Abstract
Purpose: The animated activity questionnaire (AAQ) is a computer-based measure of activity limitations. To answer a question, patients choose the animation of a person performing an activity that matches their own level of limitation. The AAQ has not yet been tested for suitability to be applied as computer-adaptive test (CAT). Thus, the objective of this study was to develop and evaluate an AAQ-based CAT to facilitate the application of the AAQ in daily clinical care. Methods: Patients (n = 1408) with hip/knee osteoarthritis from Brazil, Denmark, France, The Netherlands, Norway, Spain, and the UK responded to all 17 AAQ items. Assumptions of item-response theory (IRT) modelling were investigated. To establish item parameters for the CAT, a graded response model was estimated. To evaluate the performance of post-hoc simulated AAQ-based CATs, precision, test length, and construct validity (correlations with well-established measures of activity limitations) were evaluated. Results: Unidimensionality (CFI = 0.95), measurement invariance (R2-change < 2%), and IRT item fit (S-X2p >.003) of the AAQ were supported. Performing simulated CATs, the mean test length was more than halved (≤ 8 items), while the range of precise measurement (standard error ≤ 0.3) was comparable to the full AAQ. The correlations between original AAQ scores and three AAQ-CAT versions were ≥ 0.95. Correlations of AAQ-CAT scores with patient-reported and performance measures of activity limitations were ≥ 0.60. Conclusion: The almost non-verbal AAQ-CAT is an innovative and efficient tool in patients with hip/knee osteoarthritis from various countries, measuring activity limitations with lower respondent burden, but similar precision and construct validity compared to the full AAQ.
| Original language | English |
|---|---|
| Pages (from-to) | 2403-2413 |
| Number of pages | 11 |
| Journal | Quality of Life Research |
| Volume | 32 |
| Issue number | 8 |
| Early online date | 3 Apr 2023 |
| DOIs | |
| Publication status | Published - Aug 2023 |
Keywords
- Computer-adaptive testing
- Hip and knee osteoarthritis
- Item-response theory
- Patient reported outcomes
- Performance outcomes
- Physical function
ASJC Scopus subject areas
- Public Health, Environmental and Occupational Health
Documents and Links
- Liegl, G. et al. (2023) Suitability of the animated activity questionnaire for use as computer adaptive test: establishing the AAQ-CAT
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