@article {1632294,
	title = {Implementation of an Online Glaucoma-Specific Quality of Life Computerized Adaptive Test System in a US Glaucoma Hospital},
	journal = {Transl Vis Sci Technol},
	volume = {11},
	number = {2},
	year = {2022},
	month = {2022 Feb 01},
	pages = {24},
	abstract = {Purpose: The feasibility of implementing a computerized adaptive test (CAT) system in routine clinical care in ophthalmology has not been assessed. We evaluated the implementation of a glaucoma-specific CAT (GlauCAT) in outpatients at Massachusetts Eye and Ear Institute. Methods: In this implementation study (July 2020-April 2021), 216 adults (mean {\textpm} SD age 64.8 {\textpm} 15.3 years; 56.0\% women) completed six adaptive GlauCAT quality of life (QOL) tests on an internet-enabled tablet at the clinic. A real-time printable report summarizing domain scores was shared with physicians prior to consultation. The implementation was evaluated using Proctor{\textquoteright}s outcomes: acceptability (patient satisfaction); appropriateness (independent complete rate [\%]); feasibility (acceptance rate [\%]; completion time); and fidelity (percentage of patients discussing GlauCAT results with their physician). Physician barriers/facilitators were explored using open-ended questions. Results: Patients{\textquoteright} mean {\textpm} SD satisfaction score was 3.5 {\textpm} 0.5 of 4, with \&gt;95\% of patients willing to recommend it to others. Of the 216 (89.2\%) patients accepting to participate, 173 (80\%) completed GlauCAT independently. Patients took 8 minutes and 5 seconds (median) to complete all 6 GlauCAT tests. Almost two-thirds (n = 136/216) of the patients reported discussing their GlauCAT results with their doctor. Physicians described the GlauCAT summary report as helpful and user-friendly, although lack of time and uncertainty about how to action information were reported. Conclusions: Pilot implementation of six GlauCAT QOL tests in glaucoma outpatient clinics was feasible and acceptable. Integration of GlauCAT with electronic medical records (EMRs) and evaluation of long-term implementation outcomes are needed. Translational Relevance: GlauCAT{\textquoteright}s multiple outcomes and low test-taking burden makes it attractive for measuring glaucoma-specific QOL in routine clinical care.},
	issn = {2164-2591},
	doi = {10.1167/tvst.11.2.24},
	author = {Fenwick, Eva K and Roldan, Ana M and Halawa, Omar A and Meshkin, Ryan S and Zebardast, Nazlee and Popov, Vesselin and Lis, Przemyslaw and Friedman, David S and Lamoureux, Ecosse L}
}
