Accuracy and Validity of Computer Adaptive Testing for Outcome Assessment in Patients Undergoing Total Knee Arthroplasty.

The Journal of Arthroplasty
Samik BanerjeeP Maxwell Courtney

Abstract

Computerized adaptive test (CAT) questionnaires may allow standardization of patient-reported outcome measures and reductions in questionnaire burden. We evaluated the validity, accuracy, and efficacy of a CAT system in patients with end-stage osteoarthritis undergoing total knee arthroplasty. CAT Knee Osteoarthritis Outcome Scores (KOOS) and CAT KOOS-JR questionnaires were applied to 1871 standard form KOOS and 1493 KOOS-JR patient responses, respectively. Mean, standard deviations, Pearson's correlation coefficients, interclass correlation coefficients (ICCs), frequency distribution plots, and Bland-Altman plots were used to compare the precision, validity, and accuracy between CAT scores and full-form scores. There was a mean reduction of 14 questions (33%) in the CAT KOOS and 1.4 questions (20%) with the CAT KOOS-JR version, compared with the standard KOOS and KOOS-JR surveys, respectively. There were no significant differences between KOOS and CAT KOOS scores with respect to pain (P = .66), symptoms (P = .43), quality of life (P = .99), activities of daily living (P = .68), and sports (P = .84). Similarly, there were no significant differences between the standard form KOOS-JR and CAT KOOS-JR scores (P = .94). There were s...Continue Reading

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