01609nas a2200205 4500008004500000022001400045245005000059210004900109300001000158490000600168520099300174653003501167653003401202653002301236653001901259653002701278100002301305700001501328856006001343 2019 Engldsh  a2165-659200aTime-Efficient Adaptive Measurement of Change0 aTimeEfficient Adaptive Measurement of Change a15-340 v73 a

The adaptive measurement of change (AMC) refers to the use of computerized adaptive testing (CAT) at multiple occasions to efficiently assess a respondent’s improvement, decline, or sameness from occasion to occasion. Whereas previous AMC research focused on administering the most informative item to a respondent at each stage of testing, the current research proposes the use of Fisher information per time unit as an item selection procedure for AMC. The latter procedure incorporates not only the amount of information provided by a given item but also the expected amount of time required to complete it. In a simulation study, the use of Fisher information per time unit item selection resulted in a lower false positive rate in the majority of conditions studied, and a higher true positive rate in all conditions studied, compared to item selection via Fisher information without accounting for the expected time taken. Future directions of research are suggested.

10aadaptive measurement of change10acomputerized adaptive testing10aFisher information10aitem selection10aresponse-time modeling1 aFinkelman, Matthew1 aWang, Chun uhttp://iacat.org/jcat/index.php/jcat/article/view/73/3505519nas a2200193 4500008004100000245009000041210006900131260005500200520480200255653002305057653001905080653002105099653002605120100002205146700002005168700001605188700001905204856010205223 2017 eng d00aAdaptive Item and Feedback Selection in Personalized Learning with a Network Approach0 aAdaptive Item and Feedback Selection in Personalized Learning wi aNiigata, JapanbNiigata Seiryo Universityc08/20173 a

Personalized learning is a term used to describe educational systems that adapt student-specific curriculum sequencing, pacing, and presentation based on their unique backgrounds, knowledge, preferences, interests, and learning goals. (Chen, 2008; Netcoh, 2016). The technological approach to personalized learning provides data-driven models to incorporate these adaptations automatically. Examples of applications include online learning systems, educational games, and revision-aid systems. In this study we introduce Bayesian networks as a methodology to implement an adaptive framework within a personalized learning environment. Existing ideas from Computerized Adaptive Testing (CAT) with Item Response Theory (IRT), where choices about content provision are based on maximizing information, are related to the goals of personalized learning environments. Personalized learning entails other goals besides efficient ability estimation by maximizing information, such as an adaptive configuration of preferences and feedback to the student. These considerations will be discussed and their application in networks will be illustrated.

Adaptivity in Personalized Learning.In standard CAT’s there is a focus on selecting items that provide maximum information about the ability of an individual at a certain point in time (Van der Linden & Glas, 2000). When learning is the main goal of testing, alternative adaptive item selection methods were explored by Eggen (2012). The adaptive choices made in personalized learning applications require additional adaptivity with respect to the following aspects; the moment of feedback, the kind of feedback, and the possibility for students to actively influence the learning process.

Bayesian Networks and Personalized Learning.Personalized learning aims at constructing a framework to incorporate all the aspects mentioned above. Therefore, the goal of this framework is not only to focus on retrieving ability estimates by choosing items on maximum information, but also to construct a framework that allows for these other factors to play a role. Plajner and Vomlel (2016) have already applied Bayesian Networks to adaptive testing, selecting items with help of entropy reduction. Almond et al. (2015) provide a reference work on Bayesian Networks in Educational Assessment. Both acknowledge the potential of the method in terms of features such as modularity options to build finer-grained models. IRT does not allow to model sub-skills very easily and to gather information on fine-grained level, due to its dependency on the assumption of generally one underlying trait. The local independence assumption in IRT implies being interested in mainly the student’s overall ability on the subject of interest. When the goal is to improve student’s learning, we are not just interested in efficiently coming to their test score on a global subject. One wants a model that is able to map educational problems and talents in detail over the whole educational program, while allowing for dependency between items. The moment in time can influence topics to be better mastered than others, and this is exactly what we can to get out of a model. The possibility to model flexible structures, estimate abilities on a very detailed level for sub-skills and to easily incorporate other variables such as feedback in Bayesian Networks makes it a very promising method for making adaptive choices in personalized learning. It is shown in this research how item and feedback selection can be performed with help of the promising Bayesian Networks. A student involvement possibility is also introduced and evaluated.

References

Almond, R. G., Mislevy, R. J., Steinberg, L. S., Yan, D., & Williamson, D. M. (2015). Bayesian Networks in Educational Assessment. Test. New York: Springer Science+Business Media. http://doi.org/10.1007/978-0-387-98138-3

Eggen, T.J.H.M. (2012) Computerized Adaptive Testing Item Selection in Computerized Adaptive Learning Systems. In: Eggen. TJHM & Veldkamp, BP.. (Eds). Psychometrics in Practice at RCEC. Enschede: RCEC

Netcoh, S. (2016, March). “What Do You Mean by ‘Personalized Learning?’. Croscutting Conversations in Education – Research, Reflections & Practice. Blogpost.

Plajner, M., & Vomlel, J. (2016). Student Skill Models in Adaptive Testing. In Proceedings of the Eighth International Conference on Probabilistic Graphical Models (pp. 403-414).

Van der Linden, W. J., & Glas, C. A. (2000). Computerized adaptive testing: Theory and practice. Dordrecht: Kluwer Academic Publishers.

Session Video

10afeedback selection10aitem selection10anetwork approach10apersonalized learning1 avan Buuren, Nikky1 aStraat, Hendrik1 aEggen, Theo1 aFox, Jean-Paul uhttp://mail.iacat.org/adaptive-item-and-feedback-selection-personalized-learning-network-approach03453nas a2200157 4500008004100000245008400041210006900125260005500194520283600249653001203085653002503097653002803122100002303150700002003173856010203193 2017 eng d00aConsiderations in Performance Evaluations of Computerized Formative Assessments0 aConsiderations in Performance Evaluations of Computerized Format aNiigata, JapanbNiigata Seiryo Universityc08/20173 a

Computerized adaptive instruments have been widely established and used in the context of summative assessments for purposes including licensure, admissions and proficiency testing. The benefits of examinee tailored examinations, which can provide estimates of performance that are more reliable and valid, have in recent years attracted a greater audience (i.e. patient oriented outcomes, test prep, etc.). Formative assessment, which are most widely understood in their implementation as diagnostic tools, have recently started to expand to lesser known areas of computerized testing such as in implementations of instructional designs aiming to maximize examinee learning through targeted practice.

Using a CAT instrument within the framework of evaluating repetitious examinee performances (in such settings as a Quiz Bank practices for example) poses unique challenges not germane to summative assessments. The scale on which item parameters (and subsequently examinee performance estimates such as Maximum Likelihood Estimates) are determined usually do not take change over time under consideration. While vertical scaling features resolve the learning acquisition problem, most content practice engines do not make use of explicit practice windows which could be vertically aligned. Alternatively, the Multidimensional (MIRT)- and Hierarchical Item Response Theory (HIRT) models allow for the specification of random effects associated with change over time in examinees’ skills, but are often complex and require content and usage resources not often observed.

The research submitted for consideration simulated examinees’ repeated variable length Quiz Bank practice in algebra using a 500 1-PL operational item pool. The stability simulations sought to determine with which rolling item interval size ability estimates would provide the most informative insight into the examinees’ learning progression over time. Estimates were evaluated in terms of reduction in estimate uncertainty, bias and RMSD with the true and total item based ability estimates. It was found that rolling item intervals between 20-25 items provided the best reduction of uncertainty around the estimate without compromising the ability to provide informed performance estimates to students. However, while asymptotically intervals of 20-25 items tended to provide adequate estimates of performance, changes over shorter periods of time assessed with shorter quizzes could not be detected as those changes would be suppressed in lieu of the performance based on the full interval considered. Implications for infrastructure (such as recommendation engines, etc.), product and scale development are discussed.

Session video

10aalgebra10aFormative Assessment10aPerformance Evaluations1 aChajewski, Michael1 aHarnisher, John uhttp://mail.iacat.org/considerations-performance-evaluations-computerized-formative-assessments-003807nas a2200145 4500008004100000245008500041210006900126260005500195520326300250653002503513653001503538653001203553100002503565856007103590 2017 eng d00aFastCAT – Customizing CAT Administration Rules to Increase Response Efficiency0 aFastCAT Customizing CAT Administration Rules to Increase Respons aNiigata, JapanbNiigata Seiryo Universityc08/20173 a

A typical pre-requisite for CAT administration is the existence of an underlying item bank completely covering the range of the trait being measured. When a bank fails to cover the full range of the trait, examinees who are close to the floor or ceiling will often never achieve a standard error cut-off and examinees will be forced to answer items increasingly less relevant to their trait level. This scenario is fairly typical for many patients responding to patient reported outcome measures (PROMS). For IACAT 2017 ABSTRACTS BOOKLET 65 example, in the assessment of physical functioning, many item banks ceiling at about the 50%ile. For most healthy patients, after a few items the only items remaining in the bank will represent decreasing ability (even though the patient has already indicated that they are at or above the mean for the population). Another example would be for a patient with no pain taking a Pain CAT. They will probably answer “Never” pain for every succeeding item out to the maximum test length. For this project we sought to reduce patient burden, while maintaining test accuracy, through the reduction of CAT length using novel stopping rules.

We studied CAT administration assessment histories for patients who were administered Patient Reported Outcomes Measurement Information System (PROMIS) CATs. In the PROMIS 1 Wave 2 Back Pain/Depression Study, CATs were administered to N=417 cases assessed across 11 PROMIS domains. Original CAT administration rules were: start with a pre-identified item of moderate difficulty; administer a minimum four items per case; stop when an estimated theta’s SE declines to < 0.3 OR a maximum 12 items are administered.

Original CAT. 12,622 CAT administrations were analyzed. CATs ranged in number of items administered from 4 to 12 items; 72.5% were 4-item CATs. The second and third most frequently occurring CATs were 5-item (n=1102; 8.7%) and 12-item CATs (n=964; 7.6%). 64,062 items total were administered, averaging 5.1 items per CAT. Customized CAT. Three new CAT stopping rules were introduced, each with potential to increase item-presentation efficiency and maintain required score precision: Stop if a case responds to the first two items administered using an “extreme” response category (towards the ceiling or floor for the in item bank, or at ); administer a minimum two items per case; stop if the change in SE estimate (previous to current item administration) is positive but < 0.01.

The three new stopping rules reduced the total number of items administered by 25,643 to 38,419 items (40.0% reduction). After four items were administered, only n=1,824 CATs (14.5%) were still in assessment mode (vs. n=3,477 (27.5%) in the original CATs). On average, cases completed 3.0 items per CAT (vs. 5.1).

Each new rule addressed specific inefficiencies in the original CAT administration process: Cases not having or possessing a low/clinically unimportant level of the assessed domain; allow the SE <0.3 stopping criterion to come into effect earlier in the CAT administration process; cases experiencing poor domain item bank measurement, (e.g., “floor,” “ceiling” cases).

10aAdministration Rules10aEfficiency10aFastCAT1 aGershon, Richard, C. uhttps://drive.google.com/open?id=1oPJV-x0p9hRmgJ7t6k-MCC1nAoBSFM1w03003nas a2200157 4500008004100000245007600041210006900117260005500186520243700241653002102678653002302699653002002722100001602742700001602758856007102774 2017 eng d00aGenerating Rationales to Support Formative Feedback in Adaptive Testing0 aGenerating Rationales to Support Formative Feedback in Adaptive  aNiigata, JapanbNiigata Seiryo Universityc08/20173 a

Computer adaptive testing offers many important benefits to support and promote life-long learning. Computers permit testing on-demand thereby allowing students to take the test at any time during instruction; items on computerized tests are scored immediately thereby providing students with instant feedback; computerized tests permit continuous administration thereby allowing students to have more choice about when they write their exams. But despite these important benefits, the advent of computer adaptive testing has also raised formidable challenges, particularly in the area of item development. Educators must have access to large numbers of diverse, high-quality test items to implement computerize adaptive testing because items are continuously administered to students. Hence, hundreds or even thousands of items are needed to develop the test item banks necessary for computer adaptive testing. Unfortunately, educational test items, as they are currently created, are time consuming and expensive to develop because each individual item is written, initially, by a content specialist and, then, reviewed, edited, and revised by groups of content specialists to ensure the items yield reliable and valid information. Hence, item development is one of the most important problems that must be solved before we can migrate to computer adaptive testing to support life-long learning because large numbers of high-quality, content-specific, test items are required.

One promising item development method that may be used to address this challenge is with automatic item generation. Automatic item generation is a relatively new but rapidly evolving research area where cognitive and psychometric modelling practices are used produce hundreds of new test items with the aid of computer technology. The purpose of our presentation is to describe a new methodology for generating both the items and the rationales required to solve each generated item in order to produce the feedback needed to support life-long learning. Our item generation methodology will first be described. To ensure our description is practical, the method will also be demonstrated using generated items from the health sciences to demonstrate how item generation can promote life-long learning for medical educators and practitioners.

 

