通过计算机自适应测试优化牛津肩部分数,可以减少冗余,同时保持精度
Ahmed Barakat1, Jonathan Evans2,3, Christopher Gibbons4
1University Hospitals of Leicester NHS Trust, Leicester, UK.
Bone & joint research
|August 4, 2024
概括
计算机化适应性测试 (CAT) 显著缩短了用于评估肩部手术的牛津肩部分数 (OSS). 这种量身定制的方法保持了准确性,减少了患者的负担,并改善了对患者报告的结果措施的遵守.
科学领域:
- 整形外科 整形外科 整形外科
- 医疗信息学 医疗信息学
- 心理测量 心理测量 心理测量
背景情况:
- 牛津肩部评分 (OSS) 是一个标准的12项调查问卷,用于评估肩部手术的结果.
- 患者报告的结果测量 (PROM) 对于评估外科手术有效性至关重要.
- 需要更高效和量身定制的评估工具来减少患者的负担.
研究的目的:
- 评估牛津肩部分数 (OSS) 计算机自适应测试 (CAT) 的可行性和准确性.
- 确定CAT是否可以提供缩短,个性化定制的问卷,同时保持完整的OSS的可靠性.
- 评估CAT对患者合规性的影响,并缩短评估时间.
主要方法:
- 使用了来自国家联合注册表 (NJR) 的16238个手术前OSS的大数据集.
- 已确立的项目响应理论 (IRT) 假设:单维性,单调性和局部独立性.
- 模拟CAT,在标准误差 (SE) <0.32和<0.45时使用停止标准,将结果与全部12项OSS进行比较.
主要成果:
- 确认因素分析表明满意的单维性 (RSMSR=0.06),但其他指数的混合适合性 (CFI=0.85,TLI=0.82).
- 单调性 (H=0.482) 和地方独立性被普遍支持.
- 在CAT模拟中,平均需要2-3项 (16-25%的完整问卷) 才能达到目标可靠性水平.
结论:
- 项目响应理论 (IRT) 校准使得OSS的高效,缩短的CAT版本成为可能.
- CAT 保持了完整的 OSS 的准确性和可靠性,为结果评估提供了一个有前途的方法.
- 这种缩短的CAT方法可以减轻患者的时间负担,并可能提高对肩膀手术结果措施的遵守.
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