Improving the Delivery of Function-Directed Care During Acute Hospitalizations: Methods to Develop and Validate the Functional Assessment in Acute Care Multidimensional Computerized Adaptive Test (FAMCAT)

摘要: Abstract Objective: To (1) develop a patient-reported, multidomain functional assessment tool focused on medically ill patients in acute care settings; (2) characterize the measure's psychometric performance; and (3) establish clinically actionable score strata that link to easily implemented mobility preservation plans. Design: This article describes approach our team pursued this tool, Functional Assessment Acute Care Multidimensional Computer Adaptive Test (FAMCAT). Development involved multistep process included expanding refining existing item banks optimize their salience for hospitalized patients; administering candidate items calibration cohort; estimating multidimensional response theory models; (4) calibrating banks; (5) evaluating potential computerized adaptive testing (MCAT) enhancements; (6) parameterizing MCAT; (7) it validation (8) its predictive characteristics. Setting: A large (2000-bed) Midwestern Medical Center. Participants: The overall sample 4495 adults (2341 cohort, 2154 cohort) who were admitted either medical services with at least 1 chronic condition or surgical/medical if they required readmission after hospitalization surgery (N=4495). Intervention: Not applicable. Main Outcome Measures: Results: FAMCAT is an instrument designed permit efficient, precise, low-burden, of patients. We tried FAMCAT's efficiency precision, as well ability perform multiple assessments during hospital stay, by applying cutting edge methods such measure change (AMC), differential functioning testing, integration collateral test-taking information, particularly times. Evaluation these suggested all may enhance MCAT performance, but none integrated into initial parameterization. Conclusions: has address longstanding need structured, frequent, accurate among diagnoses complications surgery.