@article {2717, title = {Time-Efficient Adaptive Measurement of Change}, journal = {Journal of Computerized Adaptive Testing}, volume = {7}, year = {2019}, pages = {15-34}, abstract = {

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.

}, keywords = {adaptive measurement of change, computerized adaptive testing, Fisher information, item selection, response-time modeling}, issn = {2165-6592}, doi = {10.7333/1909-0702015}, url = {http://iacat.org/jcat/index.php/jcat/article/view/73/35}, author = {Matthew Finkelman and Chun Wang} } @conference {2632, title = {A Comparison of Three Empirical Reliability Estimates for Computerized Adaptive Testing}, booktitle = {IACAT 2017 conference}, year = {2017}, month = {08/2017}, publisher = {Niigata Seiryo University}, organization = {Niigata Seiryo University}, address = {Niigata, Japan}, abstract = {

Reliability estimates in Computerized Adaptive Testing (CAT) are derived from estimated thetas and standard error of estimated thetas. In practical, the observed standard error (OSE) of estimated thetas can be estimated by test information function for each examinee with respect to Item response theory (IRT). Unlike classical test theory (CTT), OSEs in IRT are conditional values given each estimated thetas so that those values should be marginalized to consider test reliability. Arithmetic mean, Harmonic mean, and Jensen equality were applied to marginalize OSEs to estimate CAT reliability. Based on different marginalization method, three empirical CAT reliabilities were compared with true reliabilities. Results showed that three empirical CAT reliabilities were underestimated compared to true reliability in short test length (\< 40), whereas the magnitude of CAT reliabilities was followed by Jensen equality, Harmonic mean, and Arithmetic mean in long test length (\> 40). Specifically, Jensen equality overestimated true reliability across all conditions in long test length (\>50).

Session Video\ 

}, keywords = {CAT, Reliability}, url = {https://drive.google.com/file/d/1gXgH-epPIWJiE0LxMHGiCAxZZAwy4dAH/view?usp=sharing}, author = {Dong Gi Seo} } @conference {2662, title = {Item Response Time on Task Effect in CAT}, booktitle = {IACAT 2017 Conference}, year = {2017}, month = {08/2017}, publisher = {Niigata Seiryo University}, organization = {Niigata Seiryo University}, address = {Niigata, Japan}, abstract = {

Introduction. In addition to reduced test length and increased measurement efficiency, computerized adaptive testing (CAT) can provide new insights into the cognitive process of task completion that cannot be mined via conventional tests. Response time is a primary characteristic of the task completion procedure. It has the potential to inform us about underlying processes. In this study, the relationship between response time and response accuracy will be investigated.

Hypothesis. The present study argues that the relationship between response time on task and response accuracy, which may be positive, negative, or curvilinear, will depend on cognitive nature of task items, holding ability of the subjects and difficulty of the items constant. The interpretations regarding the associations are not uniform either.

Research question. Is there a homogeneous effect of response time on test outcome across Graduate

Proposed explanations. If the accuracy of cognitive test responses decreases with response time, then it is an indication that the underlying cognitive process is a degrading process such as knowledge retrieval. More accessible knowledge can be retrieved faster than less accessible knowledge. It is inherent to knowledge retrieval that the success rate declines with elapsing response time. For instance, in reading tasks, the time on task effect is negative and the more negative, the easier a task is. However, if the accuracy of cognitive test responses increases with response time, then the process is of an upgrading nature, with an increasing success rate as a function of response time. For example, problem-solving takes time, and fast responses are less likely to be well-founded responses. It is of course also possible that the relationship is curvilinear, as when an increasing success rate is followed by a decreasing success rate or vice versa.

Methodology. The data are from computer-based GRE quantitative and verbal tests and will be analyzed with generalized linear mixed models (GLMM) framework after controlling the effect of ability and item difficulty as possible confounding factors. A linear model means a linear combination of predictors determining the probability of person p for answering item i correctly. The models are equivalent with advanced IRT models that go beyond the regular modeling of test responses in terms of one or more latent variables and item parameters. The lme4 package for R will be utilized to conduct the statistical calculation.

Implications. The right amount of testing time in CAT is important\—too much is wasteful and costly, too little impacts score validity. The study is expected to provide new perception on the relationship between response time and response accuracy, which in turn, contribute to a better understanding of time effects and relevant cognitive process in CA.

Session Video

}, keywords = {CAT, Response time, Task effect}, author = {Yang Shi} } @conference {2670, title = {Response Time and Response Accuracy in Computerized Adaptive Testing}, booktitle = {IACAT 2017 Conference}, year = {2017}, month = {08/2017}, publisher = {Niigata Seiryo University}, organization = {Niigata Seiryo University}, address = {Niigata, Japan}, abstract = {

Introduction. This study explores the relationship between response speed and response accuracy in Computerized Adaptive Testing (CAT). CAT provides a score as well as item response times, which can offer additional diagnostic information regarding behavioral processes of task completion that cannot be uncovered by paper-based instruments. The goal of this study is to investigate how the accuracy rate evolves as a function of response time. If the accuracy of cognitive test responses decreases with response time, then it is an indication that the underlying cognitive process is a degrading process such as knowledge retrieval. More accessible knowledge can be retrieved faster than less accessible knowledge. For instance, in reading tasks, the time on task effect is negative and the more negative, the easier a task is. However, if the accuracy of cognitive test responses increases with response time, then the process is of an upgrading nature, with an increasing success rate as a function of response time. For example, problem-solving takes time, and fast responses are less likely to be well-founded responses. It is of course also possible that the relationship is curvilinear, as when an increasing success rate is followed by a decreasing success rate or vice versa.

Hypothesis. The present study argues the relationship between response time on task and response accuracy can be positive, negative, or curvilinear, which depends on cognitive nature of task items holding ability of the subjects and difficulty of the items constant.

Methodology. Data from a subsection of GRE quantitative test were available. We will use generalized linear mixed models. A linear model means a linear combination of predictors determining the probability of person p for answering item i correctly. Modeling mixed effects means both random effects and fixed effects are included. Fixed effects refer to constants across test takers. The models are equivalent with advanced IRT models that go beyond the regular modeling of test responses in terms of one or more latent variables and item parameters. The lme4 package for R will be utilized to conduct the statistical calculation.

Research questions. 1. What is the relationship between response accuracy and response speed? 2. What is the correlation between response accuracy and type of response time (fast response vs slow response) after controlling ability of people?

