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Clinical Manifestations.

Ping-Hsiu Lin1, Jacqueline Wesson2, Minal Tanvir1

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Summary

Computerized measures of instrumental activities of daily living (IADL) show promise for objective assessment. However, significant gaps in psychometric validation hinder their widespread clinical use.

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Area of Science:

  • Gerontology and Cognitive Science
  • Health Informatics and Digital Health
  • Psychometrics and Measurement Science

Background:

  • Instrumental activities of daily living (IADL) are crucial for independent living, with impairments often indicating cognitive decline.
  • Traditional IADL assessments (questionnaires, performance-based) have limitations like reporting bias and resource intensity.
  • Computerized IADL measures offer potential for objective and efficient assessment of functional abilities.

Purpose of the Study:

  • To systematically identify and describe published computerized performance-based IADL measures.
  • To review and synthesize the existing psychometric properties of these identified computerized IADL instruments.
  • To evaluate the quality of evidence for the psychometric properties using the COSMIN checklist.

Main Methods:

  • Systematic literature search conducted across multiple databases (PubMed, EMBASE, Cochrane, PsycINFO, CINAHL) following PRISMA guidelines.
  • Two-stage search strategy: first to identify instruments, second to find studies reporting psychometric properties.
  • Consensus Based Standards for the Selection of Health Measurement Instruments (COSMIN) checklist used for quality assessment.

Main Results:

  • 50 computerized IADL instruments were identified, with 26 evaluated for psychometric properties in 40 studies.
  • Research in this area is growing, with over 50% of studies published in the last 5 years.
  • Construct validity was most frequently assessed, yet half of the instruments showed insufficient construct validity; reliability and internal consistency data were limited, with significant gaps in other psychometric domains.

Conclusions:

  • Computerized IADL assessments are a developing field with potential for efficient and accurate evaluation.
  • Significant research gaps exist regarding crucial psychometric properties like measurement error, cross-cultural validity, criterion validity, and responsiveness.
  • Further rigorous validation across diverse populations and psychometric domains is essential for clinical adoption.