Computerized adaptive testing for the Oxford Hip, Knee, Shoulder, and Elbow scores

Harrison, CJ; Plummer, OR; Dawson, J; Jenkinson, C; Hunt, A; Rodrigues, JN

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Journal article

Computerized adaptive testing for the Oxford Hip, Knee, Shoulder, and Elbow scores

Abstract:: AIMS: The aim of this study was to develop and evaluate machine-learning-based computerized adaptive tests (CATs) for the Oxford Hip Score (OHS), Oxford Knee Score (OKS), Oxford Shoulder Score (OSS), and the Oxford Elbow Score (OES) and its subscales. METHODS: We developed CAT algorithms for the OHS, OKS, OSS, overall OES, and each of the OES subscales, using responses to the full-length questionnaires and a machine-learning technique called regression tree learning. The algorithms were evaluated through a series of simulation studies, in which they aimed to predict respondents' full-length questionnaire scores from only a selection of their item responses. In each case, the total number of items used by the CAT algorithm was recorded and CAT scores were compared to full-length questionnaire scores by mean, SD, score distribution plots, Pearson's correlation coefficient, intraclass correlation (ICC), and the Bland-Altman method. Differences between CAT scores and full-length questionnaire scores were contextualized through comparison to the instruments' minimal clinically important difference (MCID). RESULTS: The CAT algorithms accurately estimated 12-item questionnaire scores from between four and nine items. Scores followed a very similar distribution between CAT and full-length assessments, with the mean score difference ranging from 0.03 to 0.26 out of 48 points. Pearson's correlation coefficient and ICC were 0.98 for each 12-item scale and 0.95 or higher for the OES subscales. In over 95% of cases, a patient's CAT score was within five points of the full-length questionnaire score for each 12-item questionnaire. CONCLUSION: 2022;3(10):786-794.

Publication status:: Published

Peer review status:: Peer reviewed

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APA Style

Harrison, C. J., Plummer, O. R., Dawson, J., Jenkinson, C., Hunt, A., & Rodrigues, J. N. (2022). Computerized adaptive testing for the Oxford Hip, Knee, Shoulder, and Elbow scores. Bone & Joint Open, 3(10), 786–794.

MLA Style

Harrison, CJ, et al. “Computerized Adaptive Testing for the Oxford Hip, Knee, Shoulder, and Elbow Scores.” Bone & Joint Open, vol. 3, no. 10, 2022, pp. 786–94.

Chicago Style

Harrison, CJ, OR Plummer, J Dawson, C Jenkinson, A Hunt, and JN Rodrigues. 2022. “Computerized Adaptive Testing for the Oxford Hip, Knee, Shoulder, and Elbow Scores.” Bone & Joint Open 3 (10): 786–94.
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