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Updated: May 3, 2026
Computerized Adaptive Testing System of Functional Assessment of Stroke
Published on: January 7, 2019
Feasibility of computerized adaptive testing for collection of patient-reported outcomes after inpatient
Alex W K Wong1, Allen W Heinemann2, Ana Miskovic3
1Center for Healthcare Studies, Northwestern University Feinberg School of Medicine, Chicago, IL; Center for Rehabilitation Outcomes Research, Rehabilitation Institute of Chicago, Chicago, IL.
Objective:
To evaluate the feasibility of computer adaptive testing (CAT) using an Internet or telephone interface to collect patient-reported outcomes after inpatient rehabilitation and to examine patient characteristics associated with completion of the CAT-administered measure and mode of administration.
Design:
Prospective cohort study of patients contacted approximately 4 weeks after discharge from inpatient rehabilitation. Patients selected an Internet or telephone interface.
Setting:
Rehabilitation hospital.
Participants:
Patients (N=674) with diagnoses of neurologic, orthopedic, or medically complex conditions.
Interventions:
None.
Main Outcome Measure:
CAT version of the Community Participation Indicators (CAT-CPI).
Results:
From an eligible pool of 3221 patients, 674 (21%) agreed to complete the CAT-CPI. Patients who agreed to complete the CAT-CPI were younger and reported slightly higher satisfaction with overall care than those who did not participate. Among these patients, 231 (34%) actually completed the CAT-CPI; 141 (61%) selected telephone administration, and 90 (39%) selected Internet administration. Decreased odds of completing the CAT-CPI were associated with black and other race; stroke, brain injury, or orthopedic and other impairments; and being a Medicaid beneficiary, whereas increased odds of completing the CAT-CPI were associated with longer length of stay and higher discharge FIM cognition measure. Decreased odds of choosing Internet administration were associated with younger age, retirement status, and being a woman, whereas increased odds of choosing Internet administration were associated with higher discharge FIM motor measure.
Conclusions:
CAT administration by Internet and telephone has limited feasibility for collecting postrehabilitation outcomes for most rehabilitation patients, but it is feasible for a subset of patients. Providing alternative ways of answering questions helps assure that a larger proportion of patients will respond.
