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An evaluation of a patient-reported outcomes found computerized adaptive testing was efficient in assessing osteoarthritis impact
Quantitative Health Sciences Publications and Presentations
  • Mark Kosinski, QualityMetric, Inc.
  • Jakob B. Bjorner, QualityMetric, Inc.
  • John E. Ware, Jr., University of Massachusetts Medical School
  • Elizabeth Sullivan, Merck and Co.
  • Walter L. Straus, Merck and Co.
UMMS Affiliation
Department of Quantitative Health Sciences
Publication Date
Document Type
*Adaptation, Psychological; *Disability Evaluation; Humans; Osteoarthritis; Quality of Life; Questionnaires; Sickness Impact Profile; Treatment Outcome; User-Computer Interface

BACKGROUND AND OBJECTIVES: Evaluate a patient-reported outcomes questionnaire that uses computerized adaptive testing (CAT) to measure the impact of osteoarthritis (OA) on functioning and well-being.

MATERIALS AND METHODS: OA patients completed 37 questions about the impact of OA on physical, social and role functioning, emotional well-being, and vitality. Questionnaire responses were calibrated and scored using item response theory, and two scores were estimated: a Total-OA score based on patients' responses to all 37 questions, and a simulated CAT-OA score where the computer selected and scored the five most informative questions for each patient. Agreement between Total-OA and CAT-OA scores was assessed using correlations. Discriminant validity of Total-OA and CAT-OA scores was assessed with analysis of variance. Criterion measures included OA pain and severity, patient global assessment, and missed work days.

RESULTS: Simulated CAT-OA and Total-OA scores correlated highly (r = 0.96). Both Total-OA and simulated CAT-OA scores discriminated significantly between patients differing on the criterion measures. F-statistics across criterion measures ranged from 39.0 (P < .001) to 225.1 (P < .001) for the Total-OA score, and from 40.5 (P < .001) to 221.5 (P < .001) for the simulated CAT-OA score.

CONCLUSIONS: CAT methods produce valid and precise estimates of the impact of OA on functioning and well-being with significant reduction in response burden.

DOI of Published Version
J Clin Epidemiol. 2006 Jul;59(7):715-23. Link to article on publisher's site
PubMed ID
Related Resources
Link to Article in PubMed
Citation Information
Mark Kosinski, Jakob B. Bjorner, John E. Ware, Elizabeth Sullivan, et al.. "An evaluation of a patient-reported outcomes found computerized adaptive testing was efficient in assessing osteoarthritis impact" Vol. 59 Iss. 7 (2006) ISSN: 0895-4356 (Linking)
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