Preliminary Findings. 1. There is a negative relationship between response time and response accuracy. The success rate declines with elapsing response time. 2. The correlation between the two response latent variables (fast and slow) is 1.0, indicating the time on task effects between respond time types are not different.

Implications. The right amount of testing time in CAT is important\—too much is wasteful and costly, too little impacts score validity. The study is expected to provide new perception on the relationship between response time and response accuracy, which in turn, contribute to the best timing strategy in CAT\—with or without time constraints.

Session Video

}, keywords = {CAT, response accuracy, Response time}, url = {https://drive.google.com/open?id=1yYP01bzGrKvJnfLwepcAoQQ2F4TdSvZ2}, author = {Yang Shi} } @conference {2099, title = {From Reliability to Validity: Expanding Adaptive Testing Practice to Find the Most Valid Score for Each Test Taker}, booktitle = {Annual Conference of the International Association for Computerized Adaptive Testing}, year = {2011}, month = {10/2011}, abstract = {

CAT is an exception to the traditional conception of validity. It is one of the few examples of individualized testing. Item difficulty is tailored to each examinee. The intent, however, is increased efficiency. Focus on reliability (reduced standard error); Equivalence with paper \& pencil tests is valued; Validity is enhanced through improved reliability.

How Else Might We Individualize Testing Using CAT?

An ISV-Based View of Validity

Test Event -- An examinee encounters a series of items in a particular context.

CAT Goal: individualize testing to address CIV threats to score validity (i.e., maximize ISV).

Some Research Issues:

}, keywords = {CAT, CIV, construct-irrelevant variance, Individual Score Validity, ISV, low test taking motivation, Reliability, validity}, author = {Steven L. Wise} } @conference {2108, title = {Optimal Calibration Designs for Computerized Adaptive Testing}, booktitle = {Annual Conference of the International Association for Computerized Adaptive Testing}, year = {2011}, month = {10/2011}, abstract = {

Optimaztion

How can we exploit the advantages of Balanced Block Design while keeping the logistics manageable?

Homogeneous Designs: Overlap between test booklets as regular as possible

Conclusions:

}, keywords = {balanced block design, CAT, item calibration, optimization, Rasch}, author = {Angela Verschoor} } @conference {2081, title = {Practitioner{\textquoteright}s Approach to Identify Item Drift in CAT}, booktitle = {Annual Conference of the International Association for Computerized Adaptive Testing}, year = {2011}, month = {10/2011}, keywords = {CUSUM method, G2 statistic, IPA, item drift, item parameter drift, Lord{\textquoteright}s chi-square statistic, Raju{\textquoteright}s NCDIF}, author = {Huijuan Meng and Susan Steinkamp and Paul Jones and Joy Matthews-Lopez} } @conference {2105, title = {A Test Assembly Model for MST}, booktitle = {Annual Conference of the International Association for Computerized Adaptive Testing}, year = {2011}, month = {10/2011}, abstract = {

This study is just a short exploration in the matter of optimization of a MST. It is extremely hard or maybe impossible to chart influence of item pool and test specifications on optimization process. Simulations are very helpful in finding an acceptable MST.