Session Video

10aAdaptive Testing10aformative feedback10aItem generation1 aGierl, Mark1 aBulut, Okan uhttps://drive.google.com/open?id=1O5KDFtQlDLvhNoDr7X4JO4arpJkIHKUP00628nas a2200169 4500008004100000245008900041210006900130260001200199653000800211653002500219653002700244653002100271653001200292100002300304700001600327856011500343 2011 eng d00aAdaptive Item Calibration and Norming: Unique Considerations of a Global Deployment0 aAdaptive Item Calibration and Norming Unique Considerations of a c10/201110aCAT10acommon item equating10aFigural Reasoning Test10aitem calibration10anorming1 aSchwall, Alexander1 aSinar, Evan uhttp://mail.iacat.org/content/adaptive-item-calibration-and-norming-%0Bunique-considerations-global-deployment03104nas a2200445 4500008004100000020004100041245012000082210006900202250001500271260001000286300001100296490000700307520175400314653003802068653002102106653001002127653000902137653002202146653002802168653003302196653001102229653001102240653000902251653001602260653001802276653001902294653003102313653003102344653001602375100001602391700001002407700001402417700001502431700001402446700001502460700001802475700002402493700001802517856012302535 2010 eng d a0161-8105 (Print)0161-8105 (Linking)00aDevelopment and validation of patient-reported outcome measures for sleep disturbance and sleep-related impairments0 aDevelopment and validation of patientreported outcome measures f a2010/06/17 cJun 1 a781-920 v333 aSTUDY OBJECTIVES: To develop an archive of self-report questions assessing sleep disturbance and sleep-related impairments (SRI), to develop item banks from this archive, and to validate and calibrate the item banks using classic validation techniques and item response theory analyses in a sample of clinical and community participants. DESIGN: Cross-sectional self-report study. SETTING: Academic medical center and participant homes. PARTICIPANTS: One thousand nine hundred ninety-three adults recruited from an Internet polling sample and 259 adults recruited from medical, psychiatric, and sleep clinics. INTERVENTIONS: None. MEASUREMENTS AND RESULTS: This study was part of PROMIS (Patient-Reported Outcomes Information System), a National Institutes of Health Roadmap initiative. Self-report item banks were developed through an iterative process of literature searches, collecting and sorting items, expert content review, qualitative patient research, and pilot testing. Internal consistency, convergent validity, and exploratory and confirmatory factor analysis were examined in the resulting item banks. Factor analyses identified 2 preliminary item banks, sleep disturbance and SRI. Item response theory analyses and expert content review narrowed the item banks to 27 and 16 items, respectively. Validity of the item banks was supported by moderate to high correlations with existing scales and by significant differences in sleep disturbance and SRI scores between participants with and without sleep disorders. CONCLUSIONS: The PROMIS sleep disturbance and SRI item banks have excellent measurement properties and may prove to be useful for assessing general aspects of sleep and SRI with various groups of patients and interventions.10a*Outcome Assessment (Health Care)10a*Self Disclosure10aAdult10aAged10aAged, 80 and over10aCross-Sectional Studies10aFactor Analysis, Statistical10aFemale10aHumans10aMale10aMiddle Aged10aPsychometrics10aQuestionnaires10aReproducibility of Results10aSleep Disorders/*diagnosis10aYoung Adult1 aBuysse, D J1 aYu, L1 aMoul, D E1 aGermain, A1 aStover, A1 aDodds, N E1 aJohnston, K L1 aShablesky-Cade, M A1 aPilkonis, P A uhttp://mail.iacat.org/content/development-and-validation-patient-reported-outcome-measures-sleep-disturbance-and-sleep02750nas a2200409 4500008004100000020004600041245009400087210006900181250001500250260000800265300001200273490000700285520144500292653001501737653002001752653003101772653003001803653002001833653001901853653002601872653001101898653001101909653000901920653001601929653002601945653003701971653003002008653004402038653001802082653002002100653002802120100002002148700002302168700001602191700001702207856011602224 2009 eng d a1528-8447 (Electronic)1526-5900 (Linking)00aDevelopment and preliminary testing of a computerized adaptive assessment of chronic pain0 aDevelopment and preliminary testing of a computerized adaptive a a2009/07/15 cSep a932-9430 v103 aThe aim of this article is to report the development and preliminary testing of a prototype computerized adaptive test of chronic pain (CHRONIC PAIN-CAT) conducted in 2 stages: (1) evaluation of various item selection and stopping rules through real data-simulated administrations of CHRONIC PAIN-CAT; (2) a feasibility study of the actual prototype CHRONIC PAIN-CAT assessment system conducted in a pilot sample. Item calibrations developed from a US general population sample (N = 782) were used to program a pain severity and impact item bank (kappa = 45), and real data simulations were conducted to determine a CAT stopping rule. The CHRONIC PAIN-CAT was programmed on a tablet PC using QualityMetric's Dynamic Health Assessment (DYHNA) software and administered to a clinical sample of pain sufferers (n = 100). The CAT was completed in significantly less time than the static (full item bank) assessment (P < .001). On average, 5.6 items were dynamically administered by CAT to achieve a precise score. Scores estimated from the 2 assessments were highly correlated (r = .89), and both assessments discriminated across pain severity levels (P < .001, RV = .95). Patients' evaluations of the CHRONIC PAIN-CAT were favorable. PERSPECTIVE: This report demonstrates that the CHRONIC PAIN-CAT is feasible for administration in a clinic. The application has the potential to improve pain assessment and help clinicians manage chronic pain.10a*Computers10a*Questionnaires10aActivities of Daily Living10aAdaptation, Psychological10aChronic Disease10aCohort Studies10aDisability Evaluation10aFemale10aHumans10aMale10aMiddle Aged10aModels, Psychological10aOutcome Assessment (Health Care)10aPain Measurement/*methods10aPain, Intractable/*diagnosis/psychology10aPsychometrics10aQuality of Life10aUser-Computer Interface1 aAnatchkova, M D1 aSaris-Baglama, R N1 aKosinski, M1 aBjorner, J B uhttp://mail.iacat.org/content/development-and-preliminary-testing-computerized-adaptive-assessment-chronic-pain02882nas a2200493 4500008004100000020004100041245014100082210006900223250001500292260000800307300001100315490000700326520125100333653003001584653001001614653000901624653004601633653003301679653001101712653003101723653001101754653000901765653003301774653001601807653002401823653004601847653005501893653005501948653004602003653001902049653003102068653001402099100001602113700001502129700001302144700001402157700001502171700001702186700001502203700001702218700001502235700001302250856012502263 2009 eng d a0090-5550 (Print)0090-5550 (Linking)00aDevelopment of an item bank for the assessment of depression in persons with mental illnesses and physical diseases using Rasch analysis0 aDevelopment of an item bank for the assessment of depression in  a2009/05/28 cMay a186-970 v543 aOBJECTIVE: The calibration of item banks provides the basis for computerized adaptive testing that ensures high diagnostic precision and minimizes participants' test burden. The present study aimed at developing a new item bank that allows for assessing depression in persons with mental and persons with somatic diseases. METHOD: The sample consisted of 161 participants treated for a depressive syndrome, and 206 participants with somatic illnesses (103 cardiologic, 103 otorhinolaryngologic; overall mean age = 44.1 years, SD =14.0; 44.7% women) to allow for validation of the item bank in both groups. Persons answered a pool of 182 depression items on a 5-point Likert scale. RESULTS: Evaluation of Rasch model fit (infit < 1.3), differential item functioning, dimensionality, local independence, item spread, item and person separation (>2.0), and reliability (>.80) resulted in a bank of 79 items with good psychometric properties. CONCLUSIONS: The bank provides items with a wide range of content coverage and may serve as a sound basis for computerized adaptive testing applications. It might also be useful for researchers who wish to develop new fixed-length scales for the assessment of depression in specific rehabilitation settings.10aAdaptation, Psychological10aAdult10aAged10aDepressive Disorder/*diagnosis/psychology10aDiagnosis, Computer-Assisted10aFemale10aHeart Diseases/*psychology10aHumans10aMale10aMental Disorders/*psychology10aMiddle Aged10aModels, Statistical10aOtorhinolaryngologic Diseases/*psychology10aPersonality Assessment/statistics & numerical data10aPersonality Inventory/*statistics & numerical data10aPsychometrics/statistics & numerical data10aQuestionnaires10aReproducibility of Results10aSick Role1 aForkmann, T1 aBoecker, M1 aNorra, C1 aEberle, N1 aKircher, T1 aSchauerte, P1 aMischke, K1 aWesthofen, M1 aGauggel, S1 aWirtz, M uhttp://mail.iacat.org/content/development-item-bank-assessment-depression-persons-mental-illnesses-and-physical-diseases02752nas a2200433 4500008004100000020004600041245012800087210006900215250001500284300001200299490000700311520139300318653003401711653001501745653001001760653000901770653002201779653002501801653001101826653001101837653000901848653001601857653001501873653003801888653001901926653003101945653002801976653004802004653002202052100002002074700001202094700001402106700001602120700001402136700001702150700001502167700001502182856012102197 2009 eng d a1878-5921 (Electronic)0895-4356 (Linking)00aAn evaluation of patient-reported outcomes found computerized adaptive testing was efficient in assessing stress perception0 aevaluation of patientreported outcomes found computerized adapti a2008/07/22 a278-2870 v623 aOBJECTIVES: This study aimed to develop and evaluate a first computerized adaptive test (CAT) for the measurement of stress perception (Stress-CAT), in terms of the two dimensions: exposure to stress and stress reaction. STUDY DESIGN AND SETTING: Item response theory modeling was performed using a two-parameter model (Generalized Partial Credit Model). The evaluation of the Stress-CAT comprised a simulation study and real clinical application. A total of 1,092 psychosomatic patients (N1) were studied. Two hundred simulees (N2) were generated for a simulated response data set. Then the Stress-CAT was given to n=116 inpatients, (N3) together with established stress questionnaires as validity criteria. RESULTS: The final banks included n=38 stress exposure items and n=31 stress reaction items. In the first simulation study, CAT scores could be estimated with a high measurement precision (SE<0.32; rho>0.90) using 7.0+/-2.3 (M+/-SD) stress reaction items and 11.6+/-1.7 stress exposure items. The second simulation study reanalyzed real patients data (N1) and showed an average use of items of 5.6+/-2.1 for the dimension stress reaction and 10.0+/-4.9 for the dimension stress exposure. Convergent validity showed significantly high correlations. CONCLUSIONS: The Stress-CAT is short and precise, potentially lowering the response burden of patients in clinical decision making.10a*Diagnosis, Computer-Assisted10aAdolescent10aAdult10aAged10aAged, 80 and over10aConfidence Intervals10aFemale10aHumans10aMale10aMiddle Aged10aPerception10aQuality of Health Care/*standards10aQuestionnaires10aReproducibility of Results10aSickness Impact Profile10aStress, Psychological/*diagnosis/psychology10aTreatment Outcome1 aKocalevent, R D1 aRose, M1 aBecker, J1 aWalter, O B1 aFliege, H1 aBjorner, J B1 aKleiber, D1 aKlapp, B F uhttp://mail.iacat.org/content/evaluation-patient-reported-outcomes-found-computerized-adaptive-testing-was-efficient03148nas a2200457 4500008004100000020004100041245015500082210006900237250001500306260000800321300001200329490000700341520174100348653002502089653001902114653002502133653003002158653001502188653003602203653001002239653002102249653003302270653001102303653001102314653000902325653001802334653001702352653001902369653001602388100001502404700001002419700001502429700002502444700001802469700001702487700001602504700001602520700001402536700001602550856012402566 2009 eng d a0962-9343 (Print)0962-9343 (Linking)00aMeasuring global physical health in children with cerebral palsy: Illustration of a multidimensional bi-factor model and computerized adaptive testing0 aMeasuring global physical health in children with cerebral palsy a2009/02/18 cApr a359-3700 v183 aPURPOSE: The purposes of this study were to apply a bi-factor model for the determination of test dimensionality and a multidimensional CAT using computer simulations of real data for the assessment of a new global physical health measure for children with cerebral palsy (CP). METHODS: Parent respondents of 306 children with cerebral palsy were recruited from four pediatric rehabilitation hospitals and outpatient clinics. We compared confirmatory factor analysis results across four models: (1) one-factor unidimensional; (2) two-factor multidimensional (MIRT); (3) bi-factor MIRT with fixed slopes; and (4) bi-factor MIRT with varied slopes. We tested whether the general and content (fatigue and pain) person score estimates could discriminate across severity and types of CP, and whether score estimates from a simulated CAT were similar to estimates based on the total item bank, and whether they correlated as expected with external measures. RESULTS: Confirmatory factor analysis suggested separate pain and fatigue sub-factors; all 37 items were retained in the analyses. From the bi-factor MIRT model with fixed slopes, the full item bank scores discriminated across levels of severity and types of CP, and compared favorably to external instruments. CAT scores based on 10- and 15-item versions accurately captured the global physical health scores. CONCLUSIONS: The bi-factor MIRT CAT application, especially the 10- and 15-item versions, yielded accurate global physical health scores that discriminated across known severity groups and types of CP, and correlated as expected with concurrent measures. The CATs have potential for collecting complex data on the physical health of children with CP in an efficient manner.10a*Computer Simulation10a*Health Status10a*Models, Statistical10aAdaptation, Psychological10aAdolescent10aCerebral Palsy/*physiopathology10aChild10aChild, Preschool10aFactor Analysis, Statistical10aFemale10aHumans10aMale10aMassachusetts10aPennsylvania10aQuestionnaires10aYoung Adult1 aHaley, S M1 aNi, P1 aDumas, H M1 aFragala-Pinkham, M A1 aHambleton, RK1 aMontpetit, K1 aBilodeau, N1 aGorton, G E1 aWatson, K1 aTucker, C A uhttp://mail.iacat.org/content/measuring-global-physical-health-children-cerebral-palsy-illustration-multidimensional-bi02598nas a2200337 4500008004100000020004600041245012800087210006900215250001500284300000700299490000600306520149200312653003201804653002301836653002501859653003401884653001101918653001101929653000901940653002601949653003101975653002702006653001102033653001802044100001502062700001202077700001402089700001802103700001202121856012702133 2009 eng d a1477-7525 (Electronic)1477-7525 (Linking)00aReduction in patient burdens with graphical computerized adaptive testing on the ADL scale: tool development and simulation0 aReduction in patient burdens with graphical computerized adaptiv a2009/05/07 a390 v73 aBACKGROUND: 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.10a*Activities of Daily Living10a*Computer Graphics10a*Computer Simulation10a*Diagnosis, Computer-Assisted10aFemale10aHumans10aMale10aPoint-of-Care Systems10aReproducibility of Results10aStroke/*rehabilitation10aTaiwan10aUnited States1 aChien, T W1 aWu, H M1 aWang, W-C1 aCastillo, R V1 aChou, W uhttp://mail.iacat.org/content/reduction-patient-burdens-graphical-computerized-adaptive-testing-adl-scale-tool-development02436nas a2200385 4500008004100000020004100041245009300082210006900175250001500244260000800259300001100267490000700278520128100285653003201566653002701598653002001625653002901645653001001674653000901684653001901693653003401712653001101746653001101757653000901768653001601777653004601793100001501839700001001854700001501864700001101879700001201890700001401902700001601916856011801932 2009 eng d a0962-9343 (Print)0962-9343 (Linking)00aReplenishing a computerized adaptive test of patient-reported daily