title: Improving Inpatient Surveys: Web-Based Computer Adaptive Testing Accessed via Mobile Phone QR Codes.
abstract: BACKGROUND
  The National Health Service (NHS) 70-item inpatient questionnaire surveys inpatients on their perceptions of their hospitalization experience. However, it imposes more burden on the patient than other similar surveys. The literature shows that computerized adaptive testing (CAT) based on item response theory can help shorten the item length of a questionnaire without compromising its precision.
  
  
  OBJECTIVE
  Our aim was to investigate whether CAT can be (1) efficient with item reduction and (2) used with quick response (QR) codes scanned by mobile phones.
  
  
  METHODS
  After downloading the 2008 inpatient survey data from the Picker Institute Europe website and analyzing the difficulties of this 70-item questionnaire, we used an author-made Excel program using the Rasch partial credit model to simulate 1000 patients' true scores followed by a standard normal distribution. The CAT was compared to two other scenarios of answering all items (AAI) and the randomized selection method (RSM), as we investigated item length (efficiency) and measurement accuracy. The author-made Web-based CAT program for gathering patient feedback was effectively accessed from mobile phones by scanning the QR code.
  
  
  RESULTS
  We found that the CAT can be more efficient for patients answering questions (ie, fewer items to respond to) than either AAI or RSM without compromising its measurement accuracy. A Web-based CAT inpatient survey accessed by scanning a QR code on a mobile phone was viable for gathering inpatient satisfaction responses.
  
  
  CONCLUSIONS
  With advances in technology, patients can now be offered alternatives for providing feedback about hospitalization satisfaction. This Web-based CAT is a possible option in health care settings for reducing the number of survey items, as well as offering an innovative QR code access.
authors.affiliation: Chi Mei Medical Center, Taiwan, Research Department, Chi Mei Medical Center, Taiwan, Tainan, Taiwan.
authors.forename: Tsair-Wei
authors.identifier: http://orcid.org/0000-0003-1329-0679
authors.initials: TW
authors.lastname: Chien
authors.forename: Weir-Sen
authors.identifier: http://orcid.org/0000-0001-7745-6100
authors.initials: WS
authors.lastname: Lin
keywords: computer adaptive testing; consultation experience and perception; partial credit model; patients’ experience; smart phone