Reduction in patient burdens with graphical computerized adaptive testing on the ADL scale: tool development and simulation.
BACKGROUND
The aim of this study was to verify the effectiveness and efficacy of saving time and reducing burden for patients, nurses, and even occupational therapists through computer adaptive testing (CAT).


METHODS
Based on an item bank of the Barthel Index (BI) and the Frenchay Activities Index (FAI) for assessing comprehensive activities of daily living (ADL) function in stroke patients, we developed a visual basic application (VBA)-Excel CAT module, and (1) investigated whether the averaged test length via CAT is shorter than that of the traditional all-item-answered non-adaptive testing (NAT) approach through simulation, (2) illustrated the CAT multimedia on a tablet PC showing data collection and response errors of ADL clinical functional measures in stroke patients, and (3) demonstrated the quality control of endorsing scale with fit statistics to detect responding errors, which will be further immediately reconfirmed by technicians once patient ends the CAT assessment.


RESULTS
The results show that endorsed items could be shorter on CAT (M = 13.42) than on NAT (M = 23) at 41.64% efficiency in test length. However, averaged ability estimations reveal insignificant differences between CAT and NAT.


CONCLUSIONS
This study found that mobile nursing services, placed at the bedsides of patients could, through the programmed VBA-Excel CAT module, reduce the burden to patients and save time, more so than the traditional NAT paper-and-pencil testing appraisals.
Chien
Tsair-Wei
TW
Department of Rehabilitation, Chi-Mei Medical Center, Taiwan, ROC. smile@mail.chimei.org.tw
Wu
Hing-Man
HM
Wang
Weng-Chung
WC
Castillo
Roberto Vasquez
RV
Chou
Willy
W
D000203:Activities of Daily Living; D003196:Computer Graphics; D003198:Computer Simulation; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D008297:Male; D019095:Point-of-Care Systems; D015203:Reproducibility of Results; D000071939:Stroke Rehabilitation; D013624:Taiwan; D014481:United States