School, Warwick, UK.
J Hand Surg Eur Vol. 2022 Oct;47(9):893-898. doi: 10.1177/17531934221087572. Epub 2022 Mar 22.
We aimed to develop a computerized adaptive testing (CAT) version of the 11 item Patient Evaluation Measure (PEM), using an item response theory model. This model transformed the ordinal scores into ratio-interval scores. We obtained PEM responses from 924 patients with trapeziometacarpal osteoarthritis to build a CAT model and tested its performance on a simulated cohort of 1000 PEM response sets. The CAT achieved high precision (median standard error or measurement 0.26) and reduced the number of questions needed for accurate scoring from 11 to median two. The CAT scores and item-response-theory-based 15-item PEM scores were similar, and a Bland-Altman analysis demonstrated a mean score difference of 0.2 between the CAT and the full-length PEM scores on a scale from 0 to 100. We conclude that the CAT substantially reduced the burden of the PEM while also harnessing the validity of item response theory scoring.
我们旨在使用项目反应理论模型开发 11 项患者评估量表（PEM）的计算机化自适应测试（CAT）版本。该模型将有序评分转换为等距评分。我们从 924 名患有腕掌关节炎的患者中获得 PEM 反应，以构建 CAT 模型，并在模拟的 1000 个 PEM 反应集中测试其性能。CAT 实现了高精度（中位数标准误差或测量值为 0.26），并将准确评分所需的问题数量从 11 个减少到中位数两个。CAT 分数和基于项目反应理论的 15 项 PEM 分数相似，Bland-Altman 分析表明，在 0 到 100 的量表上，CAT 与全长 PEM 分数之间的平均得分差异为 0.2。我们得出结论，CAT 大大减轻了 PEM 的负担，同时利用了项目反应理论评分的有效性。
