title: Acceptance of New Technology: A Usability Test of a Computerized Adaptive Test for Fatigue in Rheumatoid Arthritis.
abstract: BACKGROUND
  Little is known about the acceptance and usability of computerized adaptive tests (CATs) among patients with rheumatoid arthritis (RA). The main difference between completing a CAT and a traditional questionnaire concerns item presentation. CATs only provide one item at a time on the screen, and skipping forward or backward to review and change already given answers is often not possible.
  
  
  OBJECTIVE
  The objective of this study was to examine how patients with RA experience a Web-based CAT for fatigue.
  
  
  METHODS
  In individual sessions, participants filled in the CAT while thinking aloud, and were subsequently interviewed about their experience with the new instrument. The technology acceptance model (TAM) was used to structure the results.
  
  
  RESULTS
  The participants were 15 patients with RA. They perceived the CAT as clear, brief, and easy to use. They were positive about answering one question per screen, the changing response options, layout, progress bar, and item number. There were 40% (6/15) of the participants that also mentioned that they experienced the completion of the CAT as useful and pleasant, and liked the adaptive test mechanism. However, some participants noted that not all items were applicable to everybody, and that the wordings of questions within the severity dimension were often similar.
  
  
  CONCLUSIONS
  Participants perceived the "CAT Fatigue RA" as easy to use, and also its usefulness was expressed. A 2.0 version has been improved according to the participants' comments, and is currently being used in a validation study before it will be implemented in daily clinical practice. Our results give a first indication that CAT methodology may outperform traditional questionnaires not merely on measurement precision, but also on usability and acceptance valuation.
authors.affiliation: University of Twente, Department of Psychology, Health & Technology, Enschede, Netherlands.
authors.forename: Stephanie
authors.identifier: http://orcid.org/0000-0003-2646-2396
authors.initials: S
authors.lastname: Nikolaus
authors.forename: Christina
authors.identifier: http://orcid.org/0000-0002-1641-8028
authors.initials: C
authors.lastname: Bode
authors.forename: Erik
authors.identifier: http://orcid.org/0000-0002-9822-4488
authors.initials: E
authors.lastname: Taal
authors.forename: Harald E
authors.identifier: http://orcid.org/0000-0003-3792-7718
authors.initials: HE
authors.lastname: Vonkeman
authors.forename: Cees Aw
authors.identifier: http://orcid.org/0000-0001-6531-5503
authors.initials: CA
authors.lastname: Glas
authors.forename: Mart Afj
authors.identifier: http://orcid.org/0000-0001-9260-5741
authors.initials: MA
authors.lastname: van de Laar
keywords: computerized adaptive test (CAT); fatigue; rheumatoid arthritis; technology acceptance; usability test