activity functioning0 aReplenishing a computerized adaptive test of patientreported dai a2009/03/17 cMay a461-710 v183 aPURPOSE: Computerized adaptive testing (CAT) item banks may need to be updated, but before new items can be added, they must be linked to the previous CAT. The purpose of this study was to evaluate 41 pretest items prior to including them into an operational CAT. METHODS: We recruited 6,882 patients with spine, lower extremity, upper extremity, and nonorthopedic impairments who received outpatient rehabilitation in one of 147 clinics across 13 states of the USA. Forty-one new Daily Activity (DA) items were administered along with the Activity Measure for Post-Acute Care Daily Activity CAT (DA-CAT-1) in five separate waves. We compared the scoring consistency with the full item bank, test information function (TIF), person standard errors (SEs), and content range of the DA-CAT-1 to the new CAT (DA-CAT-2) with the pretest items by real data simulations. RESULTS: We retained 29 of the 41 pretest items. Scores from the DA-CAT-2 were more consistent (ICC = 0.90 versus 0.96) than DA-CAT-1 when compared with the full item bank. TIF and person SEs were improved for persons with higher levels of DA functioning, and ceiling effects were reduced from 16.1% to 6.1%. CONCLUSIONS: Item response theory and online calibration methods were valuable in improving the DA-CAT.10a*Activities of Daily Living10a*Disability Evaluation10a*Questionnaires10a*User-Computer Interface10aAdult10aAged10aCohort Studies10aComputer-Assisted Instruction10aFemale10aHumans10aMale10aMiddle Aged10aOutcome Assessment (Health Care)/*methods1 aHaley, S M1 aNi, P1 aJette, A M1 aTao, W1 aMoed, R1 aMeyers, D1 aLudlow, L H uhttp://mail.iacat.org/content/replenishing-computerized-adaptive-test-patient-reported-daily-activity-functioning02866nas a2200325 4500008004100000020002700041245007400068210006900142250001500211260000800226300001100234490000700245520188300252653003202135653003202167653002502199653002302224653004802247653001102295653001102306653000902317653001602326653001902342653002702361100001502388700001502403700001002418700001202428856010002440 2008 eng d a1537-7385 (Electronic)00aAdaptive short forms for outpatient rehabilitation outcome assessment0 aAdaptive short forms for outpatient rehabilitation outcome asses a2008/09/23 cOct a842-520 v873 aOBJECTIVE: To develop outpatient Adaptive Short Forms for the Activity Measure for Post-Acute Care item bank for use in outpatient therapy settings. DESIGN: A convenience sample of 11,809 adults with spine, lower limb, upper limb, and miscellaneous orthopedic impairments who received outpatient rehabilitation in 1 of 127 outpatient rehabilitation clinics in the United States. We identified optimal items for use in developing outpatient Adaptive Short Forms based on the Basic Mobility and Daily Activities domains of the Activity Measure for Post-Acute Care item bank. Patient scores were derived from the Activity Measure for Post-Acute Care computerized adaptive testing program. Items were selected for inclusion on the Adaptive Short Forms based on functional content, range of item coverage, measurement precision, item exposure rate, and data collection burden. RESULTS: Two outpatient Adaptive Short Forms were developed: (1) an 18-item Basic Mobility Adaptive Short Form and (2) a 15-item Daily Activities Adaptive Short Form, derived from the same item bank used to develop the Activity Measure for Post-Acute Care computerized adaptive testing program. Both Adaptive Short Forms achieved acceptable psychometric properties. CONCLUSIONS: In outpatient postacute care settings where computerized adaptive testing outcome applications are currently not feasible, item response theory-derived Adaptive Short Forms provide the efficient capability to monitor patients' functional outcomes. The development of Adaptive Short Form functional outcome instruments linked by a common, calibrated item bank has the potential to create a bridge to outcome monitoring across postacute care settings and can facilitate the eventual transformation from Adaptive Short Forms to computerized adaptive testing applications easier and more acceptable to the rehabilitation community.10a*Activities of Daily Living10a*Ambulatory Care Facilities10a*Mobility Limitation10a*Treatment Outcome10aDisabled Persons/psychology/*rehabilitation10aFemale10aHumans10aMale10aMiddle Aged10aQuestionnaires10aRehabilitation Centers1 aJette, A M1 aHaley, S M1 aNi, P1 aMoed, R uhttp://mail.iacat.org/content/adaptive-short-forms-outpatient-rehabilitation-outcome-assessment03437nas a2200481 4500008004100000020004600041245013800087210006900225250001500294260000800309300001200317490000700329520191400336653002702250653002302277653003102300653001502331653001602346653001002362653002102372653002402393653002302417653003802440653001102478653002202489653001102511653001102522653000902533653003702542653002102579653003102600653002602631653001702657653003202674653001602706653002802722100001602750700001502766700001002781700001502791700002502806856012402831 2008 eng d a1532-821X (Electronic)0003-9993 (Linking)00aAssessing self-care and social function using a computer adaptive testing version of the pediatric evaluation of disability inventory0 aAssessing selfcare and social function using a computer adaptive a2008/04/01 cApr a622-6290 v893 aOBJECTIVE: To examine score agreement, validity, precision, and response burden of a prototype computer adaptive testing (CAT) version of the self-care and social function scales of the Pediatric Evaluation of Disability Inventory compared with the full-length version of these scales. DESIGN: Computer simulation analysis of cross-sectional and longitudinal retrospective data; cross-sectional prospective study. SETTING: Pediatric rehabilitation hospital, including inpatient acute rehabilitation, day school program, outpatient clinics; community-based day care, preschool, and children's homes. PARTICIPANTS: Children with disabilities (n=469) and 412 children with no disabilities (analytic sample); 38 children with disabilities and 35 children without disabilities (cross-validation sample). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Summary scores from prototype CAT applications of each scale using 15-, 10-, and 5-item stopping rules; scores from the full-length self-care and social function scales; time (in seconds) to complete assessments and respondent ratings of burden. RESULTS: Scores from both computer simulations and field administration of the prototype CATs were highly consistent with scores from full-length administration (r range, .94-.99). Using computer simulation of retrospective data, discriminant validity, and sensitivity to change of the CATs closely approximated that of the full-length scales, especially when the 15- and 10-item stopping rules were applied. In the cross-validation study the time to administer both CATs was 4 minutes, compared with over 16 minutes to complete the full-length scales. CONCLUSIONS: Self-care and social function score estimates from CAT administration are highly comparable with those obtained from full-length scale administration, with small losses in validity and precision and substantial decreases in administration time.10a*Disability Evaluation10a*Social Adjustment10aActivities of Daily Living10aAdolescent10aAge Factors10aChild10aChild, Preschool10aComputer Simulation10aCross-Over Studies10aDisabled Children/*rehabilitation10aFemale10aFollow-Up Studies10aHumans10aInfant10aMale10aOutcome Assessment (Health Care)10aReference Values10aReproducibility of Results10aRetrospective Studies10aRisk Factors10aSelf Care/*standards/trends10aSex Factors10aSickness Impact Profile1 aCoster, W J1 aHaley, S M1 aNi, P1 aDumas, H M1 aFragala-Pinkham, M A uhttp://mail.iacat.org/content/assessing-self-care-and-social-function-using-computer-adaptive-testing-version-pediatric03042nas a2200481 4500008004100000020004600041245012200087210006900209250001500278260000800293300001200301490000700313520155700320653003201877653003101909653002201940653002001962653001001982653000901992653002202001653002802023653003302051653001102084653001102095653002502106653000902131653001602140653004602156653002202202653002402224653003002248653002902278100001502307700001402322700001502336700002402351700001802375700001102393700001602404700001002420700001502430856011502445 2008 eng d a1532-821X (Electronic)0003-9993 (Linking)00aComputerized adaptive testing for follow-up after discharge from inpatient rehabilitation: II. Participation outcomes0 aComputerized adaptive testing for followup after discharge from  a2008/01/30 cFeb a275-2830 v893 aOBJECTIVES: To measure participation outcomes with a computerized adaptive test (CAT) and compare CAT and traditional fixed-length surveys in terms of score agreement, respondent burden, discriminant validity, and responsiveness. DESIGN: Longitudinal, prospective cohort study of patients interviewed approximately 2 weeks after discharge from inpatient rehabilitation and 3 months later. SETTING: Follow-up interviews conducted in patient's home setting. PARTICIPANTS: Adults (N=94) with diagnoses of neurologic, orthopedic, or medically complex conditions. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Participation domains of mobility, domestic life, and community, social, & civic life, measured using a CAT version of the Participation Measure for Postacute Care (PM-PAC-CAT) and a 53-item fixed-length survey (PM-PAC-53). RESULTS: The PM-PAC-CAT showed substantial agreement with PM-PAC-53 scores (intraclass correlation coefficient, model 3,1, .71-.81). On average, the PM-PAC-CAT was completed in 42% of the time and with only 48% of the items as compared with the PM-PAC-53. Both formats discriminated across functional severity groups. The PM-PAC-CAT had modest reductions in sensitivity and responsiveness to patient-reported change over a 3-month interval as compared with the PM-PAC-53. CONCLUSIONS: Although continued evaluation is warranted, accurate estimates of participation status and responsiveness to change for group-level analyses can be obtained from CAT administrations, with a sizeable reduction in respondent burden.10a*Activities of Daily Living10a*Adaptation, Physiological10a*Computer Systems10a*Questionnaires10aAdult10aAged10aAged, 80 and over10aChi-Square Distribution10aFactor Analysis, Statistical10aFemale10aHumans10aLongitudinal Studies10aMale10aMiddle Aged10aOutcome Assessment (Health Care)/*methods10aPatient Discharge10aProspective Studies10aRehabilitation/*standards10aSubacute Care/*standards1 aHaley, S M1 aGandek, B1 aSiebens, H1 aBlack-Schaffer, R M1 aSinclair, S J1 aTao, W1 aCoster, W J1 aNi, P1 aJette, A M uhttp://mail.iacat.org/content/computerized-adaptive-testing-follow-after-discharge-inpatient-rehabilitation-ii03314nas a2200433 4500008004100000020004600041245007700087210006900164250001500233260001100248300001200259490000700271520203200278653002702310653003002337653002102367653001002388653000902398653001502407653003602422653002102458653004402479653002402523653001102547653001102558653001302569653000902582653001602591653003002607653003002637653003102667100001502698700001302713700001502726700001402741700001502755700001402770856009602784 2008 eng d a1528-1159 (Electronic)0362-2436 (Linking)00aComputerized adaptive testing in back pain: Validation of the CAT-5D-QOL0 aComputerized adaptive testing in back pain Validation of the CAT a2008/05/23 cMay 20 a1384-900 v333 aSTUDY DESIGN: We have conducted an outcome instrument validation study. OBJECTIVE: Our objective was to develop a computerized adaptive test (CAT) to measure 5 domains of health-related quality of life (HRQL) and assess its feasibility, reliability, validity, and efficiency. SUMMARY OF BACKGROUND DATA: Kopec and colleagues have recently developed item response theory based item banks for 5 domains of HRQL relevant to back pain and suitable for CAT applications. The domains are Daily Activities (DAILY), Walking (WALK), Handling Objects (HAND), Pain or Discomfort (PAIN), and Feelings (FEEL). METHODS: An adaptive algorithm was implemented in a web-based questionnaire administration system. The questionnaire included CAT-5D-QOL (5 scales), Modified Oswestry Disability Index (MODI), Roland-Morris Disability Questionnaire (RMDQ), SF-36 Health Survey, and standard clinical and demographic information. Participants were outpatients treated for mechanical back pain at a referral center in Vancouver, Canada. RESULTS: A total of 215 patients completed the questionnaire and 84 completed a retest. On average, patients answered 5.2 items per CAT-5D-QOL scale. Reliability ranged from 0.83 (FEEL) to 0.92 (PAIN) and was 0.92 for the MODI, RMDQ, and Physical Component Summary (PCS-36). The ceiling effect was 0.5% for PAIN compared with 2% for MODI and 5% for RMQ. The CAT-5D-QOL scales correlated as anticipated with other measures of HRQL and discriminated well according to the level of satisfaction with current symptoms, duration of the last episode, sciatica, and disability compensation. The average relative discrimination index was 0.87 for PAIN, 0.67 for DAILY and 0.62 for WALK, compared with 0.89 for MODI, 0.80 for RMDQ, and 0.59 for PCS-36. CONCLUSION: The CAT-5D-QOL is feasible, reliable, valid, and efficient in patients with back pain. This methodology can be recommended for use in back pain research and should improve outcome assessment, facilitate comparisons across studies, and reduce patient burden.10a*Disability Evaluation10a*Health Status Indicators10a*Quality of Life10aAdult10aAged10aAlgorithms10aBack Pain/*diagnosis/psychology10aBritish Columbia10aDiagnosis, Computer-Assisted/*standards10aFeasibility Studies10aFemale10aHumans10aInternet10aMale10aMiddle Aged10aPredictive Value of Tests10aQuestionnaires/*standards10aReproducibility of Results1 aKopec, J A1 aBadii, M1 aMcKenna, M1 aLima, V D1 aSayre, E C1 aDvorak, M uhttp://mail.iacat.org/content/computerized-adaptive-testing-back-pain-validation-cat-5d-qol03429nas a2200385 4500008004100000020004100041245010600082210006900188250001500257260001200272300001000284490000700294520220300301653002702504653001502531653001002546653002102556653002402577653002802601653003802629653001102667653001102678653001102689653003902700653000902739653002402748653003102772653004002803100001802843700001502861700001302876700001702889700001402906856012302920 2008 eng d a0271-6798 (Print)0271-6798 (Linking)00aMeasuring physical functioning in children with spinal impairments with computerized adaptive testing0 aMeasuring physical functioning in children with spinal impairmen a2008/03/26 cApr-May a330-50 v283 aBACKGROUND: The purpose of this study was to assess the utility of measuring current physical functioning status of children with scoliosis and kyphosis by applying computerized adaptive testing (CAT) methods. Computerized adaptive testing uses a computer interface to administer the most optimal items based on previous responses, reducing the number of items needed to obtain a scoring estimate. METHODS: This was a prospective study of 77 subjects (0.6-19.8 years) who were seen by a spine surgeon during a routine clinic visit for progress spine deformity. Using a multidimensional version of the Pediatric Evaluation of Disability Inventory CAT program (PEDI-MCAT), we evaluated content range, accuracy and efficiency, known-group validity, concurrent validity with the Pediatric Outcomes Data Collection Instrument, and test-retest reliability in a subsample (n = 16) within a 2-week interval. RESULTS: We found the PEDI-MCAT to have sufficient item coverage in both self-care and mobility content for this sample, although most patients tended to score at the higher ends of both scales. Both the accuracy of PEDI-MCAT scores as compared with a fixed format of the PEDI (r = 0.98 for both mobility and self-care) and test-retest reliability were very high [self-care: intraclass correlation (3,1) = 0.98, mobility: intraclass correlation (3,1) = 0.99]. The PEDI-MCAT took an average of 2.9 minutes for the parents to complete. The PEDI-MCAT detected expected differences between patient groups, and scores on the PEDI-MCAT correlated in expected directions with scores from the Pediatric Outcomes Data Collection Instrument domains. CONCLUSIONS: Use of the PEDI-MCAT to assess the physical functioning status, as perceived by parents of children with complex spinal impairments, seems to be feasible and achieves accurate and efficient estimates of self-care and mobility function. Additional item development will be needed at the higher functioning end of the scale to avoid ceiling effects for older children. LEVEL OF EVIDENCE: This is a level II prospective study designed to establish the utility of computer adaptive testing as an evaluation method in a busy pediatric spine practice.10a*Disability Evaluation10aAdolescent10aChild10aChild, Preschool10aComputer Simulation10aCross-Sectional Studies10aDisabled Children/*rehabilitation10aFemale10aHumans10aInfant10aKyphosis/*diagnosis/rehabilitation10aMale10aProspective Studies10aReproducibility of Results10aScoliosis/*diagnosis/rehabilitation1 aMulcahey, M J1 aHaley, S M1 aDuffy, T1 aPengsheng, N1 aBetz, R R uhttp://mail.iacat.org/content/measuring-physical-functioning-children-spinal-impairments-computerized-adaptive-testing03158nas a2200493 4500008004100000020002200041245008900063210006900152250001500221260000800236300001000244490000700254520169600261653003401957653002001991653001502011653001002026653000902036653002602045653003202071653003102103653001102134653001102145653000902156653003202165653001602197653002902213653004402242653002902286653003102315653003102346653001702377100001702394700001402411700001602425700001302441700001702454700002202471700001702493700001402510700001402524700001702538856010902555 2008 eng d a1075-2730 (Print)00aUsing computerized adaptive testing to reduce the burden of mental health assessment0 aUsing computerized adaptive testing to reduce the burden of ment a2008/04/02 cApr a361-80 v593 aOBJECTIVE: This study investigated the combination of item response theory and computerized adaptive testing (CAT) for psychiatric measurement as a means of reducing the burden of research and clinical assessments. METHODS: Data were from 800 participants in outpatient treatment for a mood or anxiety disorder; they completed 616 items of the 626-item Mood and Anxiety Spectrum Scales (MASS) at two times. The first administration was used to design and evaluate a CAT version of the MASS by using post hoc simulation. The second confirmed the functioning of CAT in live testing. RESULTS: Tests of competing models based on item response theory supported the scale's bifactor structure, consisting of a primary dimension and four group factors (mood, panic-agoraphobia, obsessive-compulsive, and social phobia). Both simulated and live CAT showed a 95% average reduction (585 items) in items administered (24 and 30 items, respectively) compared with administration of the full MASS. The correlation between scores on the full MASS and the CAT version was .93. For the mood disorder subscale, differences in scores between two groups of depressed patients--one with bipolar disorder and one without--on the full scale and on the CAT showed effect sizes of .63 (p<.003) and 1.19 (p<.001) standard deviation units, respectively, indicating better discriminant validity for CAT. CONCLUSIONS: Instead of using small fixed-length tests, clinicians can create item banks with a large item pool, and a small set of the items most relevant for a given individual can be administered with no loss of information, yielding a dramatic reduction in administration time and patient and clinician burden.10a*Diagnosis, Computer-Assisted10a*Questionnaires10aAdolescent10aAdult10aAged10aAgoraphobia/diagnosis10aAnxiety Disorders/diagnosis10aBipolar Disorder/diagnosis10aFemale10aHumans10aMale10aMental Disorders/*diagnosis10aMiddle Aged10aMood Disorders/diagnosis10aObsessive-Compulsive Disorder/diagnosis10aPanic Disorder/diagnosis10aPhobic Disorders/diagnosis10aReproducibility of Results10aTime Factors1 aGibbons, R D1 aWeiss, DJ1 aKupfer, D J1 aFrank, E1 aFagiolini, A1 aGrochocinski, V J1 aBhaumik, D K1 aStover, A1 aBock, R D1 aImmekus, J C uhttp://mail.iacat.org/content/using-computerized-adaptive-testing-reduce-burden-mental-health-assessment02309nas a2200301 4500008004100000020002200041245011900063210006900182250001500251260000800266300001000274490000700284520125000291653001501541653001001556653006201566653001101628653001101639653000901650653003801659653005601697653004601753653002101799653003101820100001601851700002001867856012001887 2007 eng d a1040-3590 (Print)00aComputerized adaptive personality testing: A review and illustration with the MMPI-2 Computerized Adaptive Version0 aComputerized adaptive personality testing A review and illustrat a2007/03/21 cMar a14-240 v193 aComputerized adaptive testing in personality assessment can improve efficiency by significantly reducing the number of items administered to answer an assessment question. Two approaches have been explored for adaptive testing in computerized personality assessment: item response theory and the countdown method. In this article, the authors review the literature on each and report the results of an investigation designed to explore the utility, in terms of item and time savings, and validity, in terms of correlations with external criterion measures, of an expanded countdown method-based research version of the Minnesota Multiphasic Personality Inventory-2 (MMPI-2), the MMPI-2 Computerized Adaptive Version (MMPI-2-CA). Participants were 433 undergraduate college students (170 men and 263 women). Results indicated considerable item savings and corresponding time savings for the adaptive testing modalities compared with a conventional computerized MMPI-2 administration. Furthermore, computerized adaptive administration yielded comparable results to computerized conventional administration of the MMPI-2 in terms of both test scores and their validity. Future directions for computerized adaptive personality testing are discussed.10aAdolescent10aAdult10aDiagnosis, Computer-Assisted/*statistics & numerical data10aFemale10aHumans10aMale10aMMPI/*statistics & numerical data10aPersonality Assessment/*statistics & numerical data10aPsychometrics/statistics & numerical data10aReference Values10aReproducibility of Results1 aForbey, J D1 aBen-Porath, Y S uhttp://mail.iacat.org/content/computerized-adaptive-personality-testing-review-and-illustration-mmpi-2-computerized02419nas a2200325 4500008004100000020002200041245008700063210006900150250001500219300001100234490000700245520140100252653001901653653003001672653001901702653003801721653002101759653002001780653001401800653001501814653003301829653001101862653002401873653001801897100001701915700001501932700001501947700001501962856011601977 2007 eng d a0962-9343 (Print)00aDeveloping tailored instruments: item banking and computerized adaptive assessment0 aDeveloping tailored instruments item banking and computerized ad a2007/05/29 a95-1080 v163 aItem banks and Computerized Adaptive Testing (CAT) have the potential to greatly improve the assessment of health outcomes. This review describes the unique features of item banks and CAT and discusses how to develop item banks. In CAT, a computer selects the items from an item bank that are most relevant for and informative about the particular respondent; thus optimizing test relevance and precision. Item response theory (IRT) provides the foundation for selecting the items that are most informative for the particular respondent and for scoring responses on a common metric. The development of an item bank is a multi-stage process that requires a clear definition of the construct to be measured, good items, a careful psychometric analysis of the items, and a clear specification of the final CAT. The psychometric analysis needs to evaluate the assumptions of the IRT model such as unidimensionality and local independence; that the items function the same way in different subgroups of the population; and that there is an adequate fit between the data and the chosen item response models. Also, interpretation guidelines need to be established to help the clinical application of the assessment. Although medical research can draw upon expertise from educational testing in the development of item banks and CAT, the medical field also encounters unique opportunities and challenges.10a*Health Status10a*Health Status Indicators10a*Mental Health10a*Outcome Assessment (Health Care)10a*Quality of Life10a*Questionnaires10a*Software10aAlgorithms10aFactor Analysis, Statistical10aHumans10aModels, Statistical10aPsychometrics1 aBjorner, J B1 aChang, C-H1 aThissen, D1 aReeve, B B uhttp://mail.iacat.org/content/developing-tailored-instruments-item-banking-and-computerized-adaptive-assessment03105nas a2200445 4500008004100000020002200041245007100063210006900134250001500203300001200218490000700230520183100237653003802068653001902106653002102125653002002146653001402166653001102180653003002191653001102221653000902232653002502241653004602266653001802312653002602330100001302356700001402369700001702383700001302400700001502413700001502428700001702443700001402460700001802474700002302492700001602515700001602531700001502547856009702562 2007 eng d a0962-9343 (Print)00aIRT health outcomes data analysis project: an overview and summary0 aIRT health outcomes data analysis project an overview and summar a2007/03/14 a121-1320 v163 aBACKGROUND: In June 2004, the National Cancer Institute and the Drug Information Association co-sponsored the conference, "Improving the Measurement of Health Outcomes through the Applications of Item Response Theory (IRT) Modeling: Exploration of Item Banks and Computer-Adaptive Assessment." A component of the conference was presentation of a psychometric and content analysis of a secondary dataset. OBJECTIVES: A thorough psychometric and content analysis was conducted of two primary domains within a cancer health-related quality of life (HRQOL) dataset. RESEARCH DESIGN: HRQOL scales were evaluated using factor analysis for categorical data, IRT modeling, and differential item functioning analyses. In addition, computerized adaptive administration of HRQOL item banks was simulated, and various IRT models were applied and compared. SUBJECTS: The original data were collected as part of the NCI-funded Quality of Life Evaluation in Oncology (Q-Score) Project. A total of 1,714 patients with cancer or HIV/AIDS were recruited from 5 clinical sites. MEASURES: Items from 4 HRQOL instruments were evaluated: Cancer Rehabilitation Evaluation System-Short Form, European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Functional Assessment of Cancer Therapy and Medical Outcomes Study Short-Form Health Survey. RESULTS AND CONCLUSIONS: Four lessons learned from the project are discussed: the importance of good developmental item banks, the ambiguity of model fit results, the limits of our knowledge regarding the practical implications of model misfit, and the importance in the measurement of HRQOL of construct definition. With respect to these lessons, areas for future research are suggested. The feasibility of developing item banks for broad definitions of health is discussed.10a*Data Interpretation, Statistical10a*Health Status10a*Quality of Life10a*Questionnaires10a*Software10aFemale10aHIV Infections/psychology10aHumans10aMale10aNeoplasms/psychology10aOutcome Assessment (Health Care)/*methods10aPsychometrics10aStress, Psychological1 aCook, KF1 aTeal, C R1 aBjorner, J B1 aCella, D1 aChang, C-H1 aCrane, P K1 aGibbons, L E1 aHays, R D1 aMcHorney, C A1 aOcepek-Welikson, K1 aRaczek, A E1 aTeresi, J A1 aReeve, B B uhttp://mail.iacat.org/content/irt-health-outcomes-data-analysis-project-overview-and-summary02745nas a2200541 4500008004100000020002200041245017000063210006900233250001500302260000800317300001100325490000700336520116200343653001901505653002501524653002101549653002101570653001501591653001001606653000901616653001601625653002301641653003201664653001101696653001101707653000901718653001601727653004601743653001801789653002901807653001801836100001501854700001401869700001701883700001301900700001501913700001601928700001501944700001701959700001401976700001801990700001102008700001602019700001502035700001302050700001302063856012702076 2007 eng d a0025-7079 (Print)00aPsychometric evaluation and calibration of health-related quality of life item banks: plans for the Patient-Reported Outcomes Measurement Information System (PROMIS)0 aPsychometric evaluation and calibration of healthrelated quality a2007/04/20 cMay aS22-310 v453 aBACKGROUND: The construction and evaluation of item banks to measure unidimensional constructs of health-related quality of life (HRQOL) is a fundamental objective of the Patient-Reported Outcomes Measurement Information System (PROMIS) project. OBJECTIVES: Item banks will be used as the foundation for developing short-form instruments and enabling computerized adaptive testing. The PROMIS Steering Committee selected 5 HRQOL domains for initial focus: physical functioning, fatigue, pain, emotional distress, and social role participation. This report provides an overview of the methods used in the PROMIS item analyses and proposed calibration of item banks. ANALYSES: Analyses include evaluation of data quality (eg, logic and range checking, spread of response distribution within an item), descriptive statistics (eg, frequencies, means), item response theory model assumptions (unidimensionality, local independence, monotonicity), model fit, differential item functioning, and item calibration for banking. RECOMMENDATIONS: Summarized are key analytic issues; recommendations are provided for future evaluations of item banks in HRQOL assessment.10a*Health Status10a*Information Systems10a*Quality of Life10a*Self Disclosure10aAdolescent10aAdult10aAged10aCalibration10aDatabases as Topic10aEvaluation Studies as Topic10aFemale10aHumans10aMale10aMiddle Aged10aOutcome Assessment (Health Care)/*methods10aPsychometrics10aQuestionnaires/standards10aUnited States1 aReeve, B B1 aHays, R D1 aBjorner, J B1 aCook, KF1 aCrane, P K1 aTeresi, J A1 aThissen, D1 aRevicki, D A1 aWeiss, DJ1 aHambleton, RK1 aLiu, H1 aGershon, RC1 aReise, S P1 aLai, J S1 aCella, D uhttp://mail.iacat.org/content/psychometric-evaluation-and-calibration-health-related-quality-life-item-banks-plans-patient02653nas a2200397 4500008004100000020002200041245013500063210006900198250001500267260000800282300001200290490000700302520140700309653002601716653003101742653001501773653001001788653000901798653002201807653002501829653003301854653001101887653001101898653000901909653001601918653004601934653003001980653003102010653001302041100001502054700001002069700001802079700001602097700001502113856012702128 2006 eng d a0895-4356 (Print)00aComputer adaptive testing improved accuracy and precision of scores over random item selection in a physical functioning item bank0 aComputer adaptive testing improved accuracy and precision of sco a2006/10/10 cNov a1174-820 v593 aBACKGROUND AND OBJECTIVE: Measuring physical functioning (PF) within and across postacute settings is critical for monitoring outcomes of rehabilitation; however, most current instruments lack sufficient breadth and feasibility for widespread use. Computer adaptive testing (CAT), in which item selection is tailored to the individual patient, holds promise for reducing response burden, yet maintaining measurement precision. We calibrated a PF item bank via item response theory (IRT), administered items with a post hoc CAT design, and determined whether CAT would improve accuracy and precision of score estimates over random item selection. METHODS: 1,041 adults were interviewed during postacute care rehabilitation episodes in either hospital or community settings. Responses for 124 PF items were calibrated using IRT methods to create a PF item bank. We examined the accuracy and precision of CAT-based scores compared to a random selection of items. RESULTS: CAT-based scores had higher correlations with the IRT-criterion scores, especially with short tests, and resulted in narrower confidence intervals than scores based on a random selection of items; gains, as expected, were especially large for low and high performing adults. CONCLUSION: The CAT design may have important precision and efficiency advantages for point-of-care functional assessment in rehabilitation practice settings.10a*Recovery of Function10aActivities of Daily Living10aAdolescent10aAdult10aAged10aAged, 80 and over10aConfidence Intervals10aFactor Analysis, Statistical10aFemale10aHumans10aMale10aMiddle Aged10aOutcome Assessment (Health Care)/*methods10aRehabilitation/*standards10aReproducibility of Results10aSoftware1 aHaley, S M1 aNi, P1 aHambleton, RK1 aSlavin, M D1 aJette, A M uhttp://mail.iacat.org/content/computer-adaptive-testing-improved-accuracy-and-precision-scores-over-random-item-selectio-003330nas a2200469 4500008004100000020002200041245011600063210006900179250001500248260000800263300001200271490000700283520189400290653003202184653003102216653002202247653002002269653001002289653000902299653002202308653002802330653003302358653001102391653001102402653002502413653000902438653001602447653004602463653002202509653002402531653003002555653002902585100001502614700001502629700001602644700001102660700002402671700001402695700001802709700001002727856012302737 2006 eng d a0003-9993 (Print)00aComputerized adaptive testing for follow-up after discharge from inpatient rehabilitation: I. Activity outcomes0 aComputerized adaptive testing for followup after discharge from  a2006/08/01 cAug a1033-420 v873 aOBJECTIVE: To examine score agreement, precision, validity, efficiency, and responsiveness of a computerized adaptive testing (CAT) version of the Activity Measure for Post-Acute Care (AM-PAC-CAT) in a prospective, 3-month follow-up sample of inpatient rehabilitation patients recently discharged home. DESIGN: Longitudinal, prospective 1-group cohort study of patients followed approximately 2 weeks after hospital discharge and then 3 months after the initial home visit. SETTING: Follow-up visits conducted in patients' home setting. PARTICIPANTS: Ninety-four adults who were recently discharged from inpatient rehabilitation, with diagnoses of neurologic, orthopedic, and medically complex conditions. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Summary scores from AM-PAC-CAT, including 3 activity domains of movement and physical, personal care and instrumental, and applied cognition were compared with scores from a traditional fixed-length version of the AM-PAC with 66 items (AM-PAC-66). RESULTS: AM-PAC-CAT scores were in good agreement (intraclass correlation coefficient model 3,1 range, .77-.86) with scores from the AM-PAC-66. On average, the CAT programs required 43% of the time and 33% of the items compared with the AM-PAC-66. Both formats discriminated across functional severity groups. The standardized response mean (SRM) was greater for the movement and physical fixed form than the CAT; the effect size and SRM of the 2 other AM-PAC domains showed similar sensitivity between CAT and fixed formats. Using patients' own report as an anchor-based measure of change, the CAT and fixed length formats were comparable in responsiveness to patient-reported change over a 3-month interval. CONCLUSIONS: Accurate estimates for functional activity group-level changes can be obtained from CAT administrations, with a considerable reduction in administration time.10a*Activities of Daily Living10a*Adaptation, Physiological10a*Computer Systems10a*Questionnaires10aAdult10aAged10aAged, 80 and over10aChi-Square Distribution10aFactor Analysis, Statistical10aFemale10aHumans10aLongitudinal Studies10aMale10aMiddle Aged10aOutcome Assessment (Health Care)/*methods10aPatient Discharge10aProspective Studies10aRehabilitation/*standards10aSubacute Care/*standards1 aHaley, S M1 aSiebens, H1 aCoster, W J1 aTao, W1 aBlack-Schaffer, R M1 aGandek, B1 aSinclair, S J1 aNi, P uhttp://mail.iacat.org/content/computerized-adaptive-testing-follow-after-discharge-inpatient-rehabilitation-i-activity03167nas a2200361 4500008004100000020002200041245013600063210006900199250001500268260000800283300001200291490000700303520206800310653001502378653002402393653002102417653001002438653000902448653002902457653003402486653002402520653001102544653001102555653001302566653000902579653001602588100001602604700001302620700002302633700001202656700001102668856012602679 2006 eng d a0962-9343 (Print)00aComputerized adaptive testing of diabetes impact: a feasibility study of Hispanics and non-Hispanics in an active clinic population0 aComputerized adaptive testing of diabetes impact a feasibility s a2006/10/13 cNov a1503-180 v153 aBACKGROUND: Diabetes is a leading cause of death and disability in the US and is twice as common among Hispanic Americans as non-Hispanics. The societal costs of diabetes provide an impetus for developing tools that can improve patient care and delay or prevent diabetes complications. METHODS: We implemented a feasibility study of a Computerized Adaptive Test (CAT) to measure diabetes impact using a sample of 103 English- and 97 Spanish-speaking patients (mean age = 56.5, 66.5% female) in a community medical center with a high proportion of minority patients (28% African-American). The 37 items of the Diabetes Impact Survey were translated using forward-backward translation and cognitive debriefing. Participants were randomized to receive either the full-length tool or the Diabetes-CAT first, in the patient's native language. RESULTS: The number of items and the amount of time to complete the survey for the CAT was reduced to one-sixth the amount for the full-length tool in both languages, across disease severity. Confirmatory Factor Analysis confirmed that the Diabetes Impact Survey is unidimensional. The Diabetes-CAT demonstrated acceptable internal consistency reliability, construct validity, and discriminant validity in the overall sample, although subgroup analyses suggested that the English sample data evidenced higher levels of reliability and validity than the Spanish sample and issues with discriminant validity in the Spanish sample. Differential Item Function analysis revealed differences in responses tendencies by language group in 3 of the 37 items. Participant interviews suggested that the Spanish-speaking patients generally preferred the paper survey to the computer-assisted tool, and were twice as likely to experience difficulties understanding the items. CONCLUSIONS: While the Diabetes-CAT demonstrated clear advantages in reducing respondent burden as compared to the full-length tool, simplifying the item bank will be necessary for enhancing the feasibility of the Diabetes-CAT for use with low literacy patients.10a*Computers10a*Hispanic Americans10a*Quality of Life10aAdult10aAged10aData Collection/*methods10aDiabetes Mellitus/*psychology10aFeasibility Studies10aFemale10aHumans10aLanguage10aMale10aMiddle Aged1 aSchwartz, C1 aWelch, G1 aSantiago-Kelley, P1 aBode, R1 aSun, X uhttp://mail.iacat.org/content/computerized-adaptive-testing-diabetes-impact-feasibility-study-hispanics-and-non-hispanics02161nas a2200289 4500008004100000245010000041210006900141260000800210300001200218490000700230520127700237653003401514653002101548653000901569653001201578653002201590653001101612653001101623653000901634653001601643653002901659653001901688100001301707700001501720700001301735856012301748 2006 eng d00aFactor analysis techniques for assessing sufficient unidimensionality of cancer related fatigue0 aFactor analysis techniques for assessing sufficient unidimension cSep a1179-900 v153 aBACKGROUND: Fatigue is the most common unrelieved symptom experienced by people with cancer. The purpose of this study was to examine whether cancer-related fatigue (CRF) can be summarized using a single score, that is, whether CRF is sufficiently unidimensional for measurement approaches that require or assume unidimensionality. We evaluated this question using factor analysis techniques including the theory-driven bi-factor model. METHODS: Five hundred and fifty five cancer patients from the Chicago metropolitan area completed a 72-item fatigue item bank, covering a range of fatigue-related concerns including intensity, frequency and interference with physical, mental, and social activities. Dimensionality was assessed using exploratory and confirmatory factor analysis (CFA) techniques. RESULTS: Exploratory factor analysis (EFA) techniques identified from 1 to 17 factors. The bi-factor model suggested that CRF was sufficiently unidimensional. CONCLUSIONS: CRF can be considered sufficiently unidimensional for applications that require unidimensionality. One such application, item response theory (IRT), will facilitate the development of short-form and computer-adaptive testing. This may further enable practical and accurate clinical assessment of CRF.10a*Factor Analysis, Statistical10a*Quality of Life10aAged10aChicago10aFatigue/*etiology10aFemale10aHumans10aMale10aMiddle Aged10aNeoplasms/*complications10aQuestionnaires1 aLai, J-S1 aCrane, P K1 aCella, D uhttp://mail.iacat.org/content/factor-analysis-techniques-assessing-sufficient-unidimensionality-cancer-related-fatigue02406nas a2200337 4500008004100000020002200041245010800063210006900171250001500240260000800255300001100263490000700274520139300281653002101674653002101695653001001716653001101726653001801737653001101755653000901766653001601775653003001791653002801821100001801849700001701867700001801884700001401902700001701916700001701933856011801950 2006 eng d a0962-9343 (Print)00aMultidimensional computerized adaptive testing of the EORTC QLQ-C30: basic developments and evaluations0 aMultidimensional computerized adaptive testing of the EORTC QLQC a2006/03/21 cApr a315-290 v153 aOBJECTIVE: Self-report questionnaires are widely used to measure health-related quality of life (HRQOL). Ideally, such questionnaires should be adapted to the individual patient and at the same time scores should be directly comparable across patients. This may be achieved using computerized adaptive testing (CAT). Usually, CAT is carried out for a single domain at a time. However, many HRQOL domains are highly correlated. Multidimensional CAT may utilize these correlations to improve measurement efficiency. We investigated the possible advantages and difficulties of multidimensional CAT. STUDY DESIGN AND SETTING: We evaluated multidimensional CAT of three scales from the EORTC QLQ-C30: the physical functioning, emotional functioning, and fatigue scales. Analyses utilised a database with 2958 European cancer patients. RESULTS: It was possible to obtain scores for the three domains with five to seven items administered using multidimensional CAT that were very close to the scores obtained using all 12 items and with no or little loss of measurement precision. CONCLUSION: The findings suggest that multidimensional CAT may significantly improve measurement precision and efficiency and encourage further research into multidimensional CAT. Particularly, the estimation of the model underlying the multidimensional CAT and the conceptual aspects need further investigations.10a*Quality of Life10a*Self Disclosure10aAdult10aFemale10aHealth Status10aHumans10aMale10aMiddle Aged10aQuestionnaires/*standards10aUser-Computer Interface1 aPetersen, M A1 aGroenvold, M1 aAaronson, N K1 aFayers, P1 aSprangers, M1 aBjorner, J B uhttp://mail.iacat.org/content/multidimensional-computerized-adaptive-testing-eortc-qlq-c30-basic-developments-and02517nas a2200265 4500008004100000020004100041245013200082210006900214250001500283260000800298300001100306490000700317520154000324653003101864653003701895653003301932653002401965653001101989653002402000653002702024653003302051653003002084100001602114856012102130 2006 eng d a0025-7079 (Print)0025-7079 (Linking)00aOverview of quantitative measurement methods. Equivalence, invariance, and differential item functioning in health applications0 aOverview of quantitative measurement methods Equivalence invaria a2006/10/25 cNov aS39-490 v443 aBACKGROUND: Reviewed in this article are issues relating to the study of invariance and differential item functioning (DIF). The aim of factor analyses and DIF, in the context of invariance testing, is the examination of group differences in item response conditional on an estimate of disability. Discussed are parameters and statistics that are not invariant and cannot be compared validly in crosscultural studies with varying distributions of disability in contrast to those that can be compared (if the model assumptions are met) because they are produced by models such as linear and nonlinear regression. OBJECTIVES: The purpose of this overview is to provide an integrated approach to the quantitative methods used in this special issue to examine measurement equivalence. The methods include classical test theory (CTT), factor analytic, and parametric and nonparametric approaches to DIF detection. Also included in the quantitative section is a discussion of item banking and computerized adaptive testing (CAT). METHODS: Factorial invariance and the articles discussing this topic are introduced. A brief overview of the DIF methods presented in the quantitative section of the special issue is provided together with a discussion of ways in which DIF analyses and examination of invariance using factor models may be complementary. CONCLUSIONS: Although factor analytic and DIF detection methods share features, they provide unique information and can be viewed as complementary in informing about measurement equivalence.10a*Cross-Cultural Comparison10aData Interpretation, Statistical10aFactor Analysis, Statistical10aGuidelines as Topic10aHumans10aModels, Statistical10aPsychometrics/*methods10aStatistics as Topic/*methods10aStatistics, Nonparametric1 aTeresi, J A uhttp://mail.iacat.org/content/overview-quantitative-measurement-methods-equivalence-invariance-and-differential-item02654nas a2200409 4500008004100000245013400041210006900175300001000244490000700254520123100261653002501492653003201517653003101549653001001580653000901590653002201599653003301621653001101654653001101665653000901676653001601685653002401701653003101725653004101756653004501797653006801842653006101910653003001971653002802001653002202029100001402051700001302065700001802078700001402096700001502110856011902125 2006 eng d00aSimulated computerized adaptive test for patients with shoulder impairments was efficient and produced valid measures of function0 aSimulated computerized adaptive test for patients with shoulder  a290-80 v593 aBACKGROUND AND OBJECTIVE: To test unidimensionality and local independence of a set of shoulder functional status (SFS) items, develop a computerized adaptive test (CAT) of the items using a rating scale item response theory model (RSM), and compare discriminant validity of measures generated using all items (theta(IRT)) and measures generated using the simulated CAT (theta(CAT)). STUDY DESIGN AND SETTING: We performed a secondary analysis of data collected prospectively during rehabilitation of 400 patients with shoulder impairments who completed 60 SFS items. RESULTS: Factor analytic techniques supported that the 42 SFS items formed a unidimensional scale and were locally independent. Except for five items, which were deleted, the RSM fit the data well. The remaining 37 SFS items were used to generate the CAT. On average, 6 items were needed to estimate precise measures of function using the SFS CAT, compared with all 37 SFS items. The theta(IRT) and theta(CAT) measures were highly correlated (r = .96) and resulted in similar classifications of patients. CONCLUSION: The simulated SFS CAT was efficient and produced precise, clinically relevant measures of functional status with good discriminating ability.10a*Computer Simulation10a*Range of Motion, Articular10aActivities of Daily Living10aAdult10aAged10aAged, 80 and over10aFactor Analysis, Statistical10aFemale10aHumans10aMale10aMiddle Aged10aProspective Studies10aReproducibility of Results10aResearch Support, N.I.H., Extramural10aResearch Support, U.S. Gov't, Non-P.H.S.10aShoulder Dislocation/*physiopathology/psychology/rehabilitation10aShoulder Pain/*physiopathology/psychology/rehabilitation10aShoulder/*physiopathology10aSickness Impact Profile10aTreatment Outcome1 aHart, D L1 aCook, KF1 aMioduski, J E1 aTeal, C R1 aCrane, P K uhttp://mail.iacat.org/content/simulated-computerized-adaptive-test-patients-shoulder-impairments-was-efficient-and02073nas a2200217 4500008004500000245013400045210006900179300001200248490000700260520127300267653003401540653004201574653002501616653001901641100001401660700001301674700001801687700001401705700001501719856012101734 2006 Engldsh 00aSimulated computerized adaptive test for patients with shoulder impairments was efficient and produced valid measures of function0 aSimulated computerized adaptive test for patients with shoulder  a290-2980 v593 a

Background and Objective: To test unidimensionality and local independence of a set of shoulder functional status (SFS) items,
develop a computerized adaptive test (CAT) of the items using a rating scale item response theory model (RSM), and compare discriminant validity of measures generated using all items (qIRT) and measures generated using the simulated CAT (qCAT).
Study Design and Setting: We performed a secondary analysis of data collected prospectively during rehabilitation of 400 patients
with shoulder impairments who completed 60 SFS items.
Results: Factor analytic techniques supported that the 42 SFS items formed a unidimensional scale and were locally independent. Except for five items, which were deleted, the RSM fit the data well. The remaining 37 SFS items were used to generate the CAT. On average, 6 items on were needed to estimate precise measures of function using the SFS CAT, compared with all 37 SFS items. The qIRT and qCAT measures were highly correlated (r 5 .96) and resulted in similar classifications of patients.
Conclusion: The simulated SFS CAT was efficient and produced precise, clinically relevant measures of functional status with good
discriminating ability. 

10acomputerized adaptive testing10aFlexilevel Scale of Shoulder Function10aItem Response Theory10aRehabilitation1 aHart, D L1 aCook, KF1 aMioduski, J E1 aTeal, C R1 aCrane, P K uhttp://mail.iacat.org/content/simulated-computerized-adaptive-test-patients-shoulder-impairments-was-efficient-and-003124nas a2200385 4500008004100000020002200041245012900063210006900192250001500261260000800276300001000284490000700294520188400301653002502185653002702210653001502237653001002252653002102262653002802283653003802311653001102349653001102360653001102371653000902382653004602391653002702437653003002464653003202494100001502526700001602541700001602557700001502573700002502588856012502613 2005 eng d a0003-9993 (Print)00aAssessing mobility in children using a computer adaptive testing version of the pediatric evaluation of disability inventory0 aAssessing mobility in children using a computer adaptive testing a2005/05/17 cMay a932-90 v863 aOBJECTIVE: To assess score agreement, validity, precision, and response burden of a prototype computerized adaptive testing (CAT) version of the Mobility Functional Skills Scale (Mob-CAT) of the Pediatric Evaluation of Disability Inventory (PEDI) as compared with the full 59-item version (Mob-59). DESIGN: Computer simulation analysis of cross-sectional and longitudinal retrospective data; and cross-sectional prospective study. SETTING: Pediatric rehabilitation hospital, including inpatient acute rehabilitation, day school program, outpatient clinics, community-based day care, preschool, and children's homes. PARTICIPANTS: Four hundred sixty-nine children with disabilities and 412 children with no disabilities (analytic sample); 41 children without disabilities and 39 with disabilities (cross-validation sample). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Summary scores from a prototype Mob-CAT application and versions using 15-, 10-, and 5-item stopping rules; scores from the Mob-59; and number of items and time (in seconds) to administer assessments. RESULTS: Mob-CAT scores from both computer simulations (intraclass correlation coefficient [ICC] range, .94-.99) and field administrations (ICC=.98) were in high agreement with scores from the Mob-59. Using computer simulations of retrospective data, discriminant validity, and sensitivity to change of the Mob-CAT closely approximated that of the Mob-59, especially when using the 15- and 10-item stopping rule versions of the Mob-CAT. The Mob-CAT used no more than 15% of the items for any single administration, and required 20% of the time needed to administer the Mob-59. CONCLUSIONS: Comparable score estimates for the PEDI mobility scale can be obtained from CAT administrations, with losses in validity and precision for shorter forms, but with a considerable reduction in administration time.10a*Computer Simulation10a*Disability Evaluation10aAdolescent10aChild10aChild, Preschool10aCross-Sectional Studies10aDisabled Children/*rehabilitation10aFemale10aHumans10aInfant10aMale10aOutcome Assessment (Health Care)/*methods10aRehabilitation Centers10aRehabilitation/*standards10aSensitivity and Specificity1 aHaley, S M1 aRaczek, A E1 aCoster, W J1 aDumas, H M1 aFragala-Pinkham, M A uhttp://mail.iacat.org/content/assessing-mobility-children-using-computer-adaptive-testing-version-pediatric-evaluation-002792nas a2200469 4500008004100000020002200041245010400063210006900167250001500236260000800251300001200259490000700271520132800278653002201606653003101628653001501659653001601674653001001690653003401700653002101734653002401755653002501779653001501804653001101819653005301830653002901883653001101912653001101923653002001934653000901954653003101963653004601994653003102040653001402071653003202085100001502117700001002132700002502142700001702167700001302184856012502197 2005 eng d a0012-1622 (Print)00aA computer adaptive testing approach for assessing physical functioning in children and adolescents0 acomputer adaptive testing approach for assessing physical functi a2005/02/15 cFeb a113-1200 v473 aThe purpose of this article is to demonstrate: (1) the accuracy and (2) the reduction in amount of time and effort in assessing physical functioning (self-care and mobility domains) of children and adolescents using computer-adaptive testing (CAT). A CAT algorithm selects questions directly tailored to the child's ability level, based on previous responses. Using a CAT algorithm, a simulation study was used to determine the number of items necessary to approximate the score of a full-length assessment. We built simulated CAT (5-, 10-, 15-, and 20-item versions) for self-care and mobility domains and tested their accuracy in a normative sample (n=373; 190 males, 183 females; mean age 6y 11mo [SD 4y 2m], range 4mo to 14y 11mo) and a sample of children and adolescents with Pompe disease (n=26; 21 males, 5 females; mean age 6y 1mo [SD 3y 10mo], range 5mo to 14y 10mo). Results indicated that comparable score estimates (based on computer simulations) to the full-length tests can be achieved in a 20-item CAT version for all age ranges and for normative and clinical samples. No more than 13 to 16% of the items in the full-length tests were needed for any one administration. These results support further consideration of using CAT programs for accurate and efficient clinical assessments of physical functioning.10a*Computer Systems10aActivities of Daily Living10aAdolescent10aAge Factors10aChild10aChild Development/*physiology10aChild, Preschool10aComputer Simulation10aConfidence Intervals10aDemography10aFemale10aGlycogen Storage Disease Type II/physiopathology10aHealth Status Indicators10aHumans10aInfant10aInfant, Newborn10aMale10aMotor Activity/*physiology10aOutcome Assessment (Health Care)/*methods10aReproducibility of Results10aSelf Care10aSensitivity and Specificity1 aHaley, S M1 aNi, P1 aFragala-Pinkham, M A1 aSkrinar, A M1 aCorzo, D uhttp://mail.iacat.org/content/computer-adaptive-testing-approach-assessing-physical-functioning-children-and-adolescents02444nas a2200373 4500008004100000020004100041245008200082210006900164250001500233260000800248300001000256490000700266520136700273653001001640653000901650653002201659653003301681653003301714653001101747653001101758653000901769653001601778653004001794653001801834653001901852100001301871700001301884700001401897700001201911700001701923700001601940700001501956856009901971 2005 eng d a0895-4356 (Print)0895-4356 (Linking)00aAn item bank was created to improve the measurement of cancer-related fatigue0 aitem bank was created to improve the measurement of cancerrelate a2005/02/01 cFeb a190-70 v583 aOBJECTIVE: Cancer-related fatigue (CRF) is one of the most common unrelieved symptoms experienced by patients. CRF is underrecognized and undertreated due to a lack of clinically sensitive instruments that integrate easily into clinics. Modern computerized adaptive testing (CAT) can overcome these obstacles by enabling precise assessment of fatigue without requiring the administration of a large number of questions. A working item bank is essential for development of a CAT platform. The present report describes the building of an operational item bank for use in clinical settings with the ultimate goal of improving CRF identification and treatment. STUDY DESIGN AND SETTING: The sample included 301 cancer patients. Psychometric properties of items were examined by using Rasch analysis, an Item Response Theory (IRT) model. RESULTS AND CONCLUSION: The final bank includes 72 items. These 72 unidimensional items explained 57.5% of the variance, based on factor analysis results. Excellent internal consistency (alpha=0.99) and acceptable item-total correlation were found (range: 0.51-0.85). The 72 items covered a reasonable range of the fatigue continuum. No significant ceiling effects, floor effects, or gaps were found. A sample short form was created for demonstration purposes. The resulting bank is amenable to the development of a CAT platform.10aAdult10aAged10aAged, 80 and over10aFactor Analysis, Statistical10aFatigue/*etiology/psychology10aFemale10aHumans10aMale10aMiddle Aged10aNeoplasms/*complications/psychology10aPsychometrics10aQuestionnaires1 aLai, J-S1 aCella, D1 aDineen, K1 aBode, R1 aVon Roenn, J1 aGershon, RC1 aShevrin, D uhttp://mail.iacat.org/content/item-bank-was-created-improve-measurement-cancer-related-fatigue02301nas a2200205 4500008004100000245009000041210007100131300000900202490000700211520161900218653002001837653001601857653001801873653002201891653001601913653001501929653001801944100001401962856011901976 2005 eng d00aLa Validez desde una óptica psicométrica [Validity from a psychometric perspective]0 aLa Validez desde una óptica psicométrica Validity from a psychom a9-200 v133 aEl estudio de la validez constituye el eje central de los análisis psicométricos de los instrumentos de medida. En esta comunicación se traza una breve nota histórica de los distintos modos de concebir la validez a lo largo de los tiempos, se comentan las líneas actuales, y se tratan de vislumbrar posibles vías futuras, teniendo en cuenta el impacto que las nuevas tecnologías informáticas están ejerciendo sobre los propios instrumentos de medida en Psicología y Educación. Cuestiones como los nuevos formatos multimedia de los ítems, la evaluación a distancia, el uso intercultural de las pruebas, las consecuencias de su uso, o los tests adaptativos informatizados, reclaman nuevas formas de evaluar y conceptualizar la validez. También se analizan críticamente algunos planteamientos recientes sobre el concepto de validez. The study of validity constitutes a central axis of psychometric analyses of measurement instruments. This paper presents a historical sketch of different modes of conceiving validity, with commentary on current views, and it attempts to predict future lines of research by considering the impact of new computerized technologies on measurement instruments in psychology and education. Factors such as the new multimedia format of items, distance assessment, the intercultural use of tests, the consequences of the latter, or the development of computerized adaptive tests demand new ways of conceiving and evaluating validity. Some recent thoughts about the concept of validity are also critically analyzed. (PsycINFO Database Record (c) 2005 APA ) (journal abstract)10aFactor Analysis10aMeasurement10aPsychometrics10aScaling (Testing)10aStatistical10aTechnology10aTest Validity1 aMuñiz, J uhttp://mail.iacat.org/content/la-validez-desde-una-%C3%B3ptica-psicom%C3%A9trica-validity-psychometric-perspective02903nas a2200409 4500008004100000245012300041210006900164260000800233300001000241490000700251520159700258653004701855653001001902653000901912653001901921653003101940653002601971653001101997653002902008653001102037653000902048653001602057653003902073653001402112653002502126653002702151653003002178653003202208653002802240653002202268100001502290700001602305700001702321700001602338700001502354856012402369 2005 eng d00aMeasuring physical function in patients with complex medical and postsurgical conditions: a computer adaptive approach0 aMeasuring physical function in patients with complex medical and cOct a741-80 v843 aOBJECTIVE: To examine whether the range of disability in the medically complex and postsurgical populations receiving rehabilitation is adequately sampled by the new Activity Measure--Post-Acute Care (AM-PAC), and to assess whether computer adaptive testing (CAT) can derive valid patient scores using fewer questions. DESIGN: Observational study of 158 subjects (mean age 67.2 yrs) receiving skilled rehabilitation services in inpatient (acute rehabilitation hospitals, skilled nursing facility units) and community (home health services, outpatient departments) settings for recent-onset or worsening disability from medical (excluding neurological) and surgical (excluding orthopedic) conditions. Measures were interviewer-administered activity questions (all patients) and physical functioning portion of the SF-36 (outpatients) and standardized chart items (11 Functional Independence Measure (FIM), 19 Standardized Outcome and Assessment Information Set (OASIS) items, and 22 Minimum Data Set (MDS) items). Rasch modeling analyzed all data and the relationship between person ability estimates and average item difficulty. CAT assessed the ability to derive accurate patient scores using a sample of questions. RESULTS: The 163-item activity item pool covered the range of physical movement and personal and instrumental activities. CAT analysis showed comparable scores between estimates using 10 items or the total item pool. CONCLUSION: The AM-PAC can assess a broad range of function in patients with complex medical illness. CAT achieves valid patient scores using fewer questions.10aActivities of Daily Living/*classification10aAdult10aAged10aCohort Studies10aContinuity of Patient Care10aDisability Evaluation10aFemale10aHealth Services Research10aHumans10aMale10aMiddle Aged10aPostoperative Care/*rehabilitation10aPrognosis10aRecovery of Function10aRehabilitation Centers10aRehabilitation/*standards10aSensitivity and Specificity10aSickness Impact Profile10aTreatment Outcome1 aSiebens, H1 aAndres, P L1 aPengsheng, N1 aCoster, W J1 aHaley, S M uhttp://mail.iacat.org/content/measuring-physical-function-patients-complex-medical-and-postsurgical-conditions-computer02721nas a2200373 4500008004100000245017500041210006900216300001100285490000700296520137800303653003001681653003101711653001501742653001001757653000901767653002201776653003201798653004201830653001101872653003001883653001101913653005101924653003101975653003702006653000902043653001602052653004102068653004102109653002602150100001402176700001802190700001902208856012002227 2005 eng d00aSimulated computerized adaptive tests for measuring functional status were efficient with good discriminant validity in patients with hip, knee, or foot/ankle impairments0 aSimulated computerized adaptive tests for measuring functional s a629-380 v583 aBACKGROUND AND OBJECTIVE: To develop computerized adaptive tests (CATs) designed to assess lower extremity functional status (FS) in people with lower extremity impairments using items from the Lower Extremity Functional Scale and compare discriminant validity of FS measures generated using all items analyzed with a rating scale Item Response Theory model (theta(IRT)) and measures generated using the simulated CATs (theta(CAT)). METHODS: Secondary analysis of retrospective intake rehabilitation data. RESULTS: Unidimensionality of items was strong, and local independence of items was adequate. Differential item functioning (DIF) affected item calibration related to body part, that is, hip, knee, or foot/ankle, but DIF did not affect item calibration for symptom acuity, gender, age, or surgical history. Therefore, patients were separated into three body part specific groups. The rating scale model fit all three data sets well. Three body part specific CATs were developed: each was 70% more efficient than using all LEFS items to estimate FS measures. theta(IRT) and theta(CAT) measures discriminated patients by symptom acuity, age, and surgical history in similar ways. theta(CAT) measures were as precise as theta(IRT) measures. CONCLUSION: Body part-specific simulated CATs were efficient and produced precise measures of FS with good discriminant validity.10a*Health Status Indicators10aActivities of Daily Living10aAdolescent10aAdult10aAged10aAged, 80 and over10aAnkle Joint/physiopathology10aDiagnosis, Computer-Assisted/*methods10aFemale10aHip Joint/physiopathology10aHumans10aJoint Diseases/physiopathology/*rehabilitation10aKnee Joint/physiopathology10aLower Extremity/*physiopathology10aMale10aMiddle Aged10aResearch Support, N.I.H., Extramural10aResearch Support, U.S. Gov't, P.H.S.10aRetrospective Studies1 aHart, D L1 aMioduski, J E1 aStratford, P W uhttp://mail.iacat.org/content/simulated-computerized-adaptive-tests-measuring-functional-status-were-efficient-good03708nas a2200481 4500008004100000245005200041210005200093300001200145490000700157520221100164653001902375653002902394653005802423653001002481653005302491653000902544653001102553653002502564653002602589653003302615653001102648653001002659653000902669653001602678653002402694653007402718653001802792653002902810653005802839653003102897653003202928653003602960653003202996100001503028700001603043700001603059700001603075700001003091700001403101700001803115700001503133856007803148 2004 eng d00aActivity outcome measurement for postacute care0 aActivity outcome measurement for postacute care aI49-1610 v423 aBACKGROUND: Efforts to evaluate the effectiveness of a broad range of postacute care services have been hindered by the lack of conceptually sound and comprehensive measures of outcomes. It is critical to determine a common underlying structure before employing current methods of item equating across outcome instruments for future item banking and computer-adaptive testing applications. OBJECTIVE: To investigate the factor structure, reliability, and scale properties of items underlying the Activity domains of the International Classification of Functioning, Disability and Health (ICF) for use in postacute care outcome measurement. METHODS: We developed a 41-item Activity Measure for Postacute Care (AM-PAC) that assessed an individual's execution of discrete daily tasks in his or her own environment across major content domains as defined by the ICF. We evaluated the reliability and discriminant validity of the prototype AM-PAC in 477 individuals in active rehabilitation programs across 4 rehabilitation settings using factor analyses, tests of item scaling, internal consistency reliability analyses, Rasch item response theory modeling, residual component analysis, and modified parallel analysis. RESULTS: Results from an initial exploratory factor analysis produced 3 distinct, interpretable factors that accounted for 72% of the variance: Applied Cognition (44%), Personal Care & Instrumental Activities (19%), and Physical & Movement Activities (9%); these 3 activity factors were verified by a confirmatory factor analysis. Scaling assumptions were met for each factor in the total sample and across diagnostic groups. Internal consistency reliability was high for the total sample (Cronbach alpha = 0.92 to 0.94), and for specific diagnostic groups (Cronbach alpha = 0.90 to 0.95). Rasch scaling, residual factor, differential item functioning, and modified parallel analyses supported the unidimensionality and goodness of fit of each unique activity domain. CONCLUSIONS: This 3-factor model of the AM-PAC can form the conceptual basis for common-item equating and computer-adaptive applications, leading to a comprehensive system of outcome instruments for postacute care settings.10a*Self Efficacy10a*Sickness Impact Profile10aActivities of Daily Living/*classification/psychology10aAdult10aAftercare/*standards/statistics & numerical data10aAged10aBoston10aCognition/physiology10aDisability Evaluation10aFactor Analysis, Statistical10aFemale10aHuman10aMale10aMiddle Aged10aMovement/physiology10aOutcome Assessment (Health Care)/*methods/statistics & numerical data10aPsychometrics10aQuestionnaires/standards10aRehabilitation/*standards/statistics & numerical data10aReproducibility of Results10aSensitivity and Specificity10aSupport, U.S. Gov't, Non-P.H.S.10aSupport, U.S. Gov't, P.H.S.1 aHaley, S M1 aCoster, W J1 aAndres, P L1 aLudlow, L H1 aNi, P1 aBond, T L1 aSinclair, S J1 aJette, A M uhttp://mail.iacat.org/content/activity-outcome-measurement-postacute-care02777nas a2200421 4500008004100000020004600041245011200087210006900199250001500268260001000283300000700293490000600300520144100306653002701747653003001774653004701804653001001851653000901861653002201870653002801892653001101920653001101931653002001942653000901962653001601971653001601987653001902003653001602022653003502038653002902073653004002102653003002142100001402172700001702186700001702203700001402220856012102234 2004 eng d a1477-7525 (Electronic)1477-7525 (Linking)00aThe AMC Linear Disability Score project in a population requiring residential care: psychometric properties0 aAMC Linear Disability Score project in a population requiring re a2004/08/05 cAug 3 a420 v23 aBACKGROUND: Currently there is a lot of interest in the flexible framework offered by item banks for measuring patient relevant outcomes, including functional status. However, there are few item banks, which have been developed to quantify functional status, as expressed by the ability to perform activities of daily life. METHOD: This paper examines the psychometric properties of the AMC Linear Disability Score (ALDS) project item bank using an item response theory model and full information factor analysis. Data were collected from 555 respondents on a total of 160 items. RESULTS: Following the analysis, 79 items remained in the item bank. The remaining 81 items were excluded because of: difficulties in presentation (1 item); low levels of variation in response pattern (28 items); significant differences in measurement characteristics for males and females or for respondents under or over 85 years old (26 items); or lack of model fit to the data at item level (26 items). CONCLUSIONS: It is conceivable that the item bank will have different measurement characteristics for other patient or demographic populations. However, these results indicate that the ALDS item bank has sound psychometric properties for respondents in residential care settings and could form a stable base for measuring functional status in a range of situations, including the implementation of computerised adaptive testing of functional status.10a*Disability Evaluation10a*Health Status Indicators10aActivities of Daily Living/*classification10aAdult10aAged10aAged, 80 and over10aData Collection/methods10aFemale10aHumans10aLogistic Models10aMale10aMiddle Aged10aNetherlands10aPilot Projects10aProbability10aPsychometrics/*instrumentation10aQuestionnaires/standards10aResidential Facilities/*utilization10aSeverity of Illness Index1 aHolman, R1 aLindeboom, R1 aVermeulen, M1 aHaan, R J uhttp://mail.iacat.org/content/amc-linear-disability-score-project-population-requiring-residential-care-psychometric01802nas a2200361 4500008004100000020002200041245009500063210006900158250001500227260001100242300001000253490000700263520066300270653002500933653002900958653001000987653000900997653002201006653004501028653003701073653001101110653001101121653000901132653001601141653003601157653003001193653003401223100001601257700002401273700001001297700001501307856011801322 2004 eng d a1074-9357 (Print)00aComputer adaptive testing: a strategy for monitoring stroke rehabilitation across settings0 aComputer adaptive testing a strategy for monitoring stroke rehab a2004/05/01 cSpring a33-390 v113 aCurrent functional assessment instruments in stroke rehabilitation are often setting-specific and lack precision, breadth, and/or feasibility. Computer adaptive testing (CAT) offers a promising potential solution by providing a quick, yet precise, measure of function that can be used across a broad range of patient abilities and in multiple settings. CAT technology yields a precise score by selecting very few relevant items from a large and diverse item pool based on each individual's responses. We demonstrate the potential usefulness of a CAT assessment model with a cross-sectional sample of persons with stroke from multiple rehabilitation settings.10a*Computer Simulation10a*User-Computer Interface10aAdult10aAged10aAged, 80 and over10aCerebrovascular Accident/*rehabilitation10aDisabled Persons/*classification10aFemale10aHumans10aMale10aMiddle Aged10aMonitoring, Physiologic/methods10aSeverity of Illness Index10aTask Performance and Analysis1 aAndres, P L1 aBlack-Schaffer, R M1 aNi, P1 aHaley, S M uhttp://mail.iacat.org/content/computer-adaptive-testing-strategy-monitoring-stroke-rehabilitation-across-settings01905nas a2200217 4500008004100000245010000041210006900141260000800210300001100218490000700229520117300236653002201409653001501431653003701446653003101483653001101514653001901525100001201544700001501556856011601571 2004 eng d00aA computerized adaptive knowledge test as an assessment tool in general practice: a pilot study0 acomputerized adaptive knowledge test as an assessment tool in ge cMar a178-830 v263 aAdvantageous to assessment in many fields, CAT (computerized adaptive testing) use in general practice has been scarce. In adapting CAT to general practice, the basic assumptions of item response theory and the case specificity must be taken into account. In this context, this study first evaluated the feasibility of converting written extended matching tests into CAT. Second, it questioned the content validity of CAT. A stratified sample of students was invited to participate in the pilot study. The items used in this test, together with their parameters, originated from the written test. The detailed test paths of the students were retained and analysed thoroughly. Using the predefined pass-fail standard, one student failed the test. There was a positive correlation between the number of items and the candidate's ability level. The majority of students were presented with questions in seven of the 10 existing domains. Although proved to be a feasible test format, CAT cannot substitute for the existing high-stakes large-scale written test. It may provide a reliable instrument for identifying candidates who are at risk of failing in the written test.10a*Computer Systems10aAlgorithms10aEducational Measurement/*methods10aFamily Practice/*education10aHumans10aPilot Projects1 aRoex, A1 aDegryse, J uhttp://mail.iacat.org/content/computerized-adaptive-knowledge-test-assessment-tool-general-practice-pilot-study02594nas a2200469 4500008004100000245007200041210006900113300001000182490000600192520108600198653002501284653001001309653001501319653002101334653002201355653005901377653007001436653003301506653001101539653001101550653001301561653000901574653002701583653002201610653005501632653001901687653001501706653006601721653001801787653003701805653004101842653003001883653001301913100001501926700001301941700001801954700001501972700001401987700001402001700001302015856009602028 2004 eng d00aComputerized adaptive measurement of depression: A simulation study0 aComputerized adaptive measurement of depression A simulation stu a13-230 v43 aBackground: Efficient, accurate instruments for measuring depression are increasingly importantin clinical practice. We developed a computerized adaptive version of the Beck DepressionInventory (BDI). We examined its efficiency and its usefulness in identifying Major DepressiveEpisodes (MDE) and in measuring depression severity.Methods: Subjects were 744 participants in research studies in which each subject completed boththe BDI and the SCID. In addition, 285 patients completed the Hamilton Depression Rating Scale.Results: The adaptive BDI had an AUC as an indicator of a SCID diagnosis of MDE of 88%,equivalent to the full BDI. The adaptive BDI asked fewer questions than the full BDI (5.6 versus 21items). The adaptive latent depression score correlated r = .92 with the BDI total score and thelatent depression score correlated more highly with the Hamilton (r = .74) than the BDI total scoredid (r = .70).Conclusions: Adaptive testing for depression may provide greatly increased efficiency withoutloss of accuracy in identifying MDE or in measuring depression severity.10a*Computer Simulation10aAdult10aAlgorithms10aArea Under Curve10aComparative Study10aDepressive Disorder/*diagnosis/epidemiology/psychology10aDiagnosis, Computer-Assisted/*methods/statistics & numerical data10aFactor Analysis, Statistical10aFemale10aHumans10aInternet10aMale10aMass Screening/methods10aPatient Selection10aPersonality Inventory/*statistics & numerical data10aPilot Projects10aPrevalence10aPsychiatric Status Rating Scales/*statistics & numerical data10aPsychometrics10aResearch Support, Non-U.S. Gov't10aResearch Support, U.S. Gov't, P.H.S.10aSeverity of Illness Index10aSoftware1 aGardner, W1 aShear, K1 aKelleher, K J1 aPajer, K A1 aMammen, O1 aBuysse, D1 aFrank, E uhttp://mail.iacat.org/content/computerized-adaptive-measurement-depression-simulation-study02473nas a2200193 4500008004100000245010700041210007100148300001200219490000700231520172200238653002101960653003401981653001602015653003002031653002302061653004502084100001502129856013502144 2004 eng d00aÉvaluation et multimédia dans l'apprentissage d'une L2 [Assessment and multimedia in learning an L2]0 aÉvaluation et multimédia dans lapprentissage dune L2 Assessment  a475-4870 v163 aIn the first part of this paper different areas where technology may be used for second language assessment are described. First, item banking operations, which are generally based on item Response Theory but not necessarily restricted to dichotomously scored items, facilitate assessment task organization and require technological support. Second, technology may help to design more authentic assessment tasks or may be needed in some direct testing situations. Third, the assessment environment may be more adapted and more stimulating when technology is used to give the student more control. The second part of the paper presents different functions of assessment. The monitoring function (often called formative assessment) aims at adapting the classroom activities to students and to provide continuous feedback. Technology may be used to train the teachers in monitoring techniques, to organize data or to produce diagnostic information; electronic portfolios or quizzes that are built in some educational software may also be used for monitoring. The placement function is probably the one in which the application of computer adaptive testing procedures (e.g. French CAPT) is the most appropriate. Automatic scoring devices may also be used for placement purposes. Finally the certification function requires more valid and more reliable tools. Technology may be used to enhance the testing situation (to make it more authentic) or to facilitate data processing during the construction of a test. Almond et al. (2002) propose a four component model (Selection, Presentation, Scoring and Response) for designing assessment systems. Each component must be planned taking into account the assessment function. 10aAdaptive Testing10aComputer Assisted Instruction10aEducational10aForeign Language Learning10aProgram Evaluation10aTechnology computerized adaptive testing1 aLaurier, M uhttp://mail.iacat.org/content/%C3%A9valuation-et-multim%C3%A9dia-dans-lapprentissage-dune-l2-assessment-and-multimedia-learning-l204033nas a2200433 4500008004100000245012300041210006900164260000800233300001200241490000700253520252400260653001902784653002902803653005802832653001002890653000902900653002202909653002602931653003302957653001102990653001103001653000903012653001603021653007403037653003003111653003603141653005803177653003103235653004503266653004103311653003203352100001603384700001503400700001603415700001603431700001403447700001203461856012603473 2004 eng d00aRefining the conceptual basis for rehabilitation outcome measurement: personal care and instrumental activities domain0 aRefining the conceptual basis for rehabilitation outcome measure cJan aI62-1720 v423 aBACKGROUND: Rehabilitation outcome measures routinely include content on performance of daily activities; however, the conceptual basis for item selection is rarely specified. These instruments differ significantly in format, number, and specificity of daily activity items and in the measurement dimensions and type of scale used to specify levels of performance. We propose that a requirement for upper limb and hand skills underlies many activities of daily living (ADL) and instrumental activities of daily living (IADL) items in current instruments, and that items selected based on this definition can be placed along a single functional continuum. OBJECTIVE: To examine the dimensional structure and content coverage of a Personal Care and Instrumental Activities item set and to examine the comparability of items from existing instruments and a set of new items as measures of this domain. METHODS: Participants (N = 477) from 3 different disability groups and 4 settings representing the continuum of postacute rehabilitation care were administered the newly developed Activity Measure for Post-Acute Care (AM-PAC), the SF-8, and an additional setting-specific measure: FIM (in-patient rehabilitation); MDS (skilled nursing facility); MDS-PAC (postacute settings); OASIS (home care); or PF-10 (outpatient clinic). Rasch (partial-credit model) analyses were conducted on a set of 62 items covering the Personal Care and Instrumental domain to examine item fit, item functioning, and category difficulty estimates and unidimensionality. RESULTS: After removing 6 misfitting items, the remaining 56 items fit acceptably along the hypothesized continuum. Analyses yielded different difficulty estimates for the maximum score (eg, "Independent performance") for items with comparable content from different instruments. Items showed little differential item functioning across age, diagnosis, or severity groups, and 92% of the participants fit the model. CONCLUSIONS: ADL and IADL items from existing rehabilitation outcomes instruments that depend on skilled upper limb and hand use can be located along a single continuum, along with the new personal care and instrumental items of the AM-PAC addressing gaps in content. Results support the validity of the proposed definition of the Personal Care and Instrumental Activities dimension of function as a guide for future development of rehabilitation outcome instruments, such as linked, setting-specific short forms and computerized adaptive testing approaches.10a*Self Efficacy10a*Sickness Impact Profile10aActivities of Daily Living/*classification/psychology10aAdult10aAged10aAged, 80 and over10aDisability Evaluation10aFactor Analysis, Statistical10aFemale10aHumans10aMale10aMiddle Aged10aOutcome Assessment (Health Care)/*methods/statistics & numerical data10aQuestionnaires/*standards10aRecovery of Function/physiology10aRehabilitation/*standards/statistics & numerical data10aReproducibility of Results10aResearch Support, U.S. Gov't, Non-P.H.S.10aResearch Support, U.S. Gov't, P.H.S.10aSensitivity and Specificity1 aCoster, W J1 aHaley, S M1 aAndres, P L1 aLudlow, L H1 aBond, T L1 aNi, P S uhttp://mail.iacat.org/content/refining-conceptual-basis-rehabilitation-outcome-measurement-personal-care-and-instrumental02889nas a2200301 4500008004100000020002200041245013700063210006900200250001500269260000800284300001000292490000700302520186600309653001102175653003302186653001102219653004602230653002402276653002902300653003002329653002902359100001502388700001602403700001602419700001602435700001002451856012602461 2004 eng d a0003-9993 (Print)00aScore comparability of short forms and computerized adaptive testing: Simulation study with the activity measure for post-acute care0 aScore comparability of short forms and computerized adaptive tes a2004/04/15 cApr a661-60 v853 aOBJECTIVE: To compare simulated short-form and computerized adaptive testing (CAT) scores to scores obtained from complete item sets for each of the 3 domains of the Activity Measure for Post-Acute Care (AM-PAC). DESIGN: Prospective study. SETTING: Six postacute health care networks in the greater Boston metropolitan area, including inpatient acute rehabilitation, transitional care units, home care, and outpatient services. PARTICIPANTS: A convenience sample of 485 adult volunteers who were receiving skilled rehabilitation services. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Inpatient and community-based short forms and CAT applications were developed for each of 3 activity domains (physical & mobility, personal care & instrumental, applied cognition) using item pools constructed from new items and items from existing postacute care instruments. RESULTS: Simulated CAT scores correlated highly with score estimates from the total item pool in each domain (4- and 6-item CAT r range,.90-.95; 10-item CAT r range,.96-.98). Scores on the 10-item short forms constructed for inpatient and community settings also provided good estimates of the AM-PAC item pool scores for the physical & movement and personal care & instrumental domains, but were less consistent in the applied cognition domain. Confidence intervals around individual scores were greater in the short forms than for the CATs. CONCLUSIONS: Accurate scoring estimates for AM-PAC domains can be obtained with either the setting-specific short forms or the CATs. The strong relationship between CAT and item pool scores can be attributed to the CAT's ability to select specific items to match individual responses. The CAT may have additional advantages over short forms in practicality, efficiency, and the potential for providing more precise scoring estimates for individuals.10aBoston10aFactor Analysis, Statistical10aHumans10aOutcome Assessment (Health Care)/*methods10aProspective Studies10aQuestionnaires/standards10aRehabilitation/*standards10aSubacute Care/*standards1 aHaley, S M1 aCoster, W J1 aAndres, P L1 aKosinski, M1 aNi, P uhttp://mail.iacat.org/content/score-comparability-short-forms-and-computerized-adaptive-testing-simulation-study-activity02655nas a2200385 4500008004100000245014400041210006900185300001200254490000700266520138100273653002101654653003301675653002901708653001501737653001001752653000901762653002201771653002601793653003301819653002501852653001901877653001001896653002501906653001601931653002401947653002601971653002701997653003202024653001302056653002802069100001702097700001602114700001402130856012502144 2003 eng d00aCalibration of an item pool for assessing the burden of headaches: an application of item response theory to the Headache Impact Test (HIT)0 aCalibration of an item pool for assessing the burden of headache a913-9330 v123 aBACKGROUND: Measurement of headache impact is important in clinical trials, case detection, and the clinical monitoring of patients. Computerized adaptive testing (CAT) of headache impact has potential advantages over traditional fixed-length tests in terms of precision, relevance, real-time quality control and flexibility. OBJECTIVE: To develop an item pool that can be used for a computerized adaptive test of headache impact. METHODS: We analyzed responses to four well-known tests of headache impact from a population-based sample of recent headache sufferers (n = 1016). We used confirmatory factor analysis for categorical data and analyses based on item response theory (IRT). RESULTS: In factor analyses, we found very high correlations between the factors hypothesized by the original test constructers, both within and between the original questionnaires. These results suggest that a single score of headache impact is sufficient. We established a pool of 47 items which fitted the generalized partial credit IRT model. By simulating a computerized adaptive health test we showed that an adaptive test of only five items had a very high concordance with the score based on all items and that different worst-case item selection scenarios did not lead to bias. CONCLUSION: We have established a headache impact item pool that can be used in CAT of headache impact.10a*Cost of Illness10a*Decision Support Techniques10a*Sickness Impact Profile10aAdolescent10aAdult10aAged10aComparative Study10aDisability Evaluation10aFactor Analysis, Statistical10aHeadache/*psychology10aHealth Surveys10aHuman10aLongitudinal Studies10aMiddle Aged10aMigraine/psychology10aModels, Psychological10aPsychometrics/*methods10aQuality of Life/*psychology10aSoftware10aSupport, Non-U.S. Gov't1 aBjorner, J B1 aKosinski, M1 aWare, Jr. uhttp://mail.iacat.org/content/calibration-item-pool-assessing-burden-headaches-application-item-response-theory-headache03167nas a2200361 4500008004100000245012500041210006900166300001200235490000700247520200400254653002902258653001502287653001002302653000902312653002202321653002002343653003302363653002402396653001102420653001002431653000902441653001602450653002502466653002602491653004302517653003202560653001902592653002802611100001702639700001602656700001402672856011902686 2003 eng d00aThe feasibility of applying item response theory to measures of migraine impact: a re-analysis of three clinical studies0 afeasibility of applying item response theory to measures of migr a887-9020 v123 aBACKGROUND: Item response theory (IRT) is a powerful framework for analyzing multiitem scales and is central to the implementation of computerized adaptive testing. OBJECTIVES: To explain the use of IRT to examine measurement properties and to apply IRT to a questionnaire for measuring migraine impact--the Migraine Specific Questionnaire (MSQ). METHODS: Data from three clinical studies that employed the MSQ-version 1 were analyzed by confirmatory factor analysis for categorical data and by IRT modeling. RESULTS: Confirmatory factor analyses showed very high correlations between the factors hypothesized by the original test constructions. Further, high item loadings on one common factor suggest that migraine impact may be adequately assessed by only one score. IRT analyses of the MSQ were feasible and provided several suggestions as to how to improve the items and in particular the response choices. Out of 15 items, 13 showed adequate fit to the IRT model. In general, IRT scores were strongly associated with the scores proposed by the original test developers and with the total item sum score. Analysis of response consistency showed that more than 90% of the patients answered consistently according to a unidimensional IRT model. For the remaining patients, scores on the dimension of emotional function were less strongly related to the overall IRT scores that mainly reflected role limitations. Such response patterns can be detected easily using response consistency indices. Analysis of test precision across score levels revealed that the MSQ was most precise at one standard deviation worse than the mean impact level for migraine patients that are not in treatment. Thus, gains in test precision can be achieved by developing items aimed at less severe levels of migraine impact. CONCLUSIONS: IRT proved useful for analyzing the MSQ. The approach warrants further testing in a more comprehensive item pool for headache impact that would enable computerized adaptive testing.10a*Sickness Impact Profile10aAdolescent10aAdult10aAged10aComparative Study10aCost of Illness10aFactor Analysis, Statistical10aFeasibility Studies10aFemale10aHuman10aMale10aMiddle Aged10aMigraine/*psychology10aModels, Psychological10aPsychometrics/instrumentation/*methods10aQuality of Life/*psychology10aQuestionnaires10aSupport, Non-U.S. Gov't1 aBjorner, J B1 aKosinski, M1 aWare, Jr. uhttp://mail.iacat.org/content/feasibility-applying-item-response-theory-measures-migraine-impact-re-analysis-three02749nas a2200349 4500008004100000245015800041210006900199260000800268300001200276490000700288520160300295653003001898653002001928653001001948653003201958653001101990653001102001653000902012653001602021653002802037653001802065653003702083653004102120653002802161100001302189700001502202700001302217700001502230700001402245700001902259856012102278 2003 eng d00aItem banking to improve, shorten and computerized self-reported fatigue: an illustration of steps to create a core item bank from the FACIT-Fatigue Scale0 aItem banking to improve shorten and computerized selfreported fa cAug a485-5010 v123 aFatigue is a common symptom among cancer patients and the general population. Due to its subjective nature, fatigue has been difficult to effectively and efficiently assess. Modern computerized adaptive testing (CAT) can enable precise assessment of fatigue using a small number of items from a fatigue item bank. CAT enables brief assessment by selecting questions from an item bank that provide the maximum amount of information given a person's previous responses. This article illustrates steps to prepare such an item bank, using 13 items from the Functional Assessment of Chronic Illness Therapy Fatigue Subscale (FACIT-F) as the basis. Samples included 1022 cancer patients and 1010 people from the general population. An Item Response Theory (IRT)-based rating scale model, a polytomous extension of the Rasch dichotomous model was utilized. Nine items demonstrating acceptable psychometric properties were selected and positioned on the fatigue continuum. The fatigue levels measured by these nine items along with their response categories covered 66.8% of the general population and 82.6% of the cancer patients. Although the operational CAT algorithms to handle polytomously scored items are still in progress, we illustrated how CAT may work by using nine core items to measure level of fatigue. Using this illustration, a fatigue measure comparable to its full-length 13-item scale administration was obtained using four items. The resulting item bank can serve as a core to which will be added a psychometrically sound and operational item bank covering the entire fatigue continuum.10a*Health Status Indicators10a*Questionnaires10aAdult10aFatigue/*diagnosis/etiology10aFemale10aHumans10aMale10aMiddle Aged10aNeoplasms/complications10aPsychometrics10aResearch Support, Non-U.S. Gov't10aResearch Support, U.S. Gov't, P.H.S.10aSickness Impact Profile1 aLai, J-S1 aCrane, P K1 aCella, D1 aChang, C-H1 aBode, R K1 aHeinemann, A W uhttp://mail.iacat.org/content/item-banking-improve-shorten-and-computerized-self-reported-fatigue-illustration-steps01983nas a2200289 4500008004100000245007600041210006900117260000800186300001200194490000700206520114900213653002401362653001301386653002101399653002001420653001501440653001001455653001001465653001101475653001101486653000901497653002401506653002601530100001601556700001501572856010601587 2002 eng d00aAssessing tobacco beliefs among youth using item response theory models0 aAssessing tobacco beliefs among youth using item response theory cNov aS21-S390 v683 aSuccessful intervention research programs to prevent adolescent smoking require well-chosen, psychometrically sound instruments for assessing smoking prevalence and attitudes. Twelve thousand eight hundred and ten adolescents were surveyed about their smoking beliefs as part of the Teenage Attitudes and Practices Survey project, a prospective cohort study of predictors of smoking initiation among US adolescents. Item response theory (IRT) methods are used to frame a discussion of questions that a researcher might ask when selecting an optimal item set. IRT methods are especially useful for choosing items during instrument development, trait scoring, evaluating item functioning across groups, and creating optimal item subsets for use in specialized applications such as computerized adaptive testing. Data analytic steps for IRT modeling are reviewed for evaluating item quality and differential item functioning across subgroups of gender, age, and smoking status. Implications and challenges in the use of these methods for tobacco onset research and for assessing the developmental trajectories of smoking among youth are discussed.10a*Attitude to Health10a*Culture10a*Health Behavior10a*Questionnaires10aAdolescent10aAdult10aChild10aFemale10aHumans10aMale10aModels, Statistical10aSmoking/*epidemiology1 aPanter, A T1 aReeve, B B uhttp://mail.iacat.org/content/assessing-tobacco-beliefs-among-youth-using-item-response-theory-models02895nas a2200349 4500008004100000245008300041210006900124260000800193300001100201490000700212520176600219653003001985653002802015653001502043653001002058653000902068653002202077653001102099653001902110653001102129653000902140653001602149653006202165653006102227653003302288653003602321653003102357653002602388100001402414700001602428856010102444 2002 eng d00aDevelopment of an index of physical functional health status in rehabilitation0 aDevelopment of an index of physical functional health status in  cMay a655-650 v833 aOBJECTIVE: To describe (1) the development of an index of physical functional health status (FHS) and (2) its hierarchical structure, unidimensionality, reproducibility of item calibrations, and practical application. DESIGN: Rasch analysis of existing data sets. SETTING: A total of 715 acute, orthopedic outpatient centers and 62 long-term care facilities in 41 states participating with Focus On Therapeutic Outcomes, Inc. PATIENTS: A convenience sample of 92,343 patients (40% male; mean age +/- standard deviation [SD], 48+/-17y; range, 14-99y) seeking rehabilitation between 1993 and 1999. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Patients completed self-report health status surveys at admission and discharge. The Medical Outcomes Study 36-Item Short-Form Health Survey's physical functioning scale (PF-10) is the foundation of the physical FHS. The Oswestry Low Back Pain Disability Questionnaire, Neck Disability Index, Lysholm Knee Questionnaire, items pertinent to patients with upper-extremity impairments, and items pertinent to patients with more involved neuromusculoskeletal impairments were cocalibrated into the PF-10. RESULTS: The final FHS item bank contained 36 items (patient separation, 2.3; root mean square measurement error, 5.9; mean square +/- SD infit, 0.9+/-0.5; outfit, 0.9+/-0.9). Analyses supported empirical item hierarchy, unidimensionality, reproducibility of item calibrations, and content and construct validity of the FHS-36. CONCLUSIONS: Results support the reliability and validity of FHS-36 measures in the present sample. Analyses show the potential for a dynamic, computer-controlled, adaptive survey for FHS assessment applicable for group analysis and clinical decision making for individual patients.10a*Health Status Indicators10a*Rehabilitation Centers10aAdolescent10aAdult10aAged10aAged, 80 and over10aFemale10aHealth Surveys10aHumans10aMale10aMiddle Aged10aMusculoskeletal Diseases/*physiopathology/*rehabilitation10aNervous System Diseases/*physiopathology/*rehabilitation10aPhysical Fitness/*physiology10aRecovery of Function/physiology10aReproducibility of Results10aRetrospective Studies1 aHart, D L1 aWright, B D uhttp://mail.iacat.org/content/development-index-physical-functional-health-status-rehabilitation03063nas a2200325 4500008004100000020004100041245008100082210006900163250001500232260000800247300001100255490000700266520201300273653001502286653001002301653004002311653005702351653003302408653001102441653001102452653001802463653000902481653002802490653001202518653005502530100001502585700001802600700001502618856010402633 2002 eng d a0025-7079 (Print)0025-7079 (Linking)00aMultidimensional adaptive testing for mental health problems in primary care0 aMultidimensional adaptive testing for mental health problems in  a2002/09/10 cSep a812-230 v403 aOBJECTIVES: Efficient and accurate instruments for assessing child psychopathology are increasingly important in clinical practice and research. For example, screening in primary care settings can identify children and adolescents with disorders that may otherwise go undetected. However, primary care offices are notorious for the brevity of visits and screening must not burden patients or staff with long questionnaires. One solution is to shorten assessment instruments, but dropping questions typically makes an instrument less accurate. An alternative is adaptive testing, in which a computer selects the items to be asked of a patient based on the patient's previous responses. This research used a simulation to test a child mental health screen based on this technology. RESEARCH DESIGN: Using half of a large sample of data, a computerized version was developed of the Pediatric Symptom Checklist (PSC), a parental-report psychosocial problem screen. With the unused data, a simulation was conducted to determine whether the Adaptive PSC can reproduce the results of the full PSC with greater efficiency. SUBJECTS: PSCs were completed by parents on 21,150 children seen in a national sample of primary care practices. RESULTS: Four latent psychosocial problem dimensions were identified through factor analysis: internalizing problems, externalizing problems, attention problems, and school problems. A simulated adaptive test measuring these traits asked an average of 11.6 questions per patient, and asked five or fewer questions for 49% of the sample. There was high agreement between the adaptive test and the full (35-item) PSC: only 1.3% of screening decisions were discordant (kappa = 0.93). This agreement was higher than that obtained using a comparable length (12-item) short-form PSC (3.2% of decisions discordant; kappa = 0.84). CONCLUSIONS: Multidimensional adaptive testing may be an accurate and efficient technology for screening for mental health problems in primary care settings.10aAdolescent10aChild10aChild Behavior Disorders/*diagnosis10aChild Health Services/*organization & administration10aFactor Analysis, Statistical10aFemale10aHumans10aLinear Models10aMale10aMass Screening/*methods10aParents10aPrimary Health Care/*organization & administration1 aGardner, W1 aKelleher, K J1 aPajer, K A uhttp://mail.iacat.org/content/multidimensional-adaptive-testing-mental-health-problems-primary-care02102nas a2200337 4500008004100000245014400041210006900185300001200254490000700266520096600273653002501239653003601264653002501300653001001325653003001335653001101365653001001376653000901386653003101395653003201426653003601458653003401494653002001528100001601548700001401564700001601578700001901594700001301613700001501626856012301641 2001 eng d00aAn examination of the comparative reliability, validity, and accuracy of performance ratings made using computerized adaptive rating scales0 aexamination of the comparative reliability validity and accuracy a965-9730 v863 aThis laboratory research compared the reliability, validity, and accuracy of a computerized adaptive rating scale (CARS) format and 2 relatively common and representative rating formats. The CARS is a paired-comparison rating task that uses adaptive testing principles to present pairs of scaled behavioral statements to the rater to iteratively estimate a ratee's effectiveness on 3 dimensions of contextual performance. Videotaped vignettes of 6 office workers were prepared, depicting prescripted levels of contextual performance, and 112 subjects rated these vignettes using the CARS format and one or the other competing format. Results showed 23%-37% lower standard errors of measurement for the CARS format. In addition, validity was significantly higher for the CARS format (d = .18), and Cronbach's accuracy coefficients showed significantly higher accuracy, with a median effect size of .08. The discussion focuses on possible reasons for the results.10a*Computer Simulation10a*Employee Performance Appraisal10a*Personnel Selection10aAdult10aAutomatic Data Processing10aFemale10aHuman10aMale10aReproducibility of Results10aSensitivity and Specificity10aSupport, U.S. Gov't, Non-P.H.S.10aTask Performance and Analysis10aVideo Recording1 aBorman, W C1 aBuck, D E1 aHanson, M A1 aMotowidlo, S J1 aStark, S1 aDrasgow, F uhttp://mail.iacat.org/content/examination-comparative-reliability-validity-and-accuracy-performance-ratings-made-using02032nas a2200253 4500008004100000245007700041210006900118260001200187300001200199490000700211520125800218653003901476653002901515653001501544653001001559653001101569653001101580653000901591653003001600653001301630100001601643700002001659856009901679 2001 eng d00aNCLEX-RN performance: predicting success on the computerized examination0 aNCLEXRN performance predicting success on the computerized exami cJul-Aug a158-1650 v173 aSince the adoption of the Computerized Adaptive Testing (CAT) format of the National Certification Licensure Examination for Registered Nurses (NCLEX-RN), no studies have been reported in the literature on predictors of successful performance by baccalaureate nursing graduates on the licensure examination. In this study, a discriminant analysis was used to identify which of 21 variables can be significant predictors of success on the CAT NCLEX-RN. The convenience sample consisted of 289 individuals who graduated from a baccalaureate nursing program between 1995 and 1998. Seven significant predictor variables were identified. The total number of C+ or lower grades earned in nursing theory courses was the best predictor, followed by grades in several individual nursing courses. More than 93 per cent of graduates were correctly classified. Ninety-four per cent of NCLEX "passes" were correctly classified, as were 92 per cent of NCLEX failures. This degree of accuracy in classifying CAT NCLEX-RN failures represents a marked improvement over results reported in previous studies of licensure examinations, and suggests the discriminant function will be helpful in identifying future students in danger of failure. J Prof Nurs 17:158-165, 2001.10a*Education, Nursing, Baccalaureate10a*Educational Measurement10a*Licensure10aAdult10aFemale10aHumans10aMale10aPredictive Value of Tests10aSoftware1 aBeeman, P B1 aWaterhouse, J K uhttp://mail.iacat.org/content/nclex-rn-performance-predicting-success-computerized-examination01773nas a2200265 4500008004100000245004900041210004800090300001000138490000600148520092600154653002501080653005701105653001501162653001201177653001001189653002101199653006401220653001101284653002201295653001101317653000901328653007801337100001701415856007501432 1999 eng d00aCompetency gradient for child-parent centers0 aCompetency gradient for childparent centers a35-520 v33 aThis report describes an implementation of the Rasch model during the longitudinal evaluation of a federally-funded early childhood preschool intervention program. An item bank is described for operationally defining a psychosocial construct called community life-skills competency, an expected teenage outcome of the preschool intervention. This analysis examined the position of teenage students on this scale structure, and investigated a pattern of cognitive operations necessary for students to pass community life-skills test items. Then this scale structure was correlated with nationally standardized reading and math achievement scores, teacher ratings, and school records to assess its validity as a measure of the community-related outcome goal for this intervention. The results show a functional relationship between years of early intervention and magnitude of effect on the life-skills competency variable.10a*Models, Statistical10aActivities of Daily Living/classification/psychology10aAdolescent10aChicago10aChild10aChild, Preschool10aEarly Intervention (Education)/*statistics & numerical data10aFemale10aFollow-Up Studies10aHumans10aMale10aOutcome and Process Assessment (Health Care)/*statistics & numerical data1 aBezruczko, N uhttp://mail.iacat.org/content/competency-gradient-child-parent-centers01734nas a2200169 4500008004100000245009900041210006900140300001200209490000700221520112300228653002101351653003001372653000801402653002301410100001601433856011501449 1997 eng d00aThe distribution of indexes of person fit within the computerized adaptive testing environment0 adistribution of indexes of person fit within the computerized ad a115-1270 v213 aThe extent to which a trait estimate represents the underlying latent trait of interest can be estimated by using indexes of person fit. Several statistical methods for indexing person fit have been proposed to identify nonmodel-fitting response vectors. These person-fit indexes have generally been found to follow a standard normal distribution for conventionally administered tests. The present investigation found that within the context of computerized adaptive testing (CAT) these indexes tended not to follow a standard normal distribution. As the item pool became less discriminating, as the CAT termination criterion became less stringent, and as the number of items in the pool decreased, the distributions of the indexes approached a standard normal distribution. It was determined that under these conditions the indexes' distributions approached standard normal distributions because more items were being administered. However, even when over 50 items were administered in a CAT the indexes were distributed in a fashion that was different from what was expected. (PsycINFO Database Record (c) 2006 APA )10aAdaptive Testing10aComputer Assisted Testing10aFit10aPerson Environment1 aNering, M L uhttp://mail.iacat.org/content/distribution-indexes-person-fit-within-computerized-adaptive-testing-environment01698nas a2200229 4500008004100000020004100041245006400082210006200146250001500208260000800223300001100231490000700242520102000249653003101269653002501300653001001325653001101335653001101346653000901357100001601366856008601382 1995 jpn d a0021-5236 (Print)0021-5236 (Linking)00aA study of psychologically optimal level of item difficulty0 astudy of psychologically optimal level of item difficulty a1995/02/01 cFeb a446-530 v653 aFor the purpose of selecting items in a test, this study presented a viewpoint of psychologically optimal difficulty level, as well as measurement efficiency, of items. A paper-and-pencil test (P & P) composed of hard, moderate and easy subtests was administered to 298 students at a university. A computerized adaptive test (CAT) was also administered to 79 students. The items of both tests were selected from Shiba's Word Meaning Comprehension Test, for which the estimates of parameters of two-parameter item response model were available. The results of P & P research showed that the psychologically optimal success level would be such that the proportion of right answers is somewhere between .75 and .85. A similar result was obtained from CAT research, where the proportion of about .8 might be desirable. Traditionally a success rate of .5 has been recommended in adaptive testing. In this study, however, it was suggested that the items of such level would be too hard psychologically for many examinees.10a*Adaptation, Psychological10a*Psychological Tests10aAdult10aFemale10aHumans10aMale1 aFujimori, S uhttp://mail.iacat.org/content/study-psychologically-optimal-level-item-difficulty00658nas a2200181 4500008004100000245008900041210006900130300000600199490000700205653001500212653001500227653003700242653002400279653002300303653001800326100001400344856011800358 1990 eng d00aNational Council Computerized Adaptive Testing Project Review--committee perspective0 aNational Council Computerized Adaptive Testing Project Reviewcom a30 v1110a*Computers10a*Licensure10aEducational Measurement/*methods10aFeasibility Studies10aSocieties, Nursing10aUnited States1 aHaynes, B uhttp://mail.iacat.org/content/national-council-computerized-adaptive-testing-project-review-committee-perspective