Computerized adaptive testing for PRWHE measurements using domains of pain and motor function

Area of Science:

• Orthopedics
• Rehabilitation Medicine
• Psychometrics

Background:

• The Patient-Rated Wrist and Hand Evaluation (PRWHE) is a common tool for assessing wrist and hand conditions.
• Optimizing outcome measures is crucial for efficient clinical assessment and research.

Purpose of the Study:

• To evaluate the structural validity of the PRWHE.
• To develop computerized adaptive testing (CAT) algorithms for the PRWHE.
• To assess the precision and comparability of CAT versions to the full PRWHE.

Main Methods:

• Psychometric techniques, including factor analysis, were used to examine the PRWHE's structure.
• Computerized adaptive testing algorithms were developed based on identified health constructs.
• Bland-Altman analysis was employed to compare scores from CAT versions and the full PRWHE.

Main Results:

• Factor analysis identified two primary constructs: 'Pain' and 'Motor Function'.
• CAT versions significantly reduced the number of items required for assessment (Pain: 5 to 1 item; Motor Function: 10 to 2 items).
• Both CAT versions demonstrated high precision (SEM <0.3) and comparable scores to the full PRWHE.

Conclusions:

• The PRWHE can be effectively divided into 'Pain' and 'Motor Function' subscales.
• CAT versions of the PRWHE offer a more efficient and standardized outcome measurement.
• These optimized measures provide precise patient symptom insights and reduce patient response burden.