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首页> 外文期刊>Journal of Hand Surgery. American Volume >Improving Efficiency of Patient-Reported Outcome Collection: Application of Computerized Adaptive Testing to DASH and QuickDASH Outcome Scores
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Improving Efficiency of Patient-Reported Outcome Collection: Application of Computerized Adaptive Testing to DASH and QuickDASH Outcome Scores

机译：提高患者报告的结果收集效率：应用计算机化的自适应测试对划线和QuickDash结果分数的应用

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Purpose Patient-reported outcome measures assess health status and treatment outcomes in orthopedic care, but they may burden patients with lengthy questionnaires. Predictive models using machine learning, known as computerized adaptive testing (CAT), offer a potential solution. This study evaluates the ability of CAT to improve efficiency of the 30-item Disabilities of the Arm, Shoulder, and Hand (DASH) and 11-item QuickDASH questionnaires. Methods A total of 2,860 DASH and 27,355 QuickDASH respondents were included in the analysis. The CAT system was retrospectively applied to each set of patient responses stored on the instrument to calculate a CAT-specific score for all DASH and QuickDASH entries. The accuracy of the CAT scores, viewed in the context of the minimal clinically important difference for both patient-reported outcome measures (DASH, 12; QuickDASH, 9), was determined through descriptive statistics, Pearson correlation coefficient, intraclass correlation coefficient, and distribution of scores and score differences. Results The CAT model required an average of 15.3 questions to be answered for the DASH and 5.8 questions for the QuickDASH, representing a 49% and 47% decrease in question burden, respectively. Mean CAT score was the same for DASH and 0.1 points lower for QuickDASH with similar SDs (DASH, 12.9 +/- 19.8 vs 12.9 +/- 19.9; QuickDASH, 32.7 +/- 24.7 vs 32.6 +/- 24.6). Pearson coefficients (DASH, 0.99; QuickDASH, 0.98) and intraclass correlation coefficients (DASH, 1.0; QuickDASH, 0.98) indicated strong agreement between scores. The difference between the CAT and full score was less than the minimal clinically important difference in 99% of cases for DASH and approximately 95% of cases for QuickDASH. Conclusions The application of CAT to DASH and QuickDASH surveys demonstrated an ability to lessen the response burden with negligible effect on score integrity. Clinical relevance In the case of DASH and QuickDASH, CAT is an appropriate alternative to full questionnaire implementation for patient outcome score collection. Copyright (C) 2021 by the American Society for Surgery of the Hand. All rights reserved.)
机译：目的：患者报告的结果测量评估骨科护理中的健康状况和治疗结果，但它们可能会给患者带来冗长的问卷调查。使用机器学习的预测模型，即计算机自适应测试（CAT），提供了一种潜在的解决方案。本研究评估了CAT提高30项手臂、肩膀和手残疾（短跑）和11项快速短跑问卷效率的能力。方法对2860名DASH和27355名QuickDASH受访者进行分析。回顾性地将CAT系统应用于仪器上存储的每组患者反应，以计算所有短跑和快速短跑条目的CAT特定分数。通过描述性统计、Pearson相关系数、组内相关系数以及分数和分数差异的分布来确定CAT分数的准确性，从两个患者报告的结果指标（DASH，12；QuickDASH，9）的最小临床重要差异的角度来看。结果CAT模型要求短跑平均回答15.3个问题，快速短跑平均回答5.8个问题，分别代表问题负担减少49%和47%。DASH的CAT平均得分与SDs相似，而QuickDASH的CAT平均得分则低0.1分（DASH，12.9+/-19.8 vs 12.9+/-19.9；QuickDASH，32.7+/-24.7 vs 32.6+/-24.6）。皮尔逊系数（DASH，0.99；QuickDASH，0.98）和组内相关系数（DASH，1.0；QuickDASH，0.98）表明分数之间有很强的一致性。在99%的DASH病例和大约95%的QuickDASH病例中，CAT和满分之间的差异小于最小的临床重要差异。结论CAT-to-DASH和QuickDASH调查的应用表明，能够减轻反应负担，但对分数完整性的影响微乎其微。临床相关性在DASH和QuickDASH的情况下，CAT是收集患者结果评分的完整问卷实施的合适替代方案。版权所有（C）2021美国外科学会的手。版权所有。）

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