Does the Mode of PROM Administration Affect the Responses of Hospitalized Patients?

Published:October 01, 2021DOI:



      To determine whether a multidimensional computerized adaptive test, the Functional Assessment in Acute Care Multidimensional Computerized Adaptive Test (FAMCAT), could be administered to hospitalized patients via a tablet computer rather than being orally administered by an interviewer.


      A randomized comparison of the responses of hospitalized patients to interviewer vs tablet delivery of the FAMCAT and its assessment of applied cognition, daily activity, and basic mobility.


      Two quaternary teaching hospitals in the Upper Midwest.


      A total of 300 patients (127 men, 165 women), average age 61.2 (range, 18-97) hospitalized on medical services or rehospitalized on surgical services were randomly assigned to either a tablet (150) or an interview (150) group.


      Electronic tablet vs interview.

      Main Outcome Measures

      Item response theory point estimates of the FAMCAT latent scales, their psychometric standard errors, number of items administered per domain, the determinant (an indicator of overall precision of the latent trait vector), as well as the time that patients required to complete their FAMCAT sessions.


      Of the 300 patients, 292 completed their assessments. The assessments of 4 individuals in each group was interrupted by clinical care and were not included in the analyses. A significant (P=.009) mode effect (ie, interview vs tablet) was identified when all outcome variables were considered simultaneously. However, the only outcome that was affected by the administration mode was test duration: tablet administration reduced the roughly 6-minute test time required by both approaches by only 20 seconds, which, though statistically significant, was clinically insignificant.


      The results of a FAMCAT assessment, at least for this cohort of hospitalized patients, are independent of administration via tablet computer or interview.


      List of abbreviations:

      AM-PAC (Activity Measure for Post-Acute Care), EHR (electronic health record), e-PROM (electronic patient-reported outcome measure), FAMCAT (Functional Assessment in Acute Care Multidimensional Computerized Adaptive Test), IRT (item response theory), MANOVA (multivariate analysis of variance), PAC (post-acute care), PROM (patient-reported outcome measure)
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