Opportunities for CAT applications in medical rehabilitation: development of targeted item banks

Researchers in the field of rehabilitation medicine have increasingly turned to qualitative data collection methods to better understand the experience of living with a disability. In rehabilitation psychology, these techniques are embodied by participatory action research (PAR; Hall 1981; White, Suchowierska, and Campbell 2004), whereby researchers garner qualitative feedback from key stakeholders such as patients and physicians. Glaser and Strauss (1967) and, later, Strauss and Corbin (1998) have outlined a systematic method of gathering and analyzing qualitative data to ensure that results are conceptually grounded to the population of interest. This type of analysis yields a set of interrelated concepts ("codes") to describe the phenomenon of interest. Using this data, however, becomes somewhat of a methodological problem. While this data is often used to describe phenomena of interest, it is challenging to transform the knowledge gained into practical data to inform research and clinical practice. In the case of developing patient-reported outcomes (PRO) measures for use in a rehabilitation population, it is difficult to make sense of the qualitative analysis results. Qualitative feedback tends to be open-ended and free-flowing, not conforming to any traditional data analysis methodology. Researchers involved in measure development need a practical way to quantify the qualitative feedback. This manuscript will focus on a detailed methodology of empiricizing qualitative data for practical application, in the context of developing targeted, rehabilitation-specific PRO measures within a larger, more generic PRO measurement system.