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Computerized Adaptive Testing System of Functional Assessment of Stroke
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Computerized Adaptive Testing in Pediatric Brain Tumor Clinics.

Jin-Shei Lai1, Jennifer L Beaumont2, Cindy J Nowinski2

  • 1Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA; Pediatrics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Journal of Pain and Symptom Management
|August 12, 2017
PubMed
Summary

Computerized adaptive testing (CAT) and short forms show comparable scores for brain tumor patients, though CATs offer more individualized longitudinal monitoring. Both methods are brief and precise for clinical use.

Keywords:
ChildrenPROMISbrain tumorcomputerized adaptive testing (CAT)patient-centered outcomes

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Area of Science:

  • Oncology
  • Psychometrics
  • Health Outcomes Research

Background:

  • Monitoring health-related quality of life and symptoms in brain tumor patients is crucial but challenging due to assessment burden.
  • Brief, precise, and easily integrated assessments are needed for routine clinical use.
  • Computerized adaptive testing (CAT) and static short forms offer potential solutions derived from item banks.

Purpose of the Study:

  • To evaluate the comparability of scores obtained from CATs and static short forms.
  • To assess the feasibility of using these brief assessments in clinical settings for brain tumor patients.

Main Methods:

  • 161 patients (ages 7-22) with brain tumors completed Patient-Reported Outcome Measurement Information System (PROMIS) CATs and short forms.
  • Assessments included Fatigue, Mobility, Upper Extremity, Depressive Symptoms, Anxiety, and Peer Relationships.
  • Statistical analyses included Pearson correlations, paired t-tests, and Cohen's d to compare scores.

Main Results:

  • CATs were completed within 2 minutes, demonstrating high correlation with short forms (r = 0.95-0.98).
  • Significant score differences were found in 4 of 6 domains, but with negligible effect sizes (|d| < 0.09).
  • Score agreement varied with symptom severity, influenced by ceiling effects in static short forms.

Conclusions:

  • CATs and short forms demonstrate score comparability for brain tumor patients.
  • CATs are recommended for individualized longitudinal monitoring due to better handling of symptom severity variations.
  • These brief assessments enhance the feasibility of routine quality of life and symptom monitoring in clinical practice.