@article {5, title = {Efficiency and sensitivity of multidimensional computerized adaptive testing of pediatric physical functioning}, journal = {Disability \& Rehabilitation}, volume = {30}, number = {6}, year = {2008}, note = {Allen, Diane DNi, PengshengHaley, Stephen MK02 HD45354-01/HD/NICHD NIH HHS/United StatesNIDDR H133P0001/DD/NCBDD CDC HHS/United StatesResearch Support, N.I.H., ExtramuralEnglandDisability and rehabilitationDisabil Rehabil. 2008;30(6):479-84.}, pages = {479-84}, edition = {2008/02/26}, abstract = {PURPOSE: Computerized adaptive tests (CATs) have efficiency advantages over fixed-length tests of physical functioning but may lose sensitivity when administering extremely low numbers of items. Multidimensional CATs may efficiently improve sensitivity by capitalizing on correlations between functional domains. Using a series of empirical simulations, we assessed the efficiency and sensitivity of multidimensional CATs compared to a longer fixed-length test. METHOD: Parent responses to the Pediatric Evaluation of Disability Inventory before and after intervention for 239 children at a pediatric rehabilitation hospital provided the data for this retrospective study. Reliability, effect size, and standardized response mean were compared between full-length self-care and mobility subscales and simulated multidimensional CATs with stopping rules at 40, 30, 20, and 10 items. RESULTS: Reliability was lowest in the 10-item CAT condition for the self-care (r = 0.85) and mobility (r = 0.79) subscales; all other conditions had high reliabilities (r > 0.94). All multidimensional CAT conditions had equivalent levels of sensitivity compared to the full set condition for both domains. CONCLUSIONS: Multidimensional CATs efficiently retain the sensitivity of longer fixed-length measures even with 5 items per dimension (10-item CAT condition). Measuring physical functioning with multidimensional CATs could enhance sensitivity following intervention while minimizing response burden.}, keywords = {*Disability Evaluation, Child, Computers, Disabled Children/*classification/rehabilitation, Efficiency, Humans, Outcome Assessment (Health Care), Psychometrics, Reproducibility of Results, Retrospective Studies, Self Care, Sensitivity and Specificity}, isbn = {0963-8288 (Print)0963-8288 (Linking)}, author = {Allen, D. D. and Ni, P. and Haley, S. M.} } @article {174, title = {Measurement precision and efficiency of multidimensional computer adaptive testing of physical functioning using the pediatric evaluation of disability inventory}, journal = {Archives of Physical Medicine and Rehabilitation}, volume = {87}, number = {9}, year = {2006}, note = {Haley, Stephen MNi, PengshengLudlow, Larry HFragala-Pinkham, Maria AK02 hd45354-01/hd/nichdResearch Support, N.I.H., ExtramuralResearch Support, Non-U.S. Gov{\textquoteright}tUnited StatesArchives of physical medicine and rehabilitationArch Phys Med Rehabil. 2006 Sep;87(9):1223-9.}, month = {Sep}, pages = {1223-9}, edition = {2006/08/29}, abstract = {OBJECTIVE: To compare the measurement efficiency and precision of a multidimensional computer adaptive testing (M-CAT) application to a unidimensional CAT (U-CAT) comparison using item bank data from 2 of the functional skills scales of the Pediatric Evaluation of Disability Inventory (PEDI). DESIGN: Using existing PEDI mobility and self-care item banks, we compared the stability of item calibrations and model fit between unidimensional and multidimensional Rasch models and compared the efficiency and precision of the U-CAT- and M-CAT-simulated assessments to a random draw of items. SETTING: Pediatric rehabilitation hospital and clinics. PARTICIPANTS: Clinical and normative samples. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Not applicable. RESULTS: The M-CAT had greater levels of precision and efficiency than the separate mobility and self-care U-CAT versions when using a similar number of items for each PEDI subdomain. Equivalent estimation of mobility and self-care scores can be achieved with a 25\% to 40\% item reduction with the M-CAT compared with the U-CAT. CONCLUSIONS: M-CAT applications appear to have both precision and efficiency advantages compared with separate U-CAT assessments when content subdomains have a high correlation. Practitioners may also realize interpretive advantages of reporting test score information for each subdomain when separate clinical inferences are desired.}, keywords = {*Disability Evaluation, *Pediatrics, Adolescent, Child, Child, Preschool, Computers, Disabled Persons/*classification/rehabilitation, Efficiency, Humans, Infant, Outcome Assessment (Health Care), Psychometrics, Self Care}, isbn = {0003-9993 (Print)}, author = {Haley, S. M. and Ni, P. and Ludlow, L. H. and Fragala-Pinkham, M. A.} }