DOI QR코드

DOI QR Code

Introducing an Online Measurement System Using Item Response Theory and Computer Adaptive Testing Methods for Measuring the Physical Activity of Community-Dwelling Frail Older Adults

  • Choi, Bong-sam (Dept. of Physical Therapy, College of Health and Welfare, Woosong University)
  • Received : 2019.03.07
  • Accepted : 2019.08.06
  • Published : 2019.09.17

Abstract

Background: It is difficult to assess whether community-dwelling frail older adults may remain pre-frail status or improve into a robust state without being directly checked by health care professionals. The health information perceived by older adults is considered to be one of best sources of potential concerns in older adult population. An online measurement system combined with item response theory (IRT) and computer adaptive testing (CAT) methods is likely to become a realistic approach to remotely monitor physical activity status of frail older adults. Objects: This article suggests an approach to provide a precise and efficient means of measuring physical activity levels of community-dwelling frail older adults. Methods: Article reviews were reviewed and summarized. Results: In comparison to the classical test theory (CTT), the IRT method is empirically aimed to focus on the psychometric properties of individual test items in lieu of the test as a whole. These properties allow creating a large item pool that can capture the broad range of physical activity levels. The CAT method administers test items by an algorithm that select items matched to the physical activity levels of the older adults. Conclusion: An online measurement system combined with these two methods would allow adequate physical activity measurement that may be useful to remotely monitor the activity level of community-dwelling frail older adults.

