Transcript item pool
New FOTO Measure Development Stroke and Lymphedema Steps to a New FOTO Measure Develop the item pool Expert panel programming PI Web CAT Calibration >> Item Bank Data Collection Functional Status The patient’s perception of his or her ability to perform the functional tasks as described in the measure and which represent the Activities and Participation dimension of the World Health Organization’s International Classification of Functioning, Disability and Health. The ICF and Functional Status Pain, Sleep, Joint Mobility/ROM, muscle power/strength Functional Status ICF d4 Mobility –d410-d429 Changing and maintaining body position –d430-d449 Carrying, moving and handling objects –d450-d469 Walking and moving d5 Self-Care –d510-d560 washing oneself, caring for body parts, toileting, dressing, eating, drinking “Patient Reported Outcomes (PROs) provide the most direct method for gauging individuals’ symptoms, functional status, participation, health status, and quality of life. PROs play a particularly important role in the approval process for chronic conditions where the goal of treatment is not curative but rather to alleviate symptoms, and improve functional ability and quality of life.” International Society for Quality of Life Research http://www.isoqol.org What Does a CAT Need? Low High Goal: Provide estimate of FS that is precise and efficient Items represent a single construct (FS) What Does a CAT Need? Range from low to high function Items mean the same thing to different people Clinician Experts Why Previous Work Existing Measures Stroke Discovery Phase Scientific Advisor Existing Guidelines (PROMIS) High level questions for low level patients UE vs. LE Low function items Question Phrasing & Reading Level Stroke Identified Needs Assistance, Mobility Aids Hand Dominance, Chronicity Stroke Module Classification Examples of Low Function Questions Wash your face Use a knife and fork to cut food Turning over in bed Moving about one floor of your home using a wheelchair Comb or brush your hair Getting in and out of a car with help from a person or assistive device Examples - Reading Level • If you do not do or have not done this activity, please make your best guess as to which response is most accurate. (8.4) • If you have not done this activity, choose the answer that you think fits the best. (5.4) • Using the hand that was affected by your stroke, do you have any difficulty washing your face? (8.3) • Using the hand that was affected by your stroke, are you able to wash your face? (5.4) • Are you able to position your affected hand so the fingernails can be trimmed? (7.5) • Are you able to open your affected hand so the fingernails can be trimmed? (6.7) Skip Patterns Skip Pattern A Skip Pattern B No Skip Pattern Patient able to stand Patient is able to Patient unable to but unable to walk walk at least 25 stand (with or 25 feet, with or feet, with or without support) without support. without support. PROMIS ® Skip Patterns Clinician Experts Why Previous Work Existing Measures Lymphedema Scientific Advisor Discovery Phase ICF Body Region Specific Condition -specific content Question phrasing and reading level Self Care Lymphedema Identified Needs Common Understanding of CAT Lower Body Regions Leg Trunk Genital Lymphedema Body Regions Head/ Neck Arm/ hand Upper Body Regions Breast/ Chest Examples of Condition-Specific and Self-Care Items Getting dressed (including compression garment, if that applies to you) Cleaning yourself after toileting? Squatting and Bending/Stooping (separate questions) Buttons (fine motor and self-care) Walking and putting on shoes/socks (separate) Reach across front of body LE Lymphedema Current Status LE LE Lower Body LE LE LE LE LE UE UE UE UE Upper Body UE UE UE UE UE Head & Neck LE UE Current Status Develop the item pool Lymphedema Expert panel programming PI Web Stroke CAT Calibration>>> Item Bank Data Collection Next Step: Data Collection Develop the item pool Expert panel programming PI Web CAT version for live FOTO use Data analysis >> Calibrated Item Bank Data Collection Next, Next Steps • Vestibular • Pelvic Floor Gratuitous Slide Amount of Functional Change 50 40 30 20 10 0 -10 -20 Functional Change is Greater for Patients With Greater Impairment Functional Change is Less for Patients With Lower Initial Severity Predicted FS Change Actual FS Change Thank you! Deanna Hayes, PT, DPT, MS Coordinator of Internal Research, Design and Development [email protected]