Computerized Adaptive Testing System of Functional Assessment of Stroke

The overall goal of this test development study is to develop a computerized adaptive testing system to assess the functions of the upper extremity, lower extremity, balance, and activities of daily living in stroke patients. No other tractive efficiency is found in assessing the functions of upper extremity, lower extremity, balance, and activities of daily living with patients of stroke. The computerized adaptive testing of the functional assessment of stroke was developed to improve the tractive efficiency of the full functions in patients with stroke.

Begin by retrieving the secondary and encrypted data from the functional assessment of stroke study to conduct a simulation. In this study, 301 patients were recruited from a medical center rehabilitation ward, and assessed at 14 days post-stroke onset. In each assessment session, patients were assessed by a well-trained occupational therapist using the Fugl Meyer Assessment, the Postural Assessment Scale for Stroke Patients, and the Barthel Index.

Establish an item bank for the testing system by adopting the bank from the study. Retrieve the item difficulties of all items in the bank, as well as each patient's responses. Also retrieve the ability distribution of the patient's for four functions.

Upper extremity motor function, lower extremity motor function, postural control, and basic activities of daily living. Then, determine the operational algorithms for the testing system. Next, adopt the maximum of Posteriori Method for estimating each patient's scores of the four functions with Newton Wraps and iteration, then use the criterion of D optimality for the items selection, select an item with the maximum determinant of the Fischer information matrix from the item bank for administration.

Now adopt 10 candidate sets of stopping rules to explore the properties of the testing system via simulation. Then, explore the measurement reliability and efficiency of the system. Finally, develop an online administration platform for the computerized adaptive testing system by writing a computer program to establish a website.

Prior to administration, connect the examiner's personal computer, tablet, or smartphone to the online administration platform of the testing system using an internet browser, then login to the administration system. Select data management to access data from previous examinees, or select new examinee to create an account and enter the examinee's name and identification number. After selecting an examinee for the assessment, click start.

The select new assessment, or results, to review the results of the examinee's previous assessments. Now, administer the items shown on the screen to the examinee. Rate the examinee's performance or responses by clicking the rating scale shown at the bottom of the screen.

Once completed, explain the results from the testing system to the examinee, including the T scores with a 95%interval, the percentile ranks of the T scores, and the reliabilities of the four functions. The results will be calculated and shown automatically by the testing system. This figure shows the process of exploring the measurement reliability and efficiency via the number of items needed for administration of the assessment with ten candidates sets of stopping rules.

As seen here, the average rash reliability of the four functions range from 0.88 to 0.93, and the individual level rash reliability shows more than 70%of participants with a rash reliability of 0.90 or greater. Here we see the average number of items needed for administration is 8.5 and that most participants, 66.4%were assessed using 5 to 10 items. Once mass heard of the demonstration of the computerized adaptive testing of the functional assessments of stroke can be done using 10 items or less for most patients.

After watching this video, you should have a good understanding of development and of the mentration methods of the system to improve the tractive efficiency for assisting the four functions in patients with stroke.