A web-based computerized adaptive testing (CAT) to assess patient perception in hospitalization.

Area of Science:

• Health Informatics
• Patient Experience Research
• Psychometrics

Background:

• Mobile nursing carts (Computers on Wheels - COW) are common in hospitals.
• Limited data exists on using COW for patient-reported outcomes at the bedside.
• Assessing patient perceptions of hospitalization is crucial for quality improvement.

Purpose of the Study:

• To evaluate the efficiency and precision of computerized adaptive testing (CAT) for patient perception surveys.
• To compare CAT with nonadaptive testing (NAT) in a hospital setting.
• To introduce an Excel module for CAT administration on COW.

Main Methods:

• 200 discharged patients completed an 18-item inpatient perception questionnaire via CAT on COW.
• Response data were calibrated using the Rasch model.
• CAT performance was compared against NAT.

Main Results:

• CAT and NAT measures were highly correlated (r=0.98).
• CAT achieved a 42% efficiency gain, requiring fewer questions.
• No significant difference in measurement precision between CAT and NAT (P=0.14).

Conclusions:

• CAT administration on wireless COW reduces patient burden without sacrificing measurement precision.
• The developed animation-CAT Excel module is recommended for hospital implementation.
• This approach enhances the collection of patient-reported outcomes.