}, keywords = {CAT, mst, multistage testing, Rasch, routing, tif}, author = {Angela Verschoor and Ingrid Radtke and Theo Eggen} } @article {46, title = {Development and validation of patient-reported outcome measures for sleep disturbance and sleep-related impairments}, journal = {Sleep}, volume = {33}, number = {6}, year = {2010}, note = {Buysse, Daniel JYu, LanMoul, Douglas EGermain, AnneStover, AngelaDodds, Nathan EJohnston, Kelly LShablesky-Cade, Melissa APilkonis, Paul AAR052155/AR/NIAMS NIH HHS/United StatesU01AR52155/AR/NIAMS NIH HHS/United StatesU01AR52158/AR/NIAMS NIH HHS/United StatesU01AR52170/AR/NIAMS NIH HHS/United StatesU01AR52171/AR/NIAMS NIH HHS/United StatesU01AR52177/AR/NIAMS NIH HHS/United StatesU01AR52181/AR/NIAMS NIH HHS/United StatesU01AR52186/AR/NIAMS NIH HHS/United StatesResearch Support, N.I.H., ExtramuralValidation StudiesUnited StatesSleepSleep. 2010 Jun 1;33(6):781-92.}, month = {Jun 1}, pages = {781-92}, edition = {2010/06/17}, abstract = {STUDY 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.}, keywords = {*Outcome Assessment (Health Care), *Self Disclosure, Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Psychometrics, Questionnaires, Reproducibility of Results, Sleep Disorders/*diagnosis, Young Adult}, isbn = {0161-8105 (Print)0161-8105 (Linking)}, author = {Buysse, D. J. and Yu, L. and Moul, D. E. and Germain, A. and Stover, A. and Dodds, N. E. and Johnston, K. L. and Shablesky-Cade, M. A. and Pilkonis, P. A.} } @article {138, title = {Development of an item bank for the assessment of depression in persons with mental illnesses and physical diseases using Rasch analysis}, journal = {Rehabilitation Psychology}, volume = {54}, number = {2}, year = {2009}, note = {Forkmann, ThomasBoecker, MarenNorra, ChristineEberle, NicoleKircher, TiloSchauerte, PatrickMischke, KarlWesthofen, MartinGauggel, SiegfriedWirtz, MarkusResearch Support, Non-U.S. Gov{\textquoteright}tUnited StatesRehabilitation psychologyRehabil Psychol. 2009 May;54(2):186-97.}, month = {May}, pages = {186-97}, edition = {2009/05/28}, abstract = {OBJECTIVE: The calibration of item banks provides the basis for computerized adaptive testing that ensures high diagnostic precision and minimizes participants{\textquoteright} 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.}, keywords = {Adaptation, Psychological, Adult, Aged, Depressive Disorder/*diagnosis/psychology, Diagnosis, Computer-Assisted, Female, Heart Diseases/*psychology, Humans, Male, Mental Disorders/*psychology, Middle Aged, Models, Statistical, Otorhinolaryngologic Diseases/*psychology, Personality Assessment/statistics \& numerical data, Personality Inventory/*statistics \& numerical data, Psychometrics/statistics \& numerical data, Questionnaires, Reproducibility of Results, Sick Role}, isbn = {0090-5550 (Print)0090-5550 (Linking)}, author = {Forkmann, T. and Boecker, M. and Norra, C. and Eberle, N. and Kircher, T. and Schauerte, P. and Mischke, K. and Westhofen, M. and Gauggel, S. and Wirtz, M.} } @article {227, title = {An evaluation of patient-reported outcomes found computerized adaptive testing was efficient in assessing stress perception}, journal = {Journal of Clinical Epidemiology}, volume = {62}, number = {3}, year = {2009}, note = {Kocalevent, Ruya-DanielaRose, MatthiasBecker, JanineWalter, Otto BFliege, HerbertBjorner, Jakob BKleiber, DieterKlapp, Burghard FEvaluation StudiesUnited StatesJournal of clinical epidemiologyJ Clin Epidemiol. 2009 Mar;62(3):278-87, 287.e1-3. Epub 2008 Jul 18.}, pages = {278-287}, edition = {2008/07/22}, abstract = {OBJECTIVES: 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.}, keywords = {*Diagnosis, Computer-Assisted, Adolescent, Adult, Aged, Aged, 80 and over, Confidence Intervals, Female, Humans, Male, Middle Aged, Perception, Quality of Health Care/*standards, Questionnaires, Reproducibility of Results, Sickness Impact Profile, Stress, Psychological/*diagnosis/psychology, Treatment Outcome}, isbn = {1878-5921 (Electronic)0895-4356 (Linking)}, author = {Kocalevent, R. D. and Rose, M. and Becker, J. and Walter, O. B. and Fliege, H. and Bjorner, J. B. and Kleiber, D. and Klapp, B. F.} } @article {77, title = {The maximum priority index method for severely constrained item selection in computerized adaptive testing}, journal = {British Journal of Mathematical and Statistical Psychology}, volume = {62}, number = {2}, year = {2009}, note = {Cheng, YingChang, Hua-HuaResearch Support, Non-U.S. Gov{\textquoteright}tEnglandThe British journal of mathematical and statistical psychologyBr J Math Stat Psychol. 2009 May;62(Pt 2):369-83. Epub 2008 Jun 2.}, month = {May}, pages = {369-83}, edition = {2008/06/07}, abstract = {This paper introduces a new heuristic approach, the maximum priority index (MPI) method, for severely constrained item selection in computerized adaptive testing. Our simulation study shows that it is able to accommodate various non-statistical constraints simultaneously, such as content balancing, exposure control, answer key balancing, and so on. Compared with the weighted deviation modelling method, it leads to fewer constraint violations and better exposure control while maintaining the same level of measurement precision.}, keywords = {Aptitude Tests/*statistics \& numerical data, Diagnosis, Computer-Assisted/*statistics \& numerical data, Educational Measurement/*statistics \& numerical data, Humans, Mathematical Computing, Models, Statistical, Personality Tests/*statistics \& numerical data, Psychometrics/*statistics \& numerical data, Reproducibility of Results, Software}, isbn = {0007-1102 (Print)0007-1102 (Linking)}, author = {Cheng, Y and Chang, Hua-Hua} } @article {143, title = {Progress in assessing physical function in arthritis: PROMIS short forms and computerized adaptive testing}, journal = {Journal of Rheumatology}, volume = {36}, number = {9}, year = {2009}, note = {Fries, James FCella, DavidRose, MatthiasKrishnan, EswarBruce, BonnieU01 AR052158/AR/NIAMS NIH HHS/United StatesU01 AR52177/AR/NIAMS NIH HHS/United StatesConsensus Development ConferenceResearch Support, N.I.H., ExtramuralCanadaThe Journal of rheumatologyJ Rheumatol. 2009 Sep;36(9):2061-6.}, month = {Sep}, pages = {2061-2066}, edition = {2009/09/10}, abstract = {OBJECTIVE: Assessing self-reported physical function/disability with the Health Assessment Questionnaire Disability Index (HAQ) and other instruments has become central in arthritis research. Item response theory (IRT) and computerized adaptive testing (CAT) techniques can increase reliability and statistical power. IRT-based instruments can improve measurement precision substantially over a wider range of disease severity. These modern methods were applied and the magnitude of improvement was estimated. METHODS: A 199-item physical function/disability item bank was developed by distilling 1865 items to 124, including Legacy Health Assessment Questionnaire (HAQ) and Physical Function-10 items, and improving precision through qualitative and quantitative evaluation in over 21,000 subjects, which included about 1500 patients with rheumatoid arthritis and osteoarthritis. Four new instruments, (A) Patient-Reported Outcomes Measurement Information (PROMIS) HAQ, which evolved from the original (Legacy) HAQ; (B) "best" PROMIS 10; (C) 20-item static (short) forms; and (D) simulated PROMIS CAT, which sequentially selected the most informative item, were compared with the HAQ. RESULTS: Online and mailed administration modes yielded similar item and domain scores. The HAQ and PROMIS HAQ 20-item scales yielded greater information content versus other scales in patients with more severe disease. The "best" PROMIS 20-item scale outperformed the other 20-item static forms over a broad range of 4 standard deviations. The 10-item simulated PROMIS CAT outperformed all other forms. CONCLUSION: Improved items and instruments yielded better information. The PROMIS HAQ is currently available and considered validated. The new PROMIS short forms, after validation, are likely to represent further improvement. CAT-based physical function/disability assessment offers superior performance over static forms of equal length.