TY - JOUR
T1 - Development of a Computerized Adaptive Testing System of the Functional Assessment of Stroke
AU - Lin, Gong Hong
AU - Huang, Yi Jing
AU - Lee, Shih Chieh
AU - Huang, Sheau Ling
AU - Hsieh, Ching Lin
N1 - Funding Information:
Supported by the Ministry of Science and Technology in Taiwan (grant nos. 106-2811-B-002-036).
Publisher Copyright:
© 2017 American Congress of Rehabilitation Medicine
Copyright:
Copyright 2019 Elsevier B.V., All rights reserved.
PY - 2018/4
Y1 - 2018/4
N2 - Objective: To develop a computerized adaptive testing system of the Functional Assessment of Stroke (CAT-FAS) to assess upper- and lower-extremity (UE/LE) motor function, postural control, and basic activities of daily living with optimal efficiency and without sacrificing psychometric properties in patients with stroke. Design: Simulation study. Setting: One rehabilitation unit in a medical center. Participants: Patients with subacute stroke (N=301; mean age, 67.3±10.9; intracranial infarction, 74.5%). Interventions: Not applicable. Main Outcome Measures: The UE and LE subscales of the Fugl-Meyer Assessment, Postural Assessment Scale for Stroke Patients, and Barthel Index. Results: The CAT-FAS adopting the optimal stopping rule (limited reliability increase of <.010) had good Rasch reliability across the 4 domains (.88–.93) and needed few items for the whole administration (8.5 items on average). The concurrent validity (CAT-FAS vs original tests, Pearson r=.91–.95) and responsiveness (standardized response mean,.65–.76) of the CAT-FAS were good in patients with stroke. Conclusions: We developed the CAT-FAS, and our results support that the CAT-FAS has sufficient efficiency, reliability, concurrent validity, and responsiveness in patients with stroke. The CAT-FAS can be used to simultaneously assess patients' functions of UE, LE, postural control, and basic activities of daily living using, on average, no more than 10 items; this efficiency is useful in reducing the assessment burdens for both clinicians and patients.
AB - Objective: To develop a computerized adaptive testing system of the Functional Assessment of Stroke (CAT-FAS) to assess upper- and lower-extremity (UE/LE) motor function, postural control, and basic activities of daily living with optimal efficiency and without sacrificing psychometric properties in patients with stroke. Design: Simulation study. Setting: One rehabilitation unit in a medical center. Participants: Patients with subacute stroke (N=301; mean age, 67.3±10.9; intracranial infarction, 74.5%). Interventions: Not applicable. Main Outcome Measures: The UE and LE subscales of the Fugl-Meyer Assessment, Postural Assessment Scale for Stroke Patients, and Barthel Index. Results: The CAT-FAS adopting the optimal stopping rule (limited reliability increase of <.010) had good Rasch reliability across the 4 domains (.88–.93) and needed few items for the whole administration (8.5 items on average). The concurrent validity (CAT-FAS vs original tests, Pearson r=.91–.95) and responsiveness (standardized response mean,.65–.76) of the CAT-FAS were good in patients with stroke. Conclusions: We developed the CAT-FAS, and our results support that the CAT-FAS has sufficient efficiency, reliability, concurrent validity, and responsiveness in patients with stroke. The CAT-FAS can be used to simultaneously assess patients' functions of UE, LE, postural control, and basic activities of daily living using, on average, no more than 10 items; this efficiency is useful in reducing the assessment burdens for both clinicians and patients.
KW - Psychometrics
KW - Rehabilitation
KW - Reproducibility of results
KW - Stroke
KW - Validation studies as topic
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U2 - 10.1016/j.apmr.2017.09.116
DO - 10.1016/j.apmr.2017.09.116
M3 - Article
C2 - 29042171
AN - SCOPUS:85039903780
SN - 0003-9993
VL - 99
SP - 676
EP - 683
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
IS - 4
ER -