SBIR-STTR Award

Our objective is to achieve a major advance in the technology used to assess disability in children and youth. Measurement and practical requirements to identify disability and to evaluate individual progress across pediatric age groups and care settings present a serious dilemma to current fixed-item survey instruments. To address these deficiencies, the principal aims of Phase I are to: (1) build a prototype computer adaptive testing (CAT) system based on existing Pediatric Evaluation of Disability Inventory (PEDI) normative and clinical databases; (2) estimate the accuracy and responsiveness of scores based on the prototype PEDI-CAT in comparison with scores for the full-length PEDI (PEDI-Fixed) using existing databases; and (3) evaluate reductions in respondent burden and acceptance of parallel versions of the PEDI-CAT and PEDI-Fixed in a pilot field test in four pediatric clinical settings. The product in Phase I will be a prototype version of a PEDI-CAT as well as preliminary evidence regarding how well it works. In Phase II, we will examine the questionnaire item calibrations of the original PEDI, add new items to broaden the age range coverage, conduct field studies to re-calibrate items, and create algorithms for a fully operational PEDI-CAT system. A practical and feasible PEDI-CAT will greatly improve the information used in making decisions about disability status, service eligibility, program needs and outcomes of rehabilitation interventions. The product of this SBIR project will be a marketable CAT system for the assessment of disability in children and youth between the ages of 6 months and 18 years. Adapted from the PEDI, and expanded to a broader age group, this new disability assessment will fill a critical void with a system that is more practical and precise. It will have the advantage of greatly reduced data collection costs, reduced respondent burden and will meet the standards of score precision required for clinical decisions at the individual patient level throughout the scale range. Many rehabilitation settings may also find this system helpful in meeting accreditation and institutional requirements for standardizing outcome monitoring in groups of children.

Thesaurus Terms:
child with disability, computer assisted diagnosis, diagnosis design /evaluation, diagnostic test, functional ability, pediatrics, rehabilitation adolescence (12-20), child (0-11), information system, measurement clinical research, human subject, medical rehabilitation related tag, questionnaire

Our objective is to achieve a major advance in the technology used to assess disability in children and youth. Measurement and practical requirements for identifying disability and evaluating individual progress across pediatric age groups and care settings present a serious dilemma to current fixed-item survey instruments. We have developed a prototype computerized, adaptive application called PEDI-CAT that produces comparable scoring levels, precision, and responsiveness to change at significant reductions in respondent burden compared to full-length version of Pediatric Evaluation of Disability Inventory (PEDI) scales. Phase II work will improve the PEDI item pool by broadening the appropriate age range measured by each scale. Norm-based item calibrations for the PEDI functional scales (mobility, self-care, and social functioning) will be developed by collecting general population data for the new PEDI. Scoring algorithms and score reports will be created for a fully operational PEDI-CAT system. The full PEDI-CAT will be evaluated in terms of reliability, validity, and precision across score levels to create an operational system for the assessment of disability in children and youth that will improve measurement in clinical research and practice. Specific aims are to: 1. Expand the original PEDI item pool in mobility, self-care and social functioning to incorporate functional tasks appropriate for children to 14 years of age; evaluate new items through content expert feedback, cognitive testing in parent and clinician focus groups, and a small field study (N=100). 2. Develop final item calibrations and normative profiles for the revised functioning item pools by collecting responses from two large, nationally-representative samples of caretakers for children age 6 months to 14 years: 1) a telephone-based survey sample (N=840); and 2) a web-based survey sample (N=1400). Estimate the extent to which data collection method (internet vs. telephone) is associated with differential item functioning. 3. Create a fully operational PEDI-CAT system with norm-based scoring and interpretive reports that can be administered on multiple platforms (e.g., desktop, hand-held devices); demonstrate the accuracy, precision, and reductions in respondent burden of the PEDI-CAT through real data simulation studies. 4. Confirm the validity and respondent acceptance of the PEDI-CAT in a clinical sample of children known to differ in disability status: receiving rehabilitation services (N=50) vs. not (N=50). A practical and feasible PEDI-CAT will greatly improve the information used in making decisions about disability status, service eligibility, program needs, outcomes of rehabilitation interventions and in clinical research. This new disability assessment will fill a critical void with a system that is more practical and precise, programmed to be fully operational on both desktop and hand-held devices.

Thesaurus Terms:
child with disability, computer assisted diagnosis, computer assisted medical decision making, computer program /software, computer system design /evaluation, diagnosis design /evaluation, diagnosis quality /standard, functional ability adolescence (12-20), child (0-11), field study, health care service, health survey, pediatrics, rehabilitation, self care, socialization behavioral /social science research tag, clinical research, data collection methodology /evaluation, focus group, human subject, mathematical model