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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.
Rights and Permissions
Citation: J Clin Epidemiol. 2006 Jul;59(7):715-23. Link to article on publisher's site
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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