Development of a Flexilevel Scale for use with computer adaptive testing for assessing shoulder function
In a 5-year study, a self-report measure of shoulder function—the Flexilevel Scale of Shoulder Function (FLEX-SF)—was developed by use of item response the-ory. A large pool of candidate items (N 68) was developed. A questionnaire that included the 68 items, another scale of shoulder function, and clinical and demographic questions were administered to 400 per-sons with shoulder complaints. Patients’ responses to the 68 items were calibrated by use of Andrich’s rat-ing scale model. Thirty-three items were selected from the pool and subdivided into three overlapping testlets targeting low, medium, and high shoulder function. A table translates raw scores on testlets to a common mathematical metric. The validity and reliability of the FLEX-SF was evaluated in a longitudinal study of 199 patients. The FLEX-SF scores were highly reliable and exhibited excellent validity (including responsiveness). We report on a simulation of a computer-adaptive test of shoulder function. This simulation is based on the developmental items we tested for use in the FLEX-SF. The results indicate that greater measurement effi-ciency can be achieved with a computer-adaptive test format. (J Shoulder Elbow Surg 2005;14:90S-94S.)
Source: Karon F. Cook, PhD,a,b,c Toni S. Roddey, PT, PhD, OCS, FAAOMPT,d Kimberly J. O’Malley,PhD,a,e,f and Gary M. Gartsman, MD,g Houston and Austin, TX http://www.drgartsman.com
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