Test-Retest Reliability and Responsiveness of the Computerized Adaptive Testing System of the Functional Assessment of Stroke

Po-Ting Chen; Shih-Chie Lee; Tzu-Yi Wu; Meng-Lin Lee; Ching-Lin Hsieh

doi:10.1016/j.apmr.2023.06.017

Test-Retest Reliability and Responsiveness of the Computerized Adaptive Testing System of the Functional Assessment of Stroke

Arch Phys Med Rehabil. 2023 Oct;104(10):1676-1682. doi: 10.1016/j.apmr.2023.06.017. Epub 2023 Jul 5.

Authors

Po-Ting Chen¹, Shih-Chie Lee², Tzu-Yi Wu³, Meng-Lin Lee⁴, Ching-Lin Hsieh⁵

Affiliations

¹ Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien, Taiwan; School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
² School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Occupational Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Institute of Long-Term Care, MacKay Medical College, New Taipei City, Taiwan; Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
³ Department of Occupational Therapy, College of Medical and Health Sciences, Asia University, Taichung, Taiwan.
⁴ Division of Cardiovascular Surgery, Department of Surgery, Cathay General Hospital, Taipei, Taiwan.
⁵ School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Occupational Therapy, College of Medical and Health Sciences, Asia University, Taichung, Taiwan; Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: clhsieh@ntu.edu.tw.

PMID: 37419234
DOI: 10.1016/j.apmr.2023.06.017

Abstract

Objective: To examine the test-retest reliability, responsiveness, and clinical utility of the Computerized Adaptive Testing System of the Functional Assessment of Stroke (CAT-FAS) in persons with stroke.

Design: Repeated measurements design.

Setting: A department of rehabilitation in a medical center.

Participants: 30 persons with chronic stroke (for test-retest reliability) and 65 persons with subacute stroke (for responsiveness) were recruited. To examine the test-retest reliability, the participants received measurements twice at 1-month intervals. To examine the responsiveness, the data were collected at admission and discharge from hospital.

Interventions: Not applicable.

Main outcome measurement tool: CAT-FAS.

Results: The intra-class correlation coefficients of the CAT-FAS were ≥0.82, indicating good to excellent test-retest reliability. The Kazis' effect size and standardized response mean of the CAT-FAS were ≥0.96, indicating good group-level responsiveness. For individual-level responsiveness, approximately two-thirds of the participants exceeded the conditional minimal detectable change. On average, the CAT-FAS was completed within 9 items and 3 minutes per administration.

Conclusions: Our results suggest the CAT-FAS is an efficient measurement tool with good to excellent test-retest reliability and responsiveness. In addition, the CAT-FAS can be used routinely in clinical settings to monitor progress of the crucial 4 domains for persons with stroke.

Keywords: Clinical utility; Computerized adaptive testing system; Rehabilitation; Responsiveness; Stroke; Test-retest reliability.