TY - JOUR
T1 - Computerised adaptive testing accurately predicts CLEFT-Q scores by selecting fewer, more patient-focused questions
AU - Harrison, Conrad J.
AU - Geerards, Daan
AU - Ottenhof, Maarten J.
AU - Klassen, Anne F.
AU - Riff, Karen W.Y.Wong
AU - Swan, Marc C.
AU - Pusic, Andrea L.
AU - Sidey-Gibbons, Chris J.
N1 - Publisher Copyright:
© 2019 British Association of Plastic, Reconstructive and Aesthetic Surgeons
PY - 2019/11
Y1 - 2019/11
N2 - Background: The International Consortium for Health Outcome Measurement (ICHOM) has recently agreed upon a core outcome set for the comprehensive appraisal of cleft care, which puts a greater emphasis on patient-reported outcome measures (PROMs) and, in particular, the CLEFT-Q. The CLEFT-Q comprises 12 scales with a total of 110 items, aimed to be answered by children as young as 8 years old. Objective: In this study, we aimed to use computerised adaptive testing (CAT) to reduce the number of items needed to predict results for each CLEFT-Q scale. Method: We used an open-source CAT simulation package to run item responses over each of the full-length scales and its CAT counterpart at varying degrees of precision, estimated by standard error (SE). The mean number of items needed to achieve a given SE was recorded for each scale's CAT, and the correlations between results from the full-length scales and those predicted by the CAT versions were calculated. Results: Using CATs for each of the 12 CLEFT-Q scales, we reduced the number of questions that participants needed to answer, that is, from 110 to a mean of 43.1 (range 34–60, SE < 0.55) while maintaining a 97% correlation between scores obtained with CAT and full-length scales. Conclusions: CAT is likely to play a fundamental role in the uptake of PROMs into clinical practice given the high degree of accuracy achievable with substantially fewer items.
AB - Background: The International Consortium for Health Outcome Measurement (ICHOM) has recently agreed upon a core outcome set for the comprehensive appraisal of cleft care, which puts a greater emphasis on patient-reported outcome measures (PROMs) and, in particular, the CLEFT-Q. The CLEFT-Q comprises 12 scales with a total of 110 items, aimed to be answered by children as young as 8 years old. Objective: In this study, we aimed to use computerised adaptive testing (CAT) to reduce the number of items needed to predict results for each CLEFT-Q scale. Method: We used an open-source CAT simulation package to run item responses over each of the full-length scales and its CAT counterpart at varying degrees of precision, estimated by standard error (SE). The mean number of items needed to achieve a given SE was recorded for each scale's CAT, and the correlations between results from the full-length scales and those predicted by the CAT versions were calculated. Results: Using CATs for each of the 12 CLEFT-Q scales, we reduced the number of questions that participants needed to answer, that is, from 110 to a mean of 43.1 (range 34–60, SE < 0.55) while maintaining a 97% correlation between scores obtained with CAT and full-length scales. Conclusions: CAT is likely to play a fundamental role in the uptake of PROMs into clinical practice given the high degree of accuracy achievable with substantially fewer items.
KW - CLEFT-Q
KW - Computerised adaptive testing
KW - Computerized adaptive testing, CAT
KW - PROM
KW - Patient-reported outcome, PRO
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U2 - 10.1016/j.bjps.2019.05.039
DO - 10.1016/j.bjps.2019.05.039
M3 - Article
C2 - 31358447
AN - SCOPUS:85069747206
SN - 1748-6815
VL - 72
SP - 1819
EP - 1824
JO - Journal of Plastic, Reconstructive and Aesthetic Surgery
JF - Journal of Plastic, Reconstructive and Aesthetic Surgery
IS - 11
ER -