}, keywords = {*Disability Evaluation, *Outcome Assessment (Health Care), Arthritis/diagnosis/*physiopathology, Health Surveys, Humans, Prognosis, Reproducibility of Results}, isbn = {0315-162X (Print)0315-162X (Linking)}, author = {Fries, J.F. and Cella, D. and Rose, M. and Krishnan, E. and Bruce, B.} } @article {78, title = {Reduction in patient burdens with graphical computerized adaptive testing on the ADL scale: tool development and simulation}, journal = {Health and Quality of Life Outcomes}, volume = {7}, year = {2009}, note = {Chien, Tsair-WeiWu, Hing-ManWang, Weng-ChungCastillo, Roberto VasquezChou, WillyComparative StudyValidation StudiesEnglandHealth and quality of life outcomesHealth Qual Life Outcomes. 2009 May 5;7:39.}, pages = {39}, edition = {2009/05/07}, abstract = {BACKGROUND: The aim of this study was to verify the effectiveness and efficacy of saving time and reducing burden for patients, nurses, and even occupational therapists through computer adaptive testing (CAT). METHODS: Based on an item bank of the Barthel Index (BI) and the Frenchay Activities Index (FAI) for assessing comprehensive activities of daily living (ADL) function in stroke patients, we developed a visual basic application (VBA)-Excel CAT module, and (1) investigated whether the averaged test length via CAT is shorter than that of the traditional all-item-answered non-adaptive testing (NAT) approach through simulation, (2) illustrated the CAT multimedia on a tablet PC showing data collection and response errors of ADL clinical functional measures in stroke patients, and (3) demonstrated the quality control of endorsing scale with fit statistics to detect responding errors, which will be further immediately reconfirmed by technicians once patient ends the CAT assessment. RESULTS: The results show that endorsed items could be shorter on CAT (M = 13.42) than on NAT (M = 23) at 41.64\% efficiency in test length. However, averaged ability estimations reveal insignificant differences between CAT and NAT. CONCLUSION: This study found that mobile nursing services, placed at the bedsides of patients could, through the programmed VBA-Excel CAT module, reduce the burden to patients and save time, more so than the traditional NAT paper-and-pencil testing appraisals.}, keywords = {*Activities of Daily Living, *Computer Graphics, *Computer Simulation, *Diagnosis, Computer-Assisted, Female, Humans, Male, Point-of-Care Systems, Reproducibility of Results, Stroke/*rehabilitation, Taiwan, United States}, isbn = {1477-7525 (Electronic)1477-7525 (Linking)}, author = {Chien, T. W. and Wu, H. M. and Wang, W-C. and Castillo, R. V. and Chou, W.} } @article {212, title = {Adaptive short forms for outpatient rehabilitation outcome assessment}, journal = {American Journal of Physical Medicine and Rehabilitation}, volume = {87}, number = {10}, year = {2008}, note = {Jette, Alan MHaley, Stephen MNi, PengshengMoed, RichardK02 HD45354-01/HD/NICHD NIH HHS/United StatesR01 HD43568/HD/NICHD NIH HHS/United StatesResearch Support, N.I.H., ExtramuralResearch Support, U.S. Gov{\textquoteright}t, Non-P.H.S.Research Support, U.S. Gov{\textquoteright}t, P.H.S.United StatesAmerican journal of physical medicine \& rehabilitation / Association of Academic PhysiatristsAm J Phys Med Rehabil. 2008 Oct;87(10):842-52.}, month = {Oct}, pages = {842-52}, edition = {2008/09/23}, abstract = {OBJECTIVE: 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{\textquoteright} 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.}, keywords = {*Activities of Daily Living, *Ambulatory Care Facilities, *Mobility Limitation, *Treatment Outcome, Disabled Persons/psychology/*rehabilitation, Female, Humans, Male, Middle Aged, Questionnaires, Rehabilitation Centers}, isbn = {1537-7385 (Electronic)}, author = {Jette, A. M. and Haley, S. M. and Ni, P. and Moed, R.} } @article {88, title = {Assessing self-care and social function using a computer adaptive testing version of the pediatric evaluation of disability inventory}, journal = {Archives of Physical Medicine and Rehabilitation}, volume = {89}, number = {4}, year = {2008}, note = {Coster, Wendy JHaley, Stephen MNi, PengshengDumas, Helene MFragala-Pinkham, Maria AK02 HD45354-01A1/HD/NICHD NIH HHS/United StatesR41 HD052318-01A1/HD/NICHD NIH HHS/United StatesR43 HD42388-01/HD/NICHD NIH HHS/United StatesComparative StudyResearch Support, N.I.H., ExtramuralUnited StatesArchives of physical medicine and rehabilitationArch Phys Med Rehabil. 2008 Apr;89(4):622-9.}, month = {Apr}, pages = {622-629}, edition = {2008/04/01}, abstract = {OBJECTIVE: 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{\textquoteright}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.}, keywords = {*Disability Evaluation, *Social Adjustment, Activities of Daily Living, Adolescent, Age Factors, Child, Child, Preschool, Computer Simulation, Cross-Over Studies, Disabled Children/*rehabilitation, Female, Follow-Up Studies, Humans, Infant, Male, Outcome Assessment (Health Care), Reference Values, Reproducibility of Results, Retrospective Studies, Risk Factors, Self Care/*standards/trends, Sex Factors, Sickness Impact Profile}, isbn = {1532-821X (Electronic)0003-9993 (Linking)}, author = {Coster, W. J. and Haley, S. M. and Ni, P. and Dumas, H. M. and Fragala-Pinkham, M. A.} } @article {169, title = {Computerized adaptive testing for follow-up after discharge from inpatient rehabilitation: II. Participation outcomes}, journal = {Archives of Physical Medicine and Rehabilitation}, volume = {89}, number = {2}, year = {2008}, note = {Haley, Stephen MGandek, BarbaraSiebens, HilaryBlack-Schaffer, Randie MSinclair, Samuel JTao, WeiCoster, Wendy JNi, PengshengJette, Alan MK02 HD045354-01A1/HD/NICHD NIH HHS/United StatesK02 HD45354-01/HD/NICHD NIH HHS/United StatesR01 HD043568/HD/NICHD NIH HHS/United StatesR01 HD043568-01/HD/NICHD NIH HHS/United StatesResearch Support, N.I.H., ExtramuralUnited StatesArchives of physical medicine and rehabilitationArch Phys Med Rehabil. 2008 Feb;89(2):275-83.}, month = {Feb}, pages = {275-283}, edition = {2008/01/30}, abstract = {OBJECTIVES: 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{\textquoteright}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.}, keywords = {*Activities of Daily Living, *Adaptation, Physiological, *Computer Systems, *Questionnaires, Adult, Aged, Aged, 80 and over, Chi-Square Distribution, Factor Analysis, Statistical, Female, Humans, Longitudinal Studies, Male, Middle Aged, Outcome Assessment (Health Care)/*methods, Patient Discharge, Prospective Studies, Rehabilitation/*standards, Subacute Care/*standards}, isbn = {1532-821X (Electronic)0003-9993 (Linking)}, author = {Haley, S. M. and Gandek, B. and Siebens, H. and Black-Schaffer, R. M. and Sinclair, S. J. and Tao, W. and Coster, W. J. and Ni, P. and Jette, A. M.} } @article {231, title = {Computerized adaptive testing in back pain: Validation of the CAT-5D-QOL}, journal = {Spine}, volume = {33}, number = {12}, year = {2008}, note = {Kopec, Jacek ABadii, MaziarMcKenna, MarioLima, Viviane DSayre, Eric CDvorak, MarcelResearch Support, Non-U.S. Gov{\textquoteright}tValidation StudiesUnited StatesSpineSpine (Phila Pa 1976). 2008 May 20;33(12):1384-90.}, month = {May 20}, pages = {1384-90}, edition = {2008/05/23}, abstract = {STUDY 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.}, keywords = {*Disability Evaluation, *Health Status Indicators, *Quality of Life, Adult, Aged, Algorithms, Back Pain/*diagnosis/psychology, British Columbia, Diagnosis, Computer-Assisted/*standards, Feasibility Studies, Female, Humans, Internet, Male, Middle Aged, Predictive Value of Tests, Questionnaires/*standards, Reproducibility of Results}, isbn = {1528-1159 (Electronic)0362-2436 (Linking)}, author = {Kopec, J. A. and Badii, M. and McKenna, M. and Lima, V. D. and Sayre, E. C. and Dvorak, M.