Date Presented 04/05/2025
We used an exploratory, sequential mixed-methods design to develop a score report designed to support therapists’ interpretation of the Pediatric Evaluation of Disability Inventory–Patient-Reported Outcomes (PEDI–PRO) criterion scores and item maps.
Primary Author and Speaker: Jessica M. Kramer
Additional Authors and Speakers: Ariel Schwartz
PURPOSE: Well-designed score reports can support therapists to accurately interpret assessments. We piloted a score report for the Pediatric Evaluation Disability Inventory-Patient Reported Outcome (PEDI-PRO) and evaluated: 1) Can occupational and physical therapists (OT, PT) accurately interpret item-response theory (IRT)-based PEDI-PRO assessment results?; 2) What is the perceived clinical utility of the score report?
DESIGN: Exploratory, sequential mixed methods design. We recruited a convenience sample of OTs and PTs across the United States. Inclusion crtieria: 1) work with youth (14–22 years) with intellectual and developmental disabilities, and 2) for at least 1 year.
METHOD: Focus groups with OT and PTs (n = 20) informed the development of the report. Next, OTs and PTs (n = 33) reviewed score reports from two fictional clients and answered survey questions about interpretation. Additional questions evaluated clinical utility.
RESULTS: Focus groups: Visual cues supported score interpretation, but therapists requested additional explanations for advanced IRT measurement concepts. Survey: Therapists accurately interpreted foundational IRT concepts (e.g., identifying most/least difficult items, highest scores), but were less accurate when interpreting advanced concepts (e.g., fit, unexpected responses) even with visual cues and explanatory text. Therapists anticipated sharing different components of the score report with family members, clinicians, and payers to support their clinical practice.
CONCLUSIONS: Colors, icons, and integrated text descriptions of measurement concepts may support therapists to accurately interpret IRT-based scores.Therapists in this study highly valued report features that supported their intervention planning and communication.
IMPACT STATEMENT: Therapists may need additional training to interpret advanced IRT concepts. PROM developers must continue to innovate the design of score reports to enhance accuracy and reduce burden.
References
Creswell, J. W., & Creswell, J. D. (2017). Research Design: Qualitative, Quantitative, and Mixed Methods Approaches. SAGE Publications.
Basford, J. R., & Cheville, A. (2022). Patient-Reported Outcome Measures: An Exploration of Their Utility in Functional Assessment and Rehabilitation. Archives of Physical Medicine and Rehabilitation, 103(5, Supplement), S1–S2. https://doi.org/10.1016/j.apmr.2022.02.005
Kramer, J., Schwartz, A. E., & Greenberg, K. (2021). Usability and Reliability of the Pediatric Evaluation of Disability Inventory-Patient Reported Outcome (PEDI-PRO) Software Interface for Youth With DD. The American Journal of Occupational Therapy, 75(Supplement_2), 7512500004p1. https://doi.org/10.5014/ajot.2021.75S2-RP4
