Abstract
BackgroundThe intent of this study was to examine and compare the ability to detect change of two patient reported outcome (PRO) instruments that use a computerized adaptive test (CAT) approach to measurement. The Patient Reported Outcomes Measurement Information System (PROMIS®) Physical Function scale is a generic PRO, while the Osteoarthritis Computerized Adaptive Test (OA-CAT) is an osteoarthritis-specific PRO.MethodsThis descriptive, longitudinal study was conducted in a community setting, involving individuals from the greater Boston area. Inclusion criteria: age > 50, self-reported doctor-diagnosed knee osteoarthritis (OA) and knee pain. The PROMIS® Physical Function CAT and OA-CAT Functional Difficulty scale were administered at baseline and at the conclusion of a 6-week exercise program. Effect sizes (ES) were calculated for both measures, and bootstrap methods were used to construct confidence intervals and to test for significant ES differences between the measures.ResultsThe OA-CAT Functional Difficulty scale achieved an ES of 0.62 (0.43, 0.87) compared to the PROMIS® Physical Function CAT ES of 0.42 (0.24, 0.63). ES estimates for the two CAT measures were not statistically different.ConclusionsThe condition-specific OA-CAT and generic PROMIS® Physical Function CAT both demonstrated the ability to detect change in function. While the OA-CAT scale showed larger effect size, no statistically significant difference was found in the effect size estimates for the generic and condition-specific CATs. Both CATs have potential for use in arthritis research.Trial registrationThis trial is registered with ClinicalTrials.gov on 6/21/11 (Identifier NCT01394874)
Highlights
The intent of this study was to examine and compare the ability to detect change of two patient reported outcome (PRO) instruments that use a computerized adaptive test (CAT) approach to measurement
Demographic characteristics of the sample are not statistically different for those enrolled at baseline and those who completed the 6-week exercise program, except for the percent of the sample identified as obese, which was significantly lower for exercise program completers
This study compared the relative ability of two PROs – Osteoarthritis Computerized Adaptive Test (OA-CAT) Functional Difficulty (FD), an OA-specific measure, and the PROMIS® Physical Function (PF) CAT, a generic measure – in a sample of adults at risk of knee OA who completed in an exercise program designed to improve physical function
Summary
The intent of this study was to examine and compare the ability to detect change of two patient reported outcome (PRO) instruments that use a computerized adaptive test (CAT) approach to measurement. Measures are constrained to a limited number of items, often lacking coverage of the broad range of ability typically observed in patient populations [5,6,7]. This limitation of fixed-form PRO measures raises concerns about the loss of score precision and the reduced ability to measure clinically meaningful change [8, 9]. These measures require respondents to answer every question even though some may be redundant and inappropriate for an individual [10,11,12]
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