} } @article {5, title = {Efficiency and sensitivity of multidimensional computerized adaptive testing of pediatric physical functioning}, journal = {Disability \& Rehabilitation}, volume = {30}, number = {6}, year = {2008}, note = {Allen, Diane DNi, PengshengHaley, Stephen MK02 HD45354-01/HD/NICHD NIH HHS/United StatesNIDDR H133P0001/DD/NCBDD CDC HHS/United StatesResearch Support, N.I.H., ExtramuralEnglandDisability and rehabilitationDisabil Rehabil. 2008;30(6):479-84.}, pages = {479-84}, edition = {2008/02/26}, abstract = {PURPOSE: Computerized adaptive tests (CATs) have efficiency advantages over fixed-length tests of physical functioning but may lose sensitivity when administering extremely low numbers of items. Multidimensional CATs may efficiently improve sensitivity by capitalizing on correlations between functional domains. Using a series of empirical simulations, we assessed the efficiency and sensitivity of multidimensional CATs compared to a longer fixed-length test. METHOD: Parent responses to the Pediatric Evaluation of Disability Inventory before and after intervention for 239 children at a pediatric rehabilitation hospital provided the data for this retrospective study. Reliability, effect size, and standardized response mean were compared between full-length self-care and mobility subscales and simulated multidimensional CATs with stopping rules at 40, 30, 20, and 10 items. RESULTS: Reliability was lowest in the 10-item CAT condition for the self-care (r = 0.85) and mobility (r = 0.79) subscales; all other conditions had high reliabilities (r > 0.94). All multidimensional CAT conditions had equivalent levels of sensitivity compared to the full set condition for both domains. CONCLUSIONS: Multidimensional CATs efficiently retain the sensitivity of longer fixed-length measures even with 5 items per dimension (10-item CAT condition). Measuring physical functioning with multidimensional CATs could enhance sensitivity following intervention while minimizing response burden.}, keywords = {*Disability Evaluation, Child, Computers, Disabled Children/*classification/rehabilitation, Efficiency, Humans, Outcome Assessment (Health Care), Psychometrics, Reproducibility of Results, Retrospective Studies, Self Care, Sensitivity and Specificity}, isbn = {0963-8288 (Print)0963-8288 (Linking)}, author = {Allen, D. D. and Ni, P. and Haley, S. M.} } @article {84, title = {Letting the CAT out of the bag: Comparing computer adaptive tests and an 11-item short form of the Roland-Morris Disability Questionnaire}, journal = {Spine}, volume = {33}, number = {12}, year = {2008}, note = {Cook, Karon FChoi, Seung WCrane, Paul KDeyo, Richard AJohnson, Kurt LAmtmann, Dagmar5 P60-AR48093/AR/United States NIAMS5U01AR052171-03/AR/United States NIAMSComparative StudyResearch Support, N.I.H., ExtramuralUnited StatesSpineSpine. 2008 May 20;33(12):1378-83.}, month = {May 20}, pages = {1378-83}, edition = {2008/05/23}, abstract = {STUDY DESIGN: A post hoc simulation of a computer adaptive administration of the items of a modified version of the Roland-Morris Disability Questionnaire. OBJECTIVE: To evaluate the effectiveness of adaptive administration of back pain-related disability items compared with a fixed 11-item short form. SUMMARY OF BACKGROUND DATA: Short form versions of the Roland-Morris Disability Questionnaire have been developed. An alternative to paper-and-pencil short forms is to administer items adaptively so that items are presented based on a person{\textquoteright}s responses to previous items. Theoretically, this allows precise estimation of back pain disability with administration of only a few items. MATERIALS AND METHODS: Data were gathered from 2 previously conducted studies of persons with back pain. An item response theory model was used to calibrate scores based on all items, items of a paper-and-pencil short form, and several computer adaptive tests (CATs). RESULTS: Correlations between each CAT condition and scores based on a 23-item version of the Roland-Morris Disability Questionnaire ranged from 0.93 to 0.98. Compared with an 11-item short form, an 11-item CAT produced scores that were significantly more highly correlated with scores based on the 23-item scale. CATs with even fewer items also produced scores that were highly correlated with scores based on all items. For example, scores from a 5-item CAT had a correlation of 0.93 with full scale scores. Seven- and 9-item CATs correlated at 0.95 and 0.97, respectively. A CAT with a standard-error-based stopping rule produced scores that correlated at 0.95 with full scale scores. CONCLUSION: A CAT-based back pain-related disability measure may be a valuable tool for use in clinical and research contexts. Use of CAT for other common measures in back pain research, such as other functional scales or measures of psychological distress, may offer similar advantages.}, keywords = {*Disability Evaluation, *Health Status Indicators, Adult, Aged, Aged, 80 and over, Back Pain/*diagnosis/psychology, Calibration, Computer Simulation, Diagnosis, Computer-Assisted/*standards, Humans, Middle Aged, Models, Psychological, Predictive Value of Tests, Questionnaires/*standards, Reproducibility of Results}, isbn = {1528-1159 (Electronic)}, author = {Cook, K. F. and Choi, S. W. and Crane, P. K. and Deyo, R. A. and Johnson, K. L. and Amtmann, D.} } @article {287, title = {Measuring physical functioning in children with spinal impairments with computerized adaptive testing}, journal = {Journal of Pediatric Orthopedics}, volume = {28}, number = {3}, year = {2008}, note = {Mulcahey, M JHaley, Stephen MDuffy, TheresaPengsheng, NiBetz, Randal RK02 HD045354-01A1/HD/NICHD NIH HHS/United StatesUnited StatesJournal of pediatric orthopedicsJ Pediatr Orthop. 2008 Apr-May;28(3):330-5.}, month = {Apr-May}, pages = {330-5}, edition = {2008/03/26}, abstract = {BACKGROUND: 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.}, keywords = {*Disability Evaluation, Adolescent, Child, Child, Preschool, Computer Simulation, Cross-Sectional Studies, Disabled Children/*rehabilitation, Female, Humans, Infant, Kyphosis/*diagnosis/rehabilitation, Male, Prospective Studies, Reproducibility of Results, Scoliosis/*diagnosis/rehabilitation}, isbn = {0271-6798 (Print)0271-6798 (Linking)}, author = {Mulcahey, M. J. and Haley, S. M. and Duffy, T. and Pengsheng, N. and Betz, R. R.} } @article {71, title = {Predicting item exposure parameters in computerized adaptive testing}, journal = {British Journal of Mathematical and Statistical Psychology}, volume = {61}, number = {1}, year = {2008}, note = {Chen, Shu-YingDoong, Shing-HwangResearch Support, Non-U.S. Gov{\textquoteright}tEnglandThe British journal of mathematical and statistical psychologyBr J Math Stat Psychol. 2008 May;61(Pt 1):75-91.}, month = {May}, pages = {75-91}, edition = {2008/05/17}, abstract = {The purpose of this study is to find a formula that describes the relationship between item exposure parameters and item parameters in computerized adaptive tests by using genetic programming (GP) - a biologically inspired artificial intelligence technique. Based on the formula, item exposure parameters for new parallel item pools can be predicted without conducting additional iterative simulations. Results show that an interesting formula between item exposure parameters and item parameters in a pool can be found by using GP. The item exposure parameters predicted based on the found formula were close to those observed from the Sympson and Hetter (1985) procedure and performed well in controlling item exposure rates. Similar results were observed for the Stocking and Lewis (1998) multinomial model for item selection and the Sympson and Hetter procedure with content balancing. The proposed GP approach has provided a knowledge-based solution for finding item exposure parameters.}, keywords = {*Algorithms, *Artificial Intelligence, Aptitude Tests/*statistics \& numerical data, Diagnosis, Computer-Assisted/*statistics \& numerical data, Humans, Models, Statistical, Psychometrics/statistics \& numerical data, Reproducibility of Results, Software}, isbn = {0007-1102 (Print)0007-1102 (Linking)}, author = {Chen, S-Y. and Doong, S. H.