title: Evaluation of the PROMIS physical function computer adaptive test in the upper extremity.
abstract: OBJECTIVE
  To compare psychometric and responder burden characteristics between the Patient-Reported Outcomes Measurement Information System Physical Function Computer Adaptive Test (PF CAT) and the Disabilities of Arm, Shoulder, and Hand (DASH) instruments in a tertiary hand and upper extremity practice.
  
  
  METHODS
  Adult patients who presented to the clinic of 2 hand and upper extremity surgeons in a university-based tertiary care center were enrolled in this study. Participants received the DASH and PF CAT administered via tablet computer. Time to completion was recorded for both the DASH and PF CAT. We conducted statistical analyses to calculate Pearson correlation coefficients between the 2 instruments and performed a Rasch item response theory analysis to determine dimensionality, reliability, ceiling and floor effects, and item bias for each instrument.
  
  
  RESULTS
  A total of 134 patients were included. Time to completion for the DASH was 262 seconds, and for the PF CAT 57 seconds. The instruments had strong correlation (r = 0.726). The item and Pearson reliability were 0.97 and 0.94, respectively, for the DASH and 0.99 and 0.96 for the PF CAT. The DASH and PF CAT had 5% and 5% of unexplained variance, respectively. The DASH exhibited 5% of ceiling effect and 1% floor effect whereas the PF CAT had no ceiling or floor effects.
  
  
  CONCLUSIONS
  The psychometric characteristics of the Patient-Reported Outcomes Measurement Information System PF CAT instrument compared favorably with the DASH in a tertiary upper extremity practice. Patient time burden was significantly reduced with the PF CAT compared with the DASH.
  
  
  METHODS
  Diagnostic III.
authors.affiliation: Department of Orthopedic Surgery, University of Utah, Salt Lake City, UT. Electronic address: andrew.tyser@gmail.com.
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Tyser
authors.affiliation: Department of Orthopedic Surgery, University of Utah, Salt Lake City, UT.
authors.forename: James
authors.initials: J
authors.lastname: Beckmann
authors.affiliation: Department of Orthopedic Surgery, University of Utah, Salt Lake City, UT.
authors.forename: Jeremy D
authors.initials: JD
authors.lastname: Franklin
authors.affiliation: Department of Orthopedic Surgery, University of Utah, Salt Lake City, UT.
authors.forename: Christine
authors.initials: C
authors.lastname: Cheng
authors.affiliation: Department of Orthopedic Surgery, University of Utah, Salt Lake City, UT.
authors.forename: Shirley D
authors.initials: SD
authors.lastname: Hon
authors.affiliation: Department of Orthopedic Surgery, University of Utah, Salt Lake City, UT.
authors.forename: Angela
authors.initials: A
authors.lastname: Wang
authors.affiliation: Department of Orthopedic Surgery, University of Utah, Salt Lake City, UT.
authors.forename: Man
authors.initials: M
authors.lastname: Hung
mesh_terms: D000328:Adult; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D063868:Patient Outcome Assessment; D011594:Psychometrics; D015203:Reproducibility of Results; D057566:Self Report; D013997:Time Factors; D034941:Upper Extremity
keywords: Patient-reported outcomes; computer adaptive testing