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Computerized Adaptive Tests: Efficient and Precise Assessment of the Patient-Centered Impact of Diabetic Retinopathy
- Source :
- Translational Vision Science & Technology
- Publication Year :
- 2020
- Publisher :
- Association for Research in Vision and Ophthalmology (ARVO), 2020.
-
Abstract
- Purpose: Evaluate efficiency, precision, and validity of RetCAT, which comprises ten diabetic retinopathy (DR) quality of life (QoL) computerized adaptive tests (CATs). Methods: In this cross-sectional clinical study, 183 English and/or Mandarin-speaking participants with DR (mean age ± standard deviation [SD] 56.4 ± 11.9 years; 38% proliferative DR [worse eye]) were recruited from retinal clinics in Singapore. Participants answered the RetCAT tests (Symptoms, Activity Limitation, Mobility, Emotional, Health Concerns, Social, Convenience, Economic, Driving, and Lighting), which were capped at seven items each, and other questionnaires, and underwent eye tests. Our primary evaluation focused on RetCAT efficiency (i.e. standard error of measurement [SEM] ± SD achieved and time needed to complete each CAT). Secondary evaluations included an assessment of RetCAT's test precision and validity Results: Mean SEM across all RetCAT tests was 0.351, ranging from 0.272 ± 0.130 for Economic to 0.484 ± 0.130 for Emotional. Four tests (Mobility, Social, Convenience, and Driving) had a high level of measurement error. The median time to take each RetCAT test was 1.79 minutes, ranging from 1.12 (IQR [interquartile range] 1.63) for Driving to 3.28 (IQR 2.52) for Activity Limitation. Test precision was highest for participants at the most impaired end of the spectrum. Most RetCAT tests displayed expected correlations with other scales (convergent/divergent validity) and were sensitive to DR and/or vision impairment severity levels (criterion validity) Conclusions: RetCAT can provide efficient, precise, and valid measurement of DR-related QoL impact. Future application of RetCAT will employ a stopping rule based on SE rather than number of items to ensure that all tests can detect meaningful differences in person abilities. Responsiveness of RetCAT to treatment interventions must also be determined Translational Relevance: RetCAT may be useful for measuring the patient-centered impact of DR severity and disease progression and evaluating the effectiveness of new therapies Refereed/Peer-reviewed
- Subjects :
- computerized adaptive testing
0301 basic medicine
medicine.medical_specialty
Biomedical Engineering
Item bank
Article
03 medical and health sciences
0302 clinical medicine
Quality of life
Interquartile range
Patient-Centered Care
vision impairment
Diabetes Mellitus
Criterion validity
Humans
Medicine
item banks
Singapore
Rasch model
business.industry
Discriminant validity
diabetic retinopathy
Ophthalmology
Cross-Sectional Studies
030104 developmental biology
Standard error
quality of life
030221 ophthalmology & optometry
Physical therapy
Computerized adaptive testing
business
Subjects
Details
- ISSN :
- 21642591
- Volume :
- 9
- Database :
- OpenAIRE
- Journal :
- Translational Vision Science & Technology
- Accession number :
- edsair.doi.dedup.....738c94c309f83f8db9e7c1278fb183ba