} } @article {152, title = {Using computerized adaptive testing to reduce the burden of mental health assessment}, journal = {Psychiatric Services}, volume = {59}, number = {4}, year = {2008}, note = {Gibbons, Robert DWeiss, David JKupfer, David JFrank, EllenFagiolini, AndreaGrochocinski, Victoria JBhaumik, Dulal KStover, AngelaBock, R DarrellImmekus, Jason CR01-MH-30915/MH/United States NIMHR01-MH-66302/MH/United States NIMHResearch Support, N.I.H., ExtramuralUnited StatesPsychiatric services (Washington, D.C.)Psychiatr Serv. 2008 Apr;59(4):361-8.}, month = {Apr}, pages = {361-8}, edition = {2008/04/02}, abstract = {OBJECTIVE: 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{\textquoteright}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.}, keywords = {*Diagnosis, Computer-Assisted, *Questionnaires, Adolescent, Adult, Aged, Agoraphobia/diagnosis, Anxiety Disorders/diagnosis, Bipolar Disorder/diagnosis, Female, Humans, Male, Mental Disorders/*diagnosis, Middle Aged, Mood Disorders/diagnosis, Obsessive-Compulsive Disorder/diagnosis, Panic Disorder/diagnosis, Phobic Disorders/diagnosis, Reproducibility of Results, Time Factors}, isbn = {1075-2730 (Print)}, author = {Gibbons, R. D. and Weiss, D. J. and Kupfer, D. J. and Frank, E. and Fagiolini, A. and Grochocinski, V. J. and Bhaumik, D. K. and Stover, A. and Bock, R. D. and Immekus, J. C.} } @article {135, title = {Computerized adaptive personality testing: A review and illustration with the MMPI-2 Computerized Adaptive Version}, journal = {Psychological Assessment}, volume = {19}, number = {1}, year = {2007}, note = {Forbey, Johnathan DBen-Porath, Yossef SResearch Support, Non-U.S. Gov{\textquoteright}tUnited StatesPsychological assessmentPsychol Assess. 2007 Mar;19(1):14-24.}, month = {Mar}, pages = {14-24}, edition = {2007/03/21}, abstract = {Computerized 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.}, keywords = {Adolescent, Adult, Diagnosis, Computer-Assisted/*statistics \& numerical data, Female, Humans, Male, MMPI/*statistics \& numerical data, Personality Assessment/*statistics \& numerical data, Psychometrics/statistics \& numerical data, Reference Values, Reproducibility of Results}, isbn = {1040-3590 (Print)}, author = {Forbey, J. D. and Ben-Porath, Y. S.} } @article {52, title = {Improving patient reported outcomes using item response theory and computerized adaptive testing}, journal = {Journal of Rheumatology}, volume = {34}, number = {6}, year = {2007}, note = {Chakravarty, Eliza FBjorner, Jakob BFries, James FAr052158/ar/niamsConsensus Development ConferenceResearch Support, N.I.H., ExtramuralCanadaThe Journal of rheumatologyJ Rheumatol. 2007 Jun;34(6):1426-31.}, month = {Jun}, pages = {1426-31}, edition = {2007/06/07}, abstract = {OBJECTIVE: Patient reported outcomes (PRO) are considered central outcome measures for both clinical trials and observational studies in rheumatology. More sophisticated statistical models, including item response theory (IRT) and computerized adaptive testing (CAT), will enable critical evaluation and reconstruction of currently utilized PRO instruments to improve measurement precision while reducing item burden on the individual patient. METHODS: We developed a domain hierarchy encompassing the latent trait of physical function/disability from the more general to most specific. Items collected from 165 English-language instruments were evaluated by a structured process including trained raters, modified Delphi expert consensus, and then patient evaluation. Each item in the refined data bank will undergo extensive analysis using IRT to evaluate response functions and measurement precision. CAT will allow for real-time questionnaires of potentially smaller numbers of questions tailored directly to each individual{\textquoteright}s level of physical function. RESULTS: Physical function/disability domain comprises 4 subdomains: upper extremity, trunk, lower extremity, and complex activities. Expert and patient review led to consensus favoring use of present-tense "capability" questions using a 4- or 5-item Likert response construct over past-tense "performance"items. Floor and ceiling effects, attribution of disability, and standardization of response categories were also addressed. CONCLUSION: By applying statistical techniques of IRT through use of CAT, existing PRO instruments may be improved to reduce questionnaire burden on the individual patients while increasing measurement precision that may ultimately lead to reduced sample size requirements for costly clinical trials.}, keywords = {*Rheumatic Diseases/physiopathology/psychology, Clinical Trials, Data Interpretation, Statistical, Disability Evaluation, Health Surveys, Humans, International Cooperation, Outcome Assessment (Health Care)/*methods, Patient Participation/*methods, Research Design/*trends, Software}, isbn = {0315-162X (Print)}, author = {Chakravarty, E. F. and Bjorner, J. B. and Fries, J.F.} } @article {363, title = {The initial development of an item bank to assess and screen for psychological distress in cancer patients}, journal = {Psycho-Oncology}, volume = {16}, number = {8}, year = {2007}, note = {10.1002/pon.1117Journal; Peer Reviewed Journal; Journal Article}, pages = {724-732}, abstract = {Psychological distress is a common problem among cancer patients. Despite the large number of instruments that have been developed to assess distress, their utility remains disappointing. This study aimed to use Rasch models to develop an item-bank which would provide the basis for better means of assessing psychological distress in cancer patients. An item bank was developed from eight psychological distress questionnaires using Rasch analysis to link common items. Items from the questionnaires were added iteratively with common items as anchor points and misfitting items (infit mean square > 1.3) removed, and unidimensionality assessed. A total of 4914 patients completed the questionnaires providing an initial pool of 83 items. Twenty items were removed resulting in a final pool of 63 items. Good fit was demonstrated and no additional factor structure was evident from the residuals. However, there was little overlap between item locations and person measures, since items mainly targeted higher levels of distress. The Rasch analysis allowed items to be pooled and generated a unidimensional instrument for measuring psychological distress in cancer patients. Additional items are required to more accurately assess patients across the whole continuum of psychological distress. (PsycINFO Database Record (c) 2007 APA ) (journal abstract)}, keywords = {3293 Cancer, cancer patients, Distress, initial development, Item Response Theory, Models, Neoplasms, Patients, Psychological, psychological distress, Rasch, Stress}, isbn = {1057-9249}, author = {Smith, A. B. and Rush, R. and Velikova, G. and Wall, L. and Wright, E. P. and Stark, D. and Selby, P. and Sharpe, M.} } @article {306, title = {Test design optimization in CAT early stage with the nominal response model}, journal = {Applied Psychological Measurement}, volume = {31}, number = {3}, year = {2007}, pages = {213-232}, publisher = {Sage Publications: US}, abstract = {The early stage of computerized adaptive testing (CAT) refers to the phase of the trait estimation during the administration of only a few items. This phase can be characterized by bias and instability of estimation. In this study, an item selection criterion is introduced in an attempt to lessen this instability: the D-optimality criterion. A polytomous unconstrained CAT simulation is carried out to evaluate this criterion{\textquoteright}s performance under different test premises. The simulation shows that the extent of early stage instability depends primarily on the quality of the item pool information and its size and secondarily on the item selection criteria. The efficiency of the D-optimality criterion is similar to the efficiency of other known item selection criteria. Yet, it often yields estimates that, at the beginning of CAT, display a more robust performance against instability. (PsycINFO Database Record (c) 2007 APA, all rights reserved)}, keywords = {computerized adaptive testing, nominal response model, robust performance, test design optimization}, isbn = {0146-6216 (Print)}, author = {Passos, V. L. and Berger, M. P. F. and Tan, F. E.