Pediatric Evaluation of Disability Inventory Computer™-Adaptive Tests

Instrument Name: Pediatric Evaluation of Disability Inventory Computer™-Adaptive Tests

Abbreviation: PEDI™-CAT

Points for Consideration:

Not recommended as potentially fit-for-purpose in a clinical trial. Recommend use as an exploratory measure rather than a primary or secondary outcome.

Description of Tool:

The PEDI-CAT is designed to assess childrens' daily performance across multiple functional domains.

Minimum Qualification Required by COA Administrator: MA or BA

Year: 2011 and updates completed in 2020

Objective of Development:

To assess children's daily performance at all functional levels

Population of Development: Age range (therapeutic indication):

0-21 (All)

Pediatric Population(s) in which COA has been used:

Nervous System Diseases; Congenital, Hereditary, and Neonatal Diseases and Abnormalities; Nutritional and Metabolic Diseases; Pathological Conditions, Signs and Symptoms; Cardiovascular Diseases; Mental Disorders

COA type:

Number of Items 276 items

Mode of Administration:

Data Collection Mode:

Time for Completion: Approximately 15 minutes to complete 60 items (15 per domain)

Response Scales: (Difficulty scale): 4-point verbal rating scale ranging from "unable" to "easy" and a separate response option "I don't kNow" (Responsibility Scale) 5-point verbal rating scale ranging from "adult/caregiver has full responsibility" to "child takes full responsibility without any direction"

Summary of Scoring:

Available Scores:
Score by domains are transformed to a scaled score ranging from 20 to 80

Weighting:
No

Score Interpretation:
Lower score = Higher functional impairment

Evidence of Literature Review: Yes

Evidence of Instrument Review: Yes

Evidence of Clinical or Expert Input: Yes

Evidence of concept elicitation in target patient population: Yes

Evidence of a Saturation Grid: None identified

Evidence for Selection of Data Collection Method: None identified

Recall/Observation Period:

Evidence for Selection of Reponse Options: Yes

Evidence of cognitive interviewing of draft instrument in target patient population: Yes

Evidence of Preliminary Scoring of Items and Domains: Yes

Evidence related to respondent and administrator burden: Yes

Evidence of a Conceptual Framework: None identified

Evidence of an item-tracking matrix: None identified

Evidence related to item selection: Yes

Evidence of re-testing the final version: None identified

Internal consistency (Cronbach's alpha): None identified

Test-retest Reliability (ICC):

Shore (2019)
Intraclass Correlation Coefficient (ICC): r= 0.98 (Mobility); r= 0.96 (Daily Activities); r=0.99 (Social/Cognitive); r=0.98 (Responsibility)
- Was a definition of stability applied to identify stable patients: No
- Time frame or interval between the two administrations: ranged from 10 to 44 days
- Population/Disease: Cerebral Palsy; n = 17

Dumas (2012)
Intraclass Correlation Coefficient (ICC): r= 0.99 (Mobility); r= 0.98 (Daily Activities); r=0.98 (Social/Cognitive); r=0.96 (Responsibility)
- Was a definition of stability applied to identify stable patients: No
- Time frame or interval between the two administrations: ranged from 7 to 30 days
- Population/Disease: Children aged 3 to 20 years with and without disabilities

Inter-rater/ inter-interviewer reliability (kappa):

Not applicable

Evidence of test-retest or inter-rater reliability: Yes

Concurrent validity (convergent, divergent):

Shore (2019)
- Correlation coefficient used: Spearman correlation coefficient
- Measure: PEDI Functional Mobility Scale 5, 50, and 500m; Pediatric Quality of Life - Cerebral Palsy (PedsQL-CP); Caregiver Priorities and Child Health Index of life with Disabilities (CPCHILD)
- Results:
Significant correlations were found between the PEDI-CAT Mobility score and FMS 5, 50, 500: r= 0.85, 0.84, 0.76, p<0.001, respectively. Significant correlations were found between PEDI-CAT Mobility score adn PedsQL-CF domains of movement and balance r=0.45; daily activities r=0.61; school activities r=0.38; fatigue r=0.43; and eating activities r=0.41, all p<0.01. Significant correlations were found between PEDI-CAT Mobility and CPCHILD Total score r=0.53, p<0.001 Significant correlations were found between PEDI-CAT Daily Activity score and PedsQL-CF domains of movement and balance r=0.33; daily activities r=0.85; school activities r=0.62; communication r=0.49; fatigue r=0.28; and eating activities r=0.76, p<0.05 to p<0.01. Significant correlations were found between PEDI-CAT Daily Activity and CPCHILD Total score r=0.61, p<0.001 Significant correlations were found between PEDI-CAT Social/Cognitive score adn PedsQL-CF domains of m daily activities r=0.70; school activities r=0.51; communication r=0.42; and eating activities r=0.57, all p<0.01. Significant correlations were found between PEDI-CAT Social/Cognitive score and CPCHILD Total score r=0.56, p<0.001 Significant correlations were found between PEDI-CAT Responsibility score adn PedsQL-CF domains of m daily activities r=0.66; school activities r=0.47; and eating activities r=0.57, all p<0.01. Significant correlations were found between PEDI-CAT Responsibility score and CPCHILD Total score r=0.40, p<0.001 - Population/Disease: caregivers of children with Cerebral Palsy, n= 95 for FMS; n=58 for PedsQL-CP; n=41 for CPCHILD Dumas (2015) - Correlation coefficient used: Spearman rank correlation coefficient - Measure: Alberta Infant Motor Scale (AIMS) - Results: Significant correlations were found between the PEDI-CAT Mobility score and AIMS, r=0.32, p=0.02. - Population/Disease: Infants and young children (less than 18 months) admitted to a pediatric postacute care hosptial and referred for physical therapist examimation, n= 53