Acknowledgement

Supported by : Woosong University

References

  1. Beleckas CM, Padovano A, Guattery J, et al. Performance of patient-reported outcomes measurement information system (PROMIS) upper extremity (UE) versus physical function (PF) computer adaptive tests (CATs) in upper extremity clinics. J Hand Surg Am. 2017:42(11):867-874. https://doi.org/10.1016/j.jhsa.2017.06.012 https://doi.org/10.1016/j.jhsa.2017.06.012
  2. Beswick AD, Reese K, Dieppe P, et al. Complex interventions to improve physical function and maintain independent living in older adult people: A systemic review and meta-analysis. Lancet. 2008;371(9614):725-735. https://doi.org/10.1016/S0140-6736(08)60342-6 https://doi.org/10.1016/S0140-6736(08)60342-6
  3. Callahan J. Aging in Place: Generations and aging series. Amityville, N.Y.: Baywood Pub. Co. 1993:65-70.
  4. Donald IP. Housing and health care for older people. Age Ageing. 2009;38(4):364-367. https://doi.org/10.1093/ageing/afp060 https://doi.org/10.1093/ageing/afp060
  5. Espinoza SE, Jung I, Hazuda H. Frailty transitions in the San Antonio longitudinal study of aging. J Am Geriatr Soc. 2012;60(4):652-660. https://doi.org/10.1111/j.1532-5415.2011.03882.x https://doi.org/10.1111/j.1532-5415.2011.03882.x
  6. Fallah N, Mitnitski A, Searle SD, et al. Transitions in frailty status in older adults in relation to mobility: A multistate modeling approach employing a deficit count. J Am Geriatr Soc. 2011;59(3):524-529. https://doi.org/10.1111/j.1532-5415.2011.03300.x https://doi.org/10.1111/j.1532-5415.2011.03300.x
  7. Fisher AG. Functional measures part 2: Selecting the right test, minimizing the limitations. Am J Occup Ther. 1992;46(3):278-281. https://doi.org/10.5014/ajot.46.3.278 https://doi.org/10.5014/ajot.46.3.278
  8. Frank JB. The Paradox of Aging in Place in Assisted Living. Bergin & Garvey, London, UK. 2002:125-128.
  9. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: Evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146-M157. https://doi.org/10.1093/gerona/56.3.m146 https://doi.org/10.1093/gerona/56.3.M146
  10. Gamper EM, Petersen MA, Aaronson N, et al. Development of an item bank for the EORTC role functioning computer adaptive test (EORTC RF-CAT). Health Qual Life Outcomes. 2016;14:72. https://doi.org/10.1186/s12955-016-0475-x https://doi.org/10.1186/s12955-016-0475-x
  11. Gill TM, Baker DI, Gottschalk M, et al. A program to prevent functional decline in physically frail, older adult persons who live at home. N Engl J Med. 2002;347(14):1068-1074. https://doi.org/10.1056/NEJMoa020423 https://doi.org/10.1056/NEJMoa020423
  12. Gill TM, Baker DI, Gottschalk M, et al. A prehabilitation program for physically frail community-living older persons. Arch Phys Med Rehabil. 2003;84(3):394-404. https://doi.org/10.1053/apmr.2003.50020 https://doi.org/10.1053/apmr.2003.50020
  13. Glass TA, Balfour JL. Neighborhoods, aging, and functional limitations. Neighborhoods and health. 2003:303-309.
  14. Gloth FM, Scheve AA, Shah S, et al. The frail elderly functional assessment questionnaire: Its responsiveness and validity in alternative settings. Arch Phys Med Rehabil. 1999;80(12):1572-1576. https://doi.org/10.1016/S0003-9993(99)90332-5
  15. Gloth FM, Walston J, Meyer J, et al. Reliability and validity of the frail older adult functional assessment questionnaire. Am J Phys Med Rehabil. 1995;74(1):45-53. https://doi.org/10.1097/00002060-199501000-00008
  16. Jette AM, Lachman M, Giorgetti MM, et al. Exercise-it's never too late: The strong-for-life program. Am J Public Health. 1999;89(1):66-72. https://doi.org/10.2015/ajph.89.1.66 https://doi.org/10.2105/AJPH.89.1.66
  17. Jette AM, Haley SM. Contemporary measurement techniques for rehabilitation outcomes assessment. J Rehabil Med. 2005;37(6):339-345. https://doi.org/10.1080/16501970500302793 https://doi.org/10.1080/16501970500302793
  18. Jette AM, Haley SM, Ni P, et al. Creating a computer adaptive test version of the late-life function and disability instrument. J Gerontol A Biol Sci Med Sci. 2008;63(11):1246-1256. https://doi.org/10.1093/gerona/63.11.1246 https://doi.org/10.1093/gerona/63.11.1246
  19. Kielhofner G, Dobria L, Frsyth K, et al. The construction of keyforms for obtaining instantaneous measures from the occupational performance history interview rating scales. Occup Ther J Res. 2005;25(1):23-32. https://doi.org/10.1177/153944920502500104. https://doi.org/10.1177/153944920502500104
  20. Lally F, Crome P. Understanding frailty. Postgrad Med J. 2007;83(975):16-20. http://doi.org/10.1136/pgmj.2006.048587 https://doi.org/10.1136/pgmj.2006.048587
