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Development of a Social Functioning Assessment Using Computerized Adaptive Testing for Patients With Stroke

  • Shih-Chieh Lee
    Affiliations
    School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
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  • Yi-Jing Huang
    Affiliations
    School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
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  • Gong-Hong Lin
    Affiliations
    School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan
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  • Yeh-Tai Chou
    Affiliations
    Department of Psychology, National Chung Cheng University, Chiayi, Taiwan

    Research Center for Psychological and Educational Testing, National Taiwan Normal University, Taipei, Taiwan
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  • Author Footnotes
    ∗ Hsieh and C.-Y. Chou contributed equally to this work.
    Chia-Yeh Chou
    Correspondence
    Corresponding author Chia-Yeh Chou, MA, Department of Occupational Therapy, College of Medicine, Fu-Jen Catholic University, No. 510 Zhong Zheng Rd, Xinzhuang Dist, New Taipei City, 24205 Taiwan.
    Footnotes
    ∗ Hsieh and C.-Y. Chou contributed equally to this work.
    Affiliations
    School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan

    Department of Occupational Therapy, College of Medicine, Fu-Jen Catholic University, Taipei, Taiwan
    Search for articles by this author
  • Author Footnotes
    ∗ Hsieh and C.-Y. Chou contributed equally to this work.
    Ching-Lin Hsieh
    Footnotes
    ∗ Hsieh and C.-Y. Chou contributed equally to this work.
    Affiliations
    School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan

    Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan

    Department of Occupational Therapy, College of Medical and Health Science, Asia University, Taiwan
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  • Author Footnotes
    ∗ Hsieh and C.-Y. Chou contributed equally to this work.
Published:October 06, 2017DOI:https://doi.org/10.1016/j.apmr.2017.08.492

      Abstract

      Objective

      To develop a computerized adaptive test of social functioning (Social-CAT) for patients with stroke.

      Design

      This study contained 2 phases. First, a unidimensional item bank was formed using social-related items with sufficient item fit (ie, infit and outfit mean square [MNSQ]). The social-related items were selected from 3 commonly used patient-reported quality-of-life measures. Items with differential item functioning (DIF) of sex were deleted. Second, we performed simulations to determine the best set of stopping rules with both high reliability and efficiency. The participants' responses to the items were extracted from a previous study.

      Setting

      Rehabilitation wards and departments of rehabilitation/neurology of 5 general hospitals.

      Participants

      Patients (N=263) with stroke (47.1% were inpatients).

      Interventions

      Not applicable.

      Main Outcome Measure

      Social-CAT.

      Results

      The unidimensionality of the 24 selected items was supported (infit and outfit MNSQs =0.8–1.2). One item had DIF of sex and was deleted. The item bank was composed of the remaining 23 items. With the best set of stopping rules (person reliability ≥.90 or limited reliability increased ≤.001), the Social-CAT used on average 10 items to achieve sufficient reliability (average person reliability =.88; 81.0% of the patients with reliability ≥.90).

      Conclusions

      The Social-CAT appears to be a unidimensional measure with acceptable reliability and efficiency, and it could be useful for both clinicians and patients in time-pressed clinical settings.

      Keywords

      List of abbreviations:

      CAT (computerized adaptive testing), DIF (differential item functioning), HRQOL (health-related quality of life), LRI (limited reliability increase), MNSQ (mean square), SIS (Stroke Impact Scale), Social-CAT (computerized adaptive testing of social functioning), SSQOL (Stroke-Specific Quality of Life Scale), WHOQOL-BREF (World Health Organization Quality of Life–Brief Version)
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