Known-group validity:

Dumas (2016)
Measure/Groups of patients: Post-Acute Acuity Rating for Children used to define children as "Less Complexity" or "More Complexity"
Results: Signficant differences were found between mean PEDI-CAT Daily Activities, Mobility, and Social/Cognitive Normative scores across the two groups
- Population/Disease: Children with complex medical conditions (n=110)

Dumas (2012)
Measure/Groups of patients: Children with and without disabilites
Results: Signficant differences were found between mean PEDI-CAT Daily Activities, Mobility, and Social/Cognitive Normative scores across the two groups, p<0.0001 - Population/Disease: Children aged 3 to 20 years with complex medical conditions (n=110)

Evidence of Translatability Assessment: Yes

Evidence related to missing data: None identified

Evidence for Selection of Recall Period: Yes

Evidence of Administration Instructions and Training Provided: None identified

Evidence of concurrent validity: Yes

Evidence of known-groups validity: Yes

Evidence of ability to detect change over time: Yes

Ability to detect change (Responsiveness):

Fragala-Pinkham (2016)
- Time horizon: mean stay was 62.4 days (SD 70.7) and mode was 15 days
- Statistics used: Paired t-test, standard response mean (SRM), and effect size
Results:
Mean differences in discharge to admission scaled score means were siginficant for Mobility, Weelchair subdomain, Daily activities, and Social/cognitive, with a large effect sizes and SRM for Mobility and Wheelchair scores, moderate effect sizes and SDM for Daily activities scores, and small effect sizes and SRM for the Social/Cognitive domain.
Mean change scores in discharge to admission scaled score for the Mobility Domain based on diagnostic group (Traumatic Brain Injury, Neurological, Orthopedic, and Medical) were all significant, with large effect sizes and SRM. Similiarly, mean change scores in discharge to admission scaled score means for Mobility based on age groups (less than 5, 5 to less than 13, and greater than or equal to 13) were all significant, with moderate to large effect sizes and SRMs.
Population/Disease: Inpatients ages 2-21 years, with a lenght of stay of greater than or equal to 5 days (n ranged from 19 to 66, by domain)

Dumas (2015)
- Time horizon: mean stay was 62.4 days (SD 70.7) and mode was 15 days
- Statistics used: Paired t-test, standard response mean (SRM), and effect size
Results:
Mean differences in discharge to admission scaled score means were siginficant for Mobility, Weelchair subdomain, Daily activities, and Social/cognitive, with a large effect sizes and SRM for Mobility and Wheelchair scores, moderate effect sizes and SDM for Daily activities scores, and small effect sizes and SRM for the Social/Cognitive domain.
Mean change scores in discharge to admission scaled score for the Mobility Domain based on diagnostic group (Traumatic Brain Injury, Neurological, Orthopedic, and Medical) were all significant, with large effect sizes and SRM. Similiarly, mean change scores in discharge to admission scaled score means for Mobility based on age groups (less than 5, 5 to less than 13, and greater than or equal to 13) were all significant, with moderate to large effect sizes and SRMs.
Population/Disease: Inpatients ages 2-21 years, with a lenght of stay of greater than or equal to 5 days (n ranged from 19 to 66, by domain)

Dumas (2015)
- Compared change scores from discharge to admission using a paired t-test.
- Measure: Alberta Infant Motor Scale (AIMS)
- Results:
Both the PEDI-CAT and AIMS had statistically significant change scores (p<0.001) - Population/Disease: Infants and young children (less than 18 months) admitted to a pediatric postacute care hosptial and referred for physical therapist examimation, n= 53

Evidence of responder thresholds: None identified

Dumas H, Fragala-Pinkham M, Haley S, Coster W, Kramer J, Kao YC, Moed R. Item bank development for a revised pediatric evaluation of disability inventory (PEDI). Phys Occup Ther Pediatr. 2010 Aug;30(3):168-84 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3627488/pdf/nihms-455609.pdf)

Dumas HM, Fragala-Pinkham MA, Haley SM, Ni P, Coster W, Kramer JM, Kao YC, Moed R, Ludlow LH. Computer adaptive test performance in children with and without disabilities: prospective field study of the PEDI-CAT. Disabil Rehabil. 2012;34(5):393-401 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3668545/)

Haley SM, Coster WJ, Dumas HM, Fragala-Pinkham MA, Moed R. PEDI-CAT: development, standardization and administration manual. Boston: Boston University. 2012

Haley SM, Coster WJ, Dumas HM, Fragala-Pinkham MA, Kramer J, Ni P, Tian F, Kao YC, Moed R, Ludlow LH. Accuracy and precision of the Pediatric Evaluation of Disability Inventory computer-adaptive tests (PEDI-CAT). Dev Med Child Neurol. 2011 Dec;53(12):1100-6 (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3638866/pdf/nihms454561.pdf)

PEDI-CAT Development and Psychometric Properties

None identified

Original Language: English for the USA

Translations:
Swedish
Norwegian
Danish
Dutch for the Netherlands
Italian
Portuguese for Brazil
German
French for Canada
Spanish for the USA

Haley SM; Dumas H; Fragala-Pinkham, M; Coster W; Moed R

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None identified