  21. Lewis ET, Dent E, Alkhouri H, et al. Which frailty scale for patients admitted via emergency department? A cohort study. Arch Gerontol Geriatr. 2019;80:104-114. https://doi.org/10.1016/j.archger.2018.11.002 https://doi.org/10.1016/j.archger.2018.11.002
  22. Lohne-Seiler H, Hansen BH, Kolle E, et al. Accelerometer-determined physical activity and selfreported health in a population of older adults (65-85 years): A cross-sectional study. BMC Public Health. 2014;14:284. https://doi.org/10.1186/1471-2458-14-284 https://doi.org/10.1186/1471-2458-14-284
  23. Manini T, Clark BC. Dynapenia and aging: An update. J Gerontol A Biol Sci Med Sci. 2012;67(1):28-40. https://doi.org/10.1093/gerona/glr010 https://doi.org/10.1093/gerona/glr010
  24. McHorney CA. Health status assessment methods for adults: Past accomplishments and future challenges. Annu Rev Public Health. 1999;20:309-335. https://doi.org/10.1146/annurev.publhealth.20.1.309 https://doi.org/10.1146/annurev.publhealth.20.1.309
  25. McHorney CA. Generic health measurement: Past accomplishments and a measurement paradigm for the 21st century. Ann Intern Med. 1997;127 (8 Pt 2):743-750. https://doi.org/10.7326/0003-4819-127-8_part_2-199710151-00061 https://doi.org/10.7326/0003-4819-127-8_Part_2-199710151-00061
  26. Morris S, Bass M, Lee M, et al. Advancing the efficiency and efficacy of patient reported outcomes with multivariate computer adaptive testing. J Am Med Inform Assoc. 2017;24(5):897-902. https://doi.org/10.1093/jamia/ocx003 https://doi.org/10.1093/jamia/ocx003
  27. Risk N. The Impact of item parameter drift in computer adaptive testing (CAT). J Appl Meas. 2016;17(1):54-78.
  28. Stuck AE, Egger M, Hammer A, et al. Home visits to prevent nursing home admission and functional decline in older adult people: systemic review and meta-regression analysis. JAMA. 2002;287(8):1022-1028. https://doi.org/10.1001/jama.287.8.1022 https://doi.org/10.1001/jama.287.8.1022
  29. United Nations. Department of economic and Social Affairs, Population Division. World Population Aging. 2015:211-215.
  30. United Nations. World Population Prospects. The 2017 Revision. Key Findings & Advance Tables. Department of Economic and Social Affairs. Population Division. [Internet], New York, 2017. Available from: https://esa.un.org/unpd/wpp/Publications/Files/WPP2017_KeyFindings.pdf
  31. Velozo CA, Choi B, Zylstra SE, et al. Measurement qualities of a self-report and therapist-scored functional instrument based on the dictionary of occupational titles. J Occup Rehabil. 2006;16(1):109-122. https://doi.org/10.1007/s10926-005-9014-z https://doi.org/10.1007/s10926-005-9014-z
  32. Velozo CA, Kielhofner G, Lai JS. The use of Rasch analysis to produce scale-free measurement of functional ability. Am J Occup Ther. 1999;53(1):83-90. https://doi.org/10.5014/ajot.53.1.83 https://doi.org/10.5014/ajot.53.1.83
  33. Velozo CA, Peterson EW. Developing meaningful fear of falling measures for community dwelling older adult. Am J Phys Med Rehabil. 2001;80(9):662-673. https://doi.org/10.1097/00002060-200109000-00006
  34. Washburn RA, Smith KW, Jette AM, et al. The physical activity scale for the older adult (PASE): Development and evaluation. J Clin Epidemiol. 1993;46(2):153-162. https://doi.org/10.1016/0895-4356(93)90053-4
  35. Weiss DJ. Computerized adaptive testing for effective and efficient measurement in counselling and education. Meas Eval Couns Dev. 2004;37:70-84. https://doi.org/10.1080/07481756.2004.11909751 https://doi.org/10.1080/07481756.2004.11909751
  36. Wiles JL, Leibing A, Guberman N, et al. The meaning of "aging in place" to older people. Gerontologist. 2001;52(3):357-366. https://doi.org/10.1093/geront/gnr098 https://doi.org/10.1093/geront/gnr098
  37. Wilson JF. Frailty and its dangerous effects might be preventable. Ann Intern Med. 2004;141(6):489-492. https://doi.org/10.7326/0003-4819-141-6-200409210-00035 https://doi.org/10.7326/0003-4819-141-6-200409210-00035
  38. Woo J, Yu R, Wong M, et al. Frailty screening in the community using the frail scale. J Am Med Dir Assoc. 2015;16(5):412-419. https://doi.org/10.1016/j.jamda.2015.01.087 https://doi.org/10.1016/j.jamda.2015.01.087
  39. World Health Organization. Towards a common language for functioning, disability and health, Geneva. 2002:126-131.
  40. Yang L, Jiang Y, Xu S, et al. Evaluation of frailty status among older people living in urban communities by Edmonton Frail Scale in Wuhu, China: A cross-sectional study. Contemp Nurse. 2018;54(6):630-639. https://doi.org/10.1080/10376178.2018.1552525 https://doi.org/10.1080/10376178.2018.1552525