} } @article {172, title = {Computer adaptive testing improved accuracy and precision of scores over random item selection in a physical functioning item bank}, journal = {Journal of Clinical Epidemiology}, volume = {59}, number = {11}, year = {2006}, note = {Haley, Stephen MNi, PengshengHambleton, Ronald KSlavin, Mary DJette, Alan MK02 hd45354-01/hd/nichdR01 hd043568/hd/nichdComparative StudyResearch Support, N.I.H., ExtramuralResearch Support, U.S. Gov{\textquoteright}t, Non-P.H.S.EnglandJournal of clinical epidemiologyJ Clin Epidemiol. 2006 Nov;59(11):1174-82. Epub 2006 Jul 11.}, month = {Nov}, pages = {1174-82}, edition = {2006/10/10}, abstract = {BACKGROUND 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.}, keywords = {*Recovery of Function, Activities of Daily Living, Adolescent, Adult, Aged, Aged, 80 and over, Confidence Intervals, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Outcome Assessment (Health Care)/*methods, Rehabilitation/*standards, Reproducibility of Results, Software}, isbn = {0895-4356 (Print)}, author = {Haley, S. M. and Ni, P. and Hambleton, R. K. and Slavin, M. D. and Jette, A. M.} } @article {176, title = {Computerized adaptive testing for follow-up after discharge from inpatient rehabilitation: I. Activity outcomes}, journal = {Archives of Physical Medicine and Rehabilitation}, volume = {87}, number = {8}, year = {2006}, note = {Haley, Stephen MSiebens, HilaryCoster, Wendy JTao, WeiBlack-Schaffer, Randie MGandek, BarbaraSinclair, Samuel JNi, PengshengK0245354-01/phsR01 hd043568/hd/nichdResearch Support, N.I.H., ExtramuralUnited StatesArchives of physical medicine and rehabilitationArch Phys Med Rehabil. 2006 Aug;87(8):1033-42.}, month = {Aug}, pages = {1033-42}, edition = {2006/08/01}, abstract = {OBJECTIVE: 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{\textquoteright} 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{\textquoteright} 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.}, keywords = {*Activities of Daily Living, *Adaptation, Physiological, *Computer Systems, *Questionnaires, Adult, Aged, Aged, 80 and over, Chi-Square Distribution, Factor Analysis, Statistical, Female, Humans, Longitudinal Studies, Male, Middle Aged, Outcome Assessment (Health Care)/*methods, Patient Discharge, Prospective Studies, Rehabilitation/*standards, Subacute Care/*standards}, isbn = {0003-9993 (Print)}, author = {Haley, S. M. and Siebens, H. and Coster, W. J. and Tao, W. and Black-Schaffer, R. M. and Gandek, B. and Sinclair, S. J. and Ni, P.} } @article {319, title = {SIMCAT 1.0: A SAS computer program for simulating computer adaptive testing}, journal = {Applied Psychological Measurement}, volume = {30}, number = {1}, year = {2006}, pages = {60-61}, publisher = {Sage Publications: US}, abstract = {Monte Carlo methodologies are frequently applied to study the sampling distribution of the estimated proficiency level in adaptive testing. These methods eliminate real situational constraints. However, these Monte Carlo methodologies are not currently supported by the available software programs, and when these programs are available, their flexibility is limited. SIMCAT 1.0 is aimed at the simulation of adaptive testing sessions under different adaptive expected a posteriori (EAP) proficiency-level estimation methods (Blais \& Ra{\^\i}che, 2005; Ra{\^\i}che \& Blais, 2005) based on the one-parameter Rasch logistic model. These methods are all adaptive in the a priori proficiency-level estimation, the proficiency-level estimation bias correction, the integration interval, or a combination of these factors. The use of these adaptive EAP estimation methods diminishes considerably the shrinking, and therefore biasing, effect of the estimated a priori proficiency level encountered when this a priori is fixed at a constant value independently of the computed previous value of the proficiency level. SIMCAT 1.0 also computes empirical and estimated skewness and kurtosis coefficients, such as the standard error, of the estimated proficiency-level sampling distribution. In this way, the program allows one to compare empirical and estimated properties of the estimated proficiency-level sampling distribution under different variations of the EAP estimation method: standard error and bias, like the skewness and kurtosis coefficients. (PsycINFO Database Record (c) 2007 APA, all rights reserved)}, keywords = {computer adaptive testing, computer program, estimated proficiency level, Monte Carlo methodologies, Rasch logistic model}, isbn = {0146-6216 (Print)}, author = {Ra{\^\i}che, G. and Blais, J-G.} } @article {2073, title = {Simulated computerized adaptive test for patients with lumbar spine impairments was efficient and produced valid measures of function}, journal = {Journal of Clinical Epidemiology}, volume = {59}, year = {2006}, pages = {947{\textendash}956}, abstract = {Objective: To equate physical functioning (PF) items with Back Pain Functional Scale (BPFS) items, develop a computerized adaptive test (CAT) designed to assess lumbar spine functional status (LFS) in people with lumbar spine impairments, and compare discriminant validity of LFS measures (qIRT) generated using all items analyzed with a rating scale Item Response Theory model (RSM) and measures generated using the simulated CAT (qCAT). Methods: We performed a secondary analysis of retrospective intake rehabilitation data. Results: Unidimensionality and local independence of 25 BPFS and PF items were supported. Differential item functioning was negligible for levels of symptom acuity, gender, age, and surgical history. The RSM fit the data well. A lumbar spine specific CAT was developed that was 72\% more efficient than using all 25 items to estimate LFS measures. qIRT and qCAT measures did not discriminate patients by symptom acuity, age, or gender, but discriminated patients by surgical history in similar clinically logical ways. qCAT measures were as precise as qIRT measures. Conclusion: A body part specific simulated CAT developed from an LFS item bank was efficient and produced precise measures of LFS without eroding discriminant validity.}, keywords = {Back Pain Functional Scale, computerized adaptive testing, Item Response Theory, Lumbar spine, Rehabilitation, True-score equating}, doi = {10.1016/j.jclinepi.2005.10.017}, author = {Hart, D. L. and Mioduski, J. E. and Werneke, M. W. and Stratford, P. W.} } @article {184, title = {Simulated computerized adaptive test for patients with shoulder impairments was efficient and produced valid measures of function}, journal = {Journal of Clinical Epidemiology}, volume = {59}, number = {3}, year = {2006}, note = {0895-4356 (Print)Journal ArticleValidation Studies}, pages = {290-8}, abstract = {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 (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.}, keywords = {*Computer Simulation, *Range of Motion, Articular, Activities of Daily Living, Adult, Aged, Aged, 80 and over, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Prospective Studies, Reproducibility of Results, Research Support, N.I.H., Extramural, Research Support, U.S. Gov{\textquoteright}t, Non-P.H.S., Shoulder Dislocation/*physiopathology/psychology/rehabilitation, Shoulder Pain/*physiopathology/psychology/rehabilitation, Shoulder/*physiopathology, Sickness Impact Profile, Treatment Outcome}, author = {Hart, D. L. and Cook, K. F. and Mioduski, J. E. and Teal, C. R. and Crane, P. K.} } @article {2074, title = {Simulated computerized adaptive test for patients with shoulder impairments was efficient and produced valid measures of function}, journal = {Journal of Clinical Epidemiology}, volume = {59}, year = {2006}, pages = {290-298}, abstract = {

