Feasibility of computerized adaptive testing for collection of patient-reported outcomes after inpatient rehabilitation.
OBJECTIVE
To evaluate the feasibility of computer adaptive testing (CAT) using an Internet or telephone interface to collect patient-reported outcomes after inpatient rehabilitation and to examine patient characteristics associated with completion of the CAT-administered measure and mode of administration.


DESIGN
Prospective cohort study of patients contacted approximately 4 weeks after discharge from inpatient rehabilitation. Patients selected an Internet or telephone interface.


SETTING
Rehabilitation hospital.


PARTICIPANTS
Patients (N=674) with diagnoses of neurologic, orthopedic, or medically complex conditions.


INTERVENTIONS
None.


MAIN OUTCOME MEASURE
CAT version of the Community Participation Indicators (CAT-CPI).


RESULTS
From an eligible pool of 3221 patients, 674 (21%) agreed to complete the CAT-CPI. Patients who agreed to complete the CAT-CPI were younger and reported slightly higher satisfaction with overall care than those who did not participate. Among these patients, 231 (34%) actually completed the CAT-CPI; 141 (61%) selected telephone administration, and 90 (39%) selected Internet administration. Decreased odds of completing the CAT-CPI were associated with black and other race; stroke, brain injury, or orthopedic and other impairments; and being a Medicaid beneficiary, whereas increased odds of completing the CAT-CPI were associated with longer length of stay and higher discharge FIM cognition measure. Decreased odds of choosing Internet administration were associated with younger age, retirement status, and being a woman, whereas increased odds of choosing Internet administration were associated with higher discharge FIM motor measure.


CONCLUSIONS
CAT administration by Internet and telephone has limited feasibility for collecting postrehabilitation outcomes for most rehabilitation patients, but it is feasible for a subset of patients. Providing alternative ways of answering questions helps assure that a larger proportion of patients will respond.
['Wong|Alex W K|AW|', 'Heinemann|Allen W|AW|', 'Miskovic|Ana|A|', 'Semik|Patrick|P|', 'Snyder|Thomas M|TM|']
D000203:Activities of Daily Living D000222:Adaptation, Physiological D000368:Aged D003199:Computer Systems D005163:Factor Analysis, Statistical D005240:Feasibility Studies D005260:Female D005500:Follow-Up Studies D006801:Humans D007297:Inpatients D020407:Internet D008297:Male D008875:Middle Aged D017063:Outcome Assessment, Health Care D010351:Patient Discharge D011446:Prospective Studies D012046:Rehabilitation D019467:Subacute Care D011795:Surveys and Questionnaires
Rehabilitation Outcome assessment (health care)