2011-01-012024-05-13https://scholars.lib.ntu.edu.tw/handle/123456789/646083摘要：背景及目的：病人自陳醫療結果(patient-reported outcomes, PRO)可提供以個案為中心之主觀症狀、身體功能、安適感、及對醫療之滿意度。因此評量PRO有助於掌握中風病人之病情、協助設定治療計畫，進而提升臨床決策及療效驗證之效能。然而，當今評量中風病人之PRO至少有4項困難：（一）、多數PRO問卷所評量之內容（層面）不一，造成選擇評估工具困難。（二）、多數PRO工具之心理計量特性（如信度與效度）缺乏實證。（三）、多數PRO工具之最小重要差異值(minimal important difference, MID)及最小可偵測之差異值(minimal detectable change, MDC)未知，造成療效驗證研究之資料解釋困難。（四）、多數PRO工具之評估費時，造成個案及臨床人員之負擔。這些難題嚴重影響評量中風病人PRO之有效性及可行性。羅序模式 (Rasch model) 可協助發展精準之評估工具，電腦適性測驗 (computerized adaptivetesting, CAT) 利用建構好之題庫，輔以電腦選擇最合適個案功能之題目測試。因此理論上，結合羅序模式及CAT能夠快速且精準地評量PRO。因此我們5年的計畫，將以羅序模式發展「中風病人自陳醫療結果電腦適性評量系統 (Computerized Adaptive Testing system for measuring Patient-Reported Outcomes of Stroke patients, CAT-PROS)以克服上述問題。我們並將證實CAT-PROS 之心理計量特性及效能（如完成率與時間）。<br> Abstract: Background and purposes: Patient-reported outcomes (PROs) provide a comprehensive patientcentered approach to specifying symptoms, subjective functioning, well-being, and satisfaction with treatment in stroke patients. Thus, assessments of PROs are critical for patient management and outcome measurements. However, several challenges exist in measuring PROs for patients with stroke. First, most measures of PROs vary in content (domains), causing difficulty in the selection of relevant PRO measures. Second, most measures of PROs lack robust evidence of psychometric properties (e.g., reliability and responsiveness). Third, the minimal important difference (MID) and minimal detectable change (MDC) of most PRO measures for stroke patients are largely unknown, which limits the interpretation of change scores in clinical and research settings. Fourth, most PRO measures are time-consuming to administer, placing a burden of administration on both clinicians and patients. These fundamental issues greatly threaten the validity and feasibility of measuring PROs for patients, clinicians, and researchers. The Rasch model is useful in developing a precise measure. Furthermore, a computerized adaptive testing (CAT) system can provide efficient measurements. Therefore, in this 5-year project, we will develop a Computerized Adaptive Testing system for measuring Patient-Reported Outcomes of Stroke patients (CAT-PROS) to overcome the aforementioned challenges. We will determine whether the CATPROS is efficient and psychometrically robust.病人自陳醫療結果中風電腦適性測驗Patient-reported outcomesstrokecomputerized adaptive