Name: computerized adaptive testing system of functional assessment of stroke
Uploaded: 2019-01-07T14:00:00
Description: Watch this Scientific Journal Video about Computerized Adaptive Testing System of Functional Assessment of Stroke at JoVE.com

This study was supported by research grants from the Ministry of Science and Technology (105-2314-B-002 -015 -MY3).

This study protocol was approved by a local institutional review board, and all patients gave informed consent.
1. Development of the CAT-FAS
<ol>
	<li>Retrieve the secondary and encrypted data from the FAS study14 to conduct simulations (Supplementary File 1: Appendix 2). 
	NOTE: In the study, a total of 301 patients were recruited froma rehabilitation ward of a medical center and assessed at 14 d after stroke onset. Among the 301 patients, 262 ...

<ol>
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The results presented here showed that the CAT-FAS administered about 10% of the items in the original tests (the average number of items used in the CAT-FAS: 8.5 items vs. the original tests: 72 items). These findings indicate that the CAT-FAS has good administrative efficiency. The results were in line with previous studies, which reported that a CAT administered only about 10 items or less to assess social function, balance, or activities of daily living in patients with stroke10,...

Dysfunctions of the upper and lower extremities (UE and LE), postural control, and basic activities of daily living (BADL) are major sequelae of stroke1,2,3. The assessment of these four functions in patients with stroke is fundamental for clinicians to evaluate patients' levels of dysfunctions, set treatment goals and plans, and monitor the longitudinal trajectories of these functions.
The Fugl-Meyer Assessment (FM),4 the Postural Assessment Scale for Stroke patients (PASS),5 and the Barthel Index (BI)6 have good psychometric properties to assess the UE/LE motor functions, postural control, and BADL, respectively, in patients with stroke7,8,9. However, the total of 72 items from these three measures impedes the feasibility of assessing all three measures within a time-limited therapeutic session. A more efficient testing method is warranted. Computerized adaptive testing (CAT) is a modern measurement method. Compared with conventional measurement methods, CAT provides a more reliable estimate of the examinee's level of function in much less time10,11,12. In conventional measurement methods, each examinee receives the same test form (or item sets), in which many items are too difficult or too easy for the examinee. These items provide limited information for estimating the examinee's level of function and are time-intensive for examinees. In contrast, in CAT, each examinee gets a tailored item set, in which the difficulty level of the selected items meets the function level of the examinee. Because these items are tailored for that particular examinee, CAT can provide a more reliable estimate of the examinee's level of function with fewer items and, thus, in much less time. The steps of CAT development are shown in Supplementary File 1: Appendix 1.
Because CAT promises reliable and efficient assessments, the CAT-FAS was developed to improve the administrative efficiency of the three measures previously used (FM, PASS, and BI)13. This paper describes the development and administration of the CAT-FAS. This protocol provides information for researchers to develop their CATs and for prospective users of the CAT-FAS to administer it. We also address the strengths and weaknesses of the CAT-FAS.

<table border="0" cellpadding="0" cellspacing="0" style="width:873px;" width="873">
	<tbody>
		<tr height="40">
			<td height="40" style="height:40px;width:223px;">Computer</td>
			<td style="width:125px;">Any</td>
			<td style="width:353px;"></td>
			<td style="width:172px;">Compatible with software listed below</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">MATLAB software</td>
			<td>The MathWorks Inc.</td>
			<td>http://www.mathworks.com/products/matlab/</td>
			<td>Numerical computing software, which is used in the Protocol Section 1 (Step 1.3)</td>
		</tr>
		<tr height="40">
			<td height="40" style="height:40px;">Java Development Kit</td>
			<td>Oracle</td>
			<td>https://www.oracle.com/java/</td>
			<td>Programming language, which is used in the Protocol Section 1 (Step 1.5)</td>
		</tr>
	</tbody>
</table>

computerized adaptive testing system of functional assessment of stroke

The computerized adaptive testing system of the functional assessment of stroke (CAT-FAS) can simultaneously assess four functions (motor functions of the upper and lower extremities, postural control, and basic activities of daily living) with sufficient reliability and administrative efficiency. CAT, a modern measurement method, aims to provide a reliable estimate of the examinee's level of function rapidly. CAT administers only a few items whose item difficulties match an examinee's level of function and, thus, the administered items of CAT can provide sufficient information to reliably estimate the examinee's level of function in a short time. The CAT-FAS was developed through four steps: (1) determining the item bank, (2) determining the stopping rules, (3) validating the CAT-FAS, and (4) establishing a platform of online administration. The results of this study indicate that the CAT-FAS has sufficient administrative efficiency (average number of items = 8.5) and reliability (group-level Rasch reliability: 0.88 - 0.93; individual-level Rasch reliability: &#8805;70% of patients had Rasch reliability score &#8805;0.90) to simultaneously assess four functions in patients with stroke. In addition, because the CAT-FAS is a computer-based test, the CAT-FAS has three additional advantages: the automatic calculation of scores, the immediate storage of data, and the easy exporting of data. These advantages of the CAT-FAS will be beneficial to data management for clinicians and researchers.

The results of the simulation showed that the 10 candidate sets of stopping rules had sufficient average Rasch reliability (0.86 - 0.95) and varied administrative efficiency (the average number of items = 6.4 - 17.5). Considering the trade-off between reliability and administrative efficiency, the set of LRI &#60; 0.010 was selected as the optimal set of stopping rules for the CAT-FAS because of its sufficient average Rasch reliability (0.88 - 0.93, see Table 1</s...

Watch this Scientific Journal Video about Computerized Adaptive Testing System of Functional Assessment of Stroke at JoVE.com

Computerized Adaptive Testing System of Functional Assessment of Stroke

Here, we present a protocol to develop the computerized adaptive testing system of the functional assessment of stroke (CAT-FAS). The CAT-FAS can simultaneously assess four functions (two motor functions [upper and lower extremities], postural control, and basic activities of daily living) with sufficient reliability and administrative efficiency.

The computerized adaptive testing system of the functional assessment of stroke (CAT-FAS) can simultaneously assess four functions (motor functions of the ...

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