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.\ 

}, keywords = {computerized adaptive testing, Flexilevel Scale of Shoulder Function, Item Response Theory, Rehabilitation}, author = {Hart, D. L. and Cook, K. F. and Mioduski, J. E. and Teal, C. R. and Crane, P. K.} } @article {175, title = {Assessing mobility in children using a computer adaptive testing version of the pediatric evaluation of disability inventory}, journal = {Archives of Physical Medicine and Rehabilitation}, volume = {86}, number = {5}, year = {2005}, note = {Haley, Stephen MRaczek, Anastasia ECoster, Wendy JDumas, Helene MFragala-Pinkham, Maria AK02 hd45354-01a1/hd/nichdR43 hd42388-01/hd/nichdResearch Support, N.I.H., ExtramuralResearch Support, U.S. Gov{\textquoteright}t, P.H.S.United StatesArchives of physical medicine and rehabilitationArch Phys Med Rehabil. 2005 May;86(5):932-9.}, month = {May}, pages = {932-9}, edition = {2005/05/17}, abstract = {OBJECTIVE: 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{\textquoteright}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.}, keywords = {*Computer Simulation, *Disability Evaluation, Adolescent, Child, Child, Preschool, Cross-Sectional Studies, Disabled Children/*rehabilitation, Female, Humans, Infant, Male, Outcome Assessment (Health Care)/*methods, Rehabilitation Centers, Rehabilitation/*standards, Sensitivity and Specificity}, isbn = {0003-9993 (Print)}, author = {Haley, S. M. and Raczek, A. E. and Coster, W. J. and Dumas, H. M. and Fragala-Pinkham, M