Development of a computer-adaptive version of the forgotten joint score

Area of Science:

• Orthopedics
• Medical Informatics
• Health Outcomes Research

Background:

• Patient-reported outcomes (PROs) are crucial in orthopedics for understanding treatment effectiveness from the patient's viewpoint.
• Traditional PRO measures can be lengthy, potentially impacting patient engagement and data quality.
• Computer-adaptive testing (CAT) offers a more efficient method for PRO assessment by tailoring item selection to individual responses.

Purpose of the Study:

• To develop and validate a computer-adaptive test (CAT) version of the Forgotten Joint Score (FJS).
• To evaluate the efficiency and precision of the FJS-CAT compared to the traditional FJS.
• To assess patient preference for electronic versus paper-based administration of the FJS-CAT.

Main Methods:

• Development of a CAT algorithm for the Forgotten Joint Score (FJS) using data from 580 orthopedic patients (808 assessments) undergoing THA or TKA.
• Comparison of measurement precision and item count between the FJS-CAT and the standard FJS.
• Feasibility study administering the FJS-CAT on tablet PCs to assess patient preference.

Main Results:

• The FJS-CAT achieved comparable measurement precision to the standard FJS while reducing the number of items by approximately 50%.
• Feasibility testing demonstrated that patients preferred using the electronic tablet-based FJS-CAT over traditional paper-and-pencil questionnaires.
• The FJS-CAT provides a more efficient and patient-preferred method for assessing joint awareness.

Conclusions:

• The developed FJS-CAT is an efficient and precise tool for measuring patient-reported joint awareness after hip or knee arthroplasty.
• Electronic administration of PRO measures, like the FJS-CAT, is well-accepted and preferred by patients.
• CAT technology holds significant potential for optimizing PRO data collection in orthopedic research and clinical practice.