The intent of this study was to examine and compare the ability to detect change of two patient reported outcome (PRO) instruments that use a computerized adaptive test (CAT) approach to measurement. The Patient Reported Outcomes Measurement Information System (PROMIS®) Physical Function scale is a generic PRO, while the Osteoarthritis Computerized Adaptive Test (OA-CAT) is an osteoarthritis-specific PRO.
This descriptive, longitudinal study was conducted in a community setting, involving individuals from the greater Boston area. Inclusion criteria: age > 50, self-reported doctor-diagnosed knee osteoarthritis (OA) and knee pain. The PROMIS® Physical Function CAT and OA-CAT Functional Difficulty scale were administered at baseline and at the conclusion of a 6-week exercise program. Effect sizes (ES) were calculated for both measures, and bootstrap methods were used to construct confidence intervals and to test for significant ES differences between the measures.
The OA-CAT Functional Difficulty scale achieved an ES of 0.62 (0.43, 0.87) compared to the PROMIS® Physical Function CAT ES of 0.42 (0.24, 0.63). ES estimates for the two CAT measures were not statistically different.
The condition-specific OA-CAT and generic PROMIS® Physical Function CAT both demonstrated the ability to detect change in function. While the OA-CAT scale showed larger effect size, no statistically significant difference was found in the effect size estimates for the generic and condition-specific CATs. Both CATs have potential for use in arthritis research.
Bruce B, Fries JF. The Stanford health assessment Questionnaire: a review of its history, issues, progress, and documentation. J Rheumatol. 2003;30(1):167–78. PubMed
Fries JF, Spitz P, Kraines RG, Holman HR. Measurement of patient outcome in arthritis. Arthritis & Rheumatism. 1980;23(2):137–45. CrossRef
Backman CL. Outcome measures for arthritis care research: recommendations from the CARE III conference. J Rheumatol. 2006;33(9):1908–11. PubMed
Beaton DE, Richards RR. Measuring function of the shoulder. A cross-sectional comparison of five questionnaires. J Bone Joint SurgAm Vol. 1996;78(6):882–90. CrossRef
Chen AL, Broadhead WE, Doe EA, Broyles WK. Patient acceptance of two health status measures: the medical outcomes study short-form general health survey and the Duke health profile. Fam Med. 1993;25(8):536–9. PubMed
CA MH, Earl Bricker D Jr. A qualitative study of patients' and physicians' views about practice-based functional health assessment. Med Care. 2002;40(11):1113–25. CrossRef
Hambleton RK. Emergence of item response modeling in instrument development and data analysis. Med Care. 2000;38(9 Suppl):II60–5. PubMed
Wainer H. Computerized adaptive testing: a primer. Mahwah: Lawrence Erlbaum Associates; 2000.
Jette AM, CM MD, Haley SM, Ni P, Olarsch S, Latham N, Hambleton RK, Felson D, Kim YJ, Hunter D. A computer-adaptive disability instrument for lower extremity osteoarthritis research demonstrated promising breadth, precision, and reliability. J Clin Epidemiol. 2009;62(8):807–15. CrossRefPubMedPubMedCentral
Jette AM, McDonough CM, Ni P, Haley SM, Hambleton RK, Olarsch S, Hunter DJ, Kim YJ, Felson DT. A functional difficulty and functional pain instrument for hip and knee osteoarthritis. Arthritis Res Therapy. 2009;11(4):R107. CrossRef
Fries JF, Bruce B, Bjorner J, Rose M: More relevant, precise, and efficient items for assessment of physical function and disability: moving beyond the classic instruments. Ann Rheum Dis 2006, 65 Suppl 3(Journal Article):iii16–21.
Cella D, Riley W, Stone A, Rothrock N, Reeve B, Yount S, Amtmann D, Bode R, Buysse D, Choi S, et al. The patient-reported outcomes measurement information system (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008. J Clin Epidemiol. 2010;63(11):1179–94. CrossRefPubMedPubMedCentral
Cella D, Yount S, Rothrock N, Gershon R, Cook K, Reeve B, Ader D, Fries JF, Bruce B, Rose M, et al. The patient-reported outcomes measurement information system (PROMIS): progress of an NIH roadmap cooperative group during its first two years. Med Care. 2007;45(5 Suppl 1):S3–S11. CrossRefPubMedPubMedCentral
Randall DP, Jennifer MB. Applying a weighted maximum Likelihood Latent Trait Estimator to the Generalized Partial Credit Model. Appl Psychol Meas. 2005;29(3):218–33. CrossRef
Warm TA. Weighted likelihood estimation of ability in item response theory. Psychometrika. 1989;54(3):427–50. CrossRef
Haley SM, Fragala-Pinkham MA. Interpreting change scores of tests and measures used in physical therapy. Phys Ther. 2006;86(5):735–43. PubMed
Cohen J: Statistical Power Analysis. Current Directions in Psychological Sciences, 1, 98–101. In .; 1992.
Driban JB, Morgan N, Price LL, Cook KF, Wang C. Patient-reported outcomes measurement information system (PROMIS) instruments among individuals with symptomatic knee osteoarthritis: a cross-sectional study of floor/ceiling effects and construct validity. BMC Musculoskelet Disord. 2015;16(1):253. CrossRefPubMedPubMedCentral
PHYSICAL FUNCTION: A brief guide to the PROMIS Physical Function instruments. https://www.assessmentcenter.net/documents/PROMIS%20Physical%20Function%20Scoring%20Manual.pdf. Accessed 18 Jan 2018.
French HP Fitzpatrick M, FitzGerald O: Responsiveness of physical function outcomes following physiotherapy intervention for osteoarthritsi of the knee: an outcome comparison study. Physiotherapy 2011, 97(4):302-308.
Juhl C, Lund H, Roos EM, Zhang W, Christensen R. A hierarchy of patient-reported outcomes for meta-analysis of knee osteoarthritis trials: empirical evidence from a survey of high impact journals. Arthritis. 2012;2012:136245. http://dx.doi.org/10.1155/2012/136245. Epub 2012 Jun 26.
- Detecting functional change in response to exercise in knee osteoarthritis: a comparison of two computerized adaptive tests
Alan M. Jette
Mary D. Slavin
Julie J. Keysor
- BioMed Central
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