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Patient reported outcome measures: from the classics to AI.

Conrad J Harrison1, Ryan W Trickett2

  • 1University Hospital Wales, Cardiff and Vale University Health Board, Cardiff, UK.

The Journal of Hand Surgery, European Volume
|March 27, 2025
PubMed
Summary
This summary is machine-generated.

Classical test theory enabled patient-reported outcome measures in hand surgery. Modern methods like item response theory and artificial intelligence offer advanced quantification of patient traits.

Keywords:
Artificial intelligenceEMCATassessmentcomputerized adaptive testingecological momentary assessmentmonitoringpatient reported outcome measurespatient-reported outcome measuressymptom monitoring

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Area of Science:

  • Orthopedics
  • Psychometrics
  • Health Outcomes Research

Background:

  • Classical test theory (CTT) historically underpinned the development of patient-reported outcome measures (PROMs), particularly in hand surgery.
  • CTT has been instrumental in quantifying subjective patient experiences and surgical outcomes.
  • However, advancements in psychometric modeling necessitate exploring more sophisticated approaches.

Purpose of the Study:

  • To review the evolution of measurement techniques in hand surgery outcome assessment.
  • To compare classical test theory with modern psychometric methods such as item response theory (IRT) and computerized adaptive testing (CAT).
  • To explore the potential impact of artificial intelligence (AI) on future outcome measurement.

Main Methods:

  • This is a review article synthesizing existing literature on measurement theories in health outcomes.
  • It traces the historical progression from CTT to IRT and CAT.
  • It discusses emerging applications of AI in outcome assessment.

Main Results:

  • CTT, while foundational, has limitations in accurately measuring patient-reported outcomes.
  • IRT and CAT offer more precise and efficient measurement of patient traits.
  • AI presents opportunities for personalized outcome prediction and assessment.

Conclusions:

  • The field of patient-reported outcome measures in hand surgery is advancing beyond classical test theory.
  • Modern psychometric approaches like IRT and CAT provide superior tools for quantifying patient outcomes.
  • Artificial intelligence holds significant promise for revolutionizing outcome assessment in the future.