The use of the time-to-event index (Tevent) to compare the negative impact of COVID-19 on public health among continents/regions in 2020 and 2021: An observational study.

BACKGROUND: During the COVID-19 pandemic, how to measure the negative impact caused by COVID-19 on public health (ImpactCOV) is an important issue. However, few studies have applied the bibliometric index, taking both infected days (quantity) and impact (damage) into account for evaluating ImpactCOV thus far. This study aims to verify the proposed the time-to-event index (Tevent) that is viable and applicable in comparison with 11 other indicators, apply the Tevent to compare the ImpactCOVs among groups in continents/countries in 2020 and 2021, and develop an online algorithm to compute the Tevent-index and draw the survival analysis. METHODS: We downloaded COVID-19 outbreak data of daily confirmed cases (DCCs) for all countries/regions. The Tevent-index was computed for each country and region. The impactCOVs among continents/countries were compared using the Tevemt indices for groups in 2020 and 2021. Three visualizations (i.e., choropleth maps, forest plot, and time-to-event, a.k.a. survival analysis) were performed. Online algorithms of Tevent as a composite score to denote the ImpactCOV and comparisons of Tevents for groups on Google Maps were programmed. RESULTS: We observed that the top 3 countries affected by COVID-19 in 2020 and 2021 were (India, Brazil, Russia) and (Brazil, India, and the UK), respectively; statistically significant differences in ImpactCOV were found among continents; and an online time-event analysis showed Hubei Province (China) with a Tevent of 100.88 and 6.93, respectively, in 2020 and 2021. CONCLUSION: The Tevent-index is viable and applicable to evaluate ImpactCOV. The time-to-event analysis as a branch of statistics for analyzing the expected duration of time until 1 event occurs is recommended to compare the difference in Tevent between groups in future research, not merely limited to ImpactCOV.

Development of a Computerized Adaptive Test of Children's Gross Motor Skills.

OBJECTIVES: To (1) develop a computerized adaptive test for gross motor skills (GM-CAT) as a diagnostic test and an outcome measure, using the gross motor skills subscale of the Comprehensive Developmental Inventory for Infants and Toddlers (CDIIT-GM) as the candidate item bank; and (2) examine the psychometric properties and the efficiency of the GM-CAT. DESIGN: Retrospective study. SETTING: A developmental center of a medical center. PARTICIPANTS: Children with and without developmental delay (N=1738). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: The CDIIT-GM contains 56 universal items on gross motor skills assessing children's antigravity control, locomotion, and body movement coordination. RESULTS: The item bank of the GM-CAT had 44 items that met the dichotomous Rasch model's assumptions. High Rasch person reliabilities were found for each estimated gross motor skill for the GM-CAT (Rasch person reliabilities =.940-.995, SE=.68-2.43). For children aged 6 to 71 months, the GM-CAT had good concurrent validity (r values =.97-.98), adequate to excellent diagnostic accuracy (area under receiver operating characteristics curve =.80-.98), and moderate to large responsiveness (effect size =.65-5.82). The averages of items administered for the GM-CAT were 7 to 11, depending on the age group. CONCLUSIONS: The results of this study support the use of the GM-CAT as a diagnostic and outcome measure to estimate children's gross motor skills in both research and clinical settings.

Can Early Rehabilitation after Total Hip Arthroplasty Reduce Its Major Complications and Medical Expenses? Report from a Nationally Representative Cohort.

OBJECTIVE: To investigate whether early rehabilitation reduces the occurrence of posttotal hip arthroplasty (THA) complications, adverse events, and medical expenses within one postoperative year. METHOD: We retrospectively retrieve data from Taiwan's National Health Insurance Research Database. Patients who had undergone THA during the period from 1998 to 2010 were recruited, matched for propensity scores, and divided into 2 groups: early rehabilitation (Early Rehab) and delayed rehabilitation (Delayed Rehab). RESULTS: Eight hundred twenty of 999 THA patients given early rehabilitation treatments were matched to 205 of 233 THA patients given delayed rehabilitation treatments. The Delayed Rehab group had significantly (all p < 0.001) higher medical and rehabilitation expenses and more outpatient department (OPD) visits than the Early Rehab group. In addition, the Delayed Rehab group was associated with more prosthetic infection (odds ratio (OR): 3.152; 95% confidence interval (CI): 1.211-8.203; p < 0.05) than the Early Rehab group. CONCLUSIONS: Early rehabilitation can significantly reduce the incidence of prosthetic infection, total rehabilitation expense, total medical expenses, and number of OPD visits within the first year after THA.

Reduction in patient burdens with graphical computerized adaptive testing on the ADL scale: tool development and simulation.

BACKGROUND: The aim of this study was to verify the effectiveness and efficacy of saving time and reducing burden for patients, nurses, and even occupational therapists through computer adaptive testing (CAT). METHODS: Based on an item bank of the Barthel Index (BI) and the Frenchay Activities Index (FAI) for assessing comprehensive activities of daily living (ADL) function in stroke patients, we developed a visual basic application (VBA)-Excel CAT module, and (1) investigated whether the averaged test length via CAT is shorter than that of the traditional all-item-answered non-adaptive testing (NAT) approach through simulation, (2) illustrated the CAT multimedia on a tablet PC showing data collection and response errors of ADL clinical functional measures in stroke patients, and (3) demonstrated the quality control of endorsing scale with fit statistics to detect responding errors, which will be further immediately reconfirmed by technicians once patient ends the CAT assessment. RESULTS: The results show that endorsed items could be shorter on CAT (M = 13.42) than on NAT (M = 23) at 41.64% efficiency in test length. However, averaged ability estimations reveal insignificant differences between CAT and NAT. CONCLUSION: This study found that mobile nursing services, placed at the bedsides of patients could, through the programmed VBA-Excel CAT module, reduce the burden to patients and save time, more so than the traditional NAT paper-and-pencil testing appraisals.