@article {5, title = {Efficiency and sensitivity of multidimensional computerized adaptive testing of pediatric physical functioning}, journal = {Disability \& Rehabilitation}, volume = {30}, number = {6}, year = {2008}, note = {Allen, Diane DNi, PengshengHaley, Stephen MK02 HD45354-01/HD/NICHD NIH HHS/United StatesNIDDR H133P0001/DD/NCBDD CDC HHS/United StatesResearch Support, N.I.H., ExtramuralEnglandDisability and rehabilitationDisabil Rehabil. 2008;30(6):479-84.}, pages = {479-84}, edition = {2008/02/26}, abstract = {PURPOSE: Computerized adaptive tests (CATs) have efficiency advantages over fixed-length tests of physical functioning but may lose sensitivity when administering extremely low numbers of items. Multidimensional CATs may efficiently improve sensitivity by capitalizing on correlations between functional domains. Using a series of empirical simulations, we assessed the efficiency and sensitivity of multidimensional CATs compared to a longer fixed-length test. METHOD: Parent responses to the Pediatric Evaluation of Disability Inventory before and after intervention for 239 children at a pediatric rehabilitation hospital provided the data for this retrospective study. Reliability, effect size, and standardized response mean were compared between full-length self-care and mobility subscales and simulated multidimensional CATs with stopping rules at 40, 30, 20, and 10 items. RESULTS: Reliability was lowest in the 10-item CAT condition for the self-care (r = 0.85) and mobility (r = 0.79) subscales; all other conditions had high reliabilities (r > 0.94). All multidimensional CAT conditions had equivalent levels of sensitivity compared to the full set condition for both domains. CONCLUSIONS: Multidimensional CATs efficiently retain the sensitivity of longer fixed-length measures even with 5 items per dimension (10-item CAT condition). Measuring physical functioning with multidimensional CATs could enhance sensitivity following intervention while minimizing response burden.}, keywords = {*Disability Evaluation, Child, Computers, Disabled Children/*classification/rehabilitation, Efficiency, Humans, Outcome Assessment (Health Care), Psychometrics, Reproducibility of Results, Retrospective Studies, Self Care, Sensitivity and Specificity}, isbn = {0963-8288 (Print)0963-8288 (Linking)}, author = {Allen, D. D. and Ni, P. and Haley, S. M.} }