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The use of computer adaptive tests in outcome assessments following upper limb trauma.

Abstract Aims Outcome measures quantifying aspects of health in a precise, efficient, and user-friendly manner are in demand. Computer adaptive tests (CATs) may overcome the limitations of established fixed scales and be more adept at measuring outcomes in trauma. The primary objective of this review was to gain a comprehensive understanding of the psychometric properties of CATs compared with fixed-length scales in the assessment of outcome in patients who have suffered trauma of the upper limb. Study designs, outcome measures and methodological quality are defined, along with trends in investigation. Materials and Methods A search of multiple electronic databases was undertaken on 1 January 2017 with terms related to "CATs", "orthopaedics", "trauma", and "anatomical regions". Studies involving adults suffering trauma to the upper limb, and undergoing any intervention, were eligible. Those involving the measurement of outcome with any CATs were included. Identification, screening, and eligibility were undertaken, followed by the extraction of data and quality assessment using the Consensus-Based Standards for the Selection of Health Measurement Instruments (COSMIN) criteria. The review is reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and reg istered (PROSPERO: CRD42016053886). Results A total of 31 studies reported trauma conditions alone, or in combination with non-traumatic conditions using CATs. Most were cross-sectional with varying level of evidence, number of patients, type of study, range of conditions and methodological quality. CATs correlated well with fixed scales and had minimal or no floor-ceiling effects. They required significantly fewer questions and/or less time for completion. Patient-Reported Outcomes Measurement Information System (PROMIS) CATs were the most frequently used, and the use of CATs is increasing. Conclusion Early studies show valid and reliable outcome measurement with CATs performing as well as, if not better than, established fixed scales. Superior properties such as floor-ceiling effects and ease of use support their use in the assessment of outcome after trauma. As CATs are being increasingly used in patient outcomes research, further psychometric evaluation, especially involving longitudinal studies and groups of patients with specific injuries are required to inform clinical practice using these contemporary measures. Cite this article: Bone Joint J 2018;100-B:693-702.
PMID
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Authors

Mayor MeshTerms
Keywords

Computer adaptive testing

Systematic review

Trauma

Upper extremity

Journal Title the bone & joint journal
Publication Year Start




PMID- 29855231
OWN - NLM
STAT- MEDLINE
DCOM- 20180612
LR  - 20180612
IS  - 2049-4408 (Electronic)
IS  - 2049-4394 (Linking)
VI  - 100-B
IP  - 6
DP  - 2018 Jun 1
TI  - The use of computer adaptive tests in outcome assessments following upper limb
      trauma.
PG  - 693-702
LID - 10.1302/0301-620X.100B6.BJJ-2017-1349.R1 [doi]
AB  - Aims Outcome measures quantifying aspects of health in a precise, efficient, and 
      user-friendly manner are in demand. Computer adaptive tests (CATs) may overcome
      the limitations of established fixed scales and be more adept at measuring
      outcomes in trauma. The primary objective of this review was to gain a
      comprehensive understanding of the psychometric properties of CATs compared with 
      fixed-length scales in the assessment of outcome in patients who have suffered
      trauma of the upper limb. Study designs, outcome measures and methodological
      quality are defined, along with trends in investigation. Materials and Methods A 
      search of multiple electronic databases was undertaken on 1 January 2017 with
      terms related to "CATs", "orthopaedics", "trauma", and "anatomical regions".
      Studies involving adults suffering trauma to the upper limb, and undergoing any
      intervention, were eligible. Those involving the measurement of outcome with any 
      CATs were included. Identification, screening, and eligibility were undertaken,
      followed by the extraction of data and quality assessment using the
      Consensus-Based Standards for the Selection of Health Measurement Instruments
      (COSMIN) criteria. The review is reported according to the Preferred Reporting
      Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria and reg istered 
      (PROSPERO: CRD42016053886). Results A total of 31 studies reported trauma
      conditions alone, or in combination with non-traumatic conditions using CATs.
      Most were cross-sectional with varying level of evidence, number of patients,
      type of study, range of conditions and methodological quality. CATs correlated
      well with fixed scales and had minimal or no floor-ceiling effects. They required
      significantly fewer questions and/or less time for completion. Patient-Reported
      Outcomes Measurement Information System (PROMIS) CATs were the most frequently
      used, and the use of CATs is increasing. Conclusion Early studies show valid and 
      reliable outcome measurement with CATs performing as well as, if not better than,
      established fixed scales. Superior properties such as floor-ceiling effects and
      ease of use support their use in the assessment of outcome after trauma. As CATs 
      are being increasingly used in patient outcomes research, further psychometric
      evaluation, especially involving longitudinal studies and groups of patients with
      specific injuries are required to inform clinical practice using these
      contemporary measures. Cite this article: Bone Joint J 2018;100-B:693-702.
FAU - Jayakumar, P
AU  - Jayakumar P
AD  - Nuffield Orthopaedic Centre, Headington, Oxford, UK.
FAU - Overbeek, C
AU  - Overbeek C
AD  - Leiden University Medical Center, Leiden, The Netherlands.
FAU - Vranceanu, A-M
AU  - Vranceanu AM
AD  - Massachusetts General Hospital and Harvard Medical School, Massachusetts, USA.
FAU - Williams, M
AU  - Williams M
AD  - Oxford Brookes University, Headington, Oxford, UK.
FAU - Lamb, S
AU  - Lamb S
AD  - Nuffield Orthopaedic Centre, Headington, Oxford, UK.
FAU - Ring, D
AU  - Ring D
AD  - Department of Surgery and Perioperative Care, Dell Medical School, The University
      of Texas at Austin, Austin, Texas, USA.
FAU - Gwilym, S
AU  - Gwilym S
AD  - Nuffield Orthopaedic Centre, Headington, Oxford, UK.
LA  - eng
PT  - Journal Article
PT  - Review
PL  - England
TA  - Bone Joint J
JT  - The bone & joint journal
JID - 101599229
SB  - AIM
SB  - IM
MH  - Adult
MH  - Arm Injuries/*diagnosis
MH  - Diagnosis, Computer-Assisted/*methods
MH  - Humans
MH  - Outcome Assessment (Health Care)/*methods
MH  - Psychometrics/*methods
MH  - Upper Extremity/injuries
OTO - NOTNLM
OT  - Computer adaptive testing
OT  - Systematic review
OT  - Trauma
OT  - Upper extremity
EDAT- 2018/06/02 06:00
MHDA- 2018/06/13 06:00
CRDT- 2018/06/02 06:00
PHST- 2018/06/02 06:00 [entrez]
PHST- 2018/06/02 06:00 [pubmed]
PHST- 2018/06/13 06:00 [medline]
AID - 10.1302/0301-620X.100B6.BJJ-2017-1349.R1 [doi]
PST - ppublish
SO  - Bone Joint J. 2018 Jun 1;100-B(6):693-702. doi:
      10.1302/0301-620X.100B6.BJJ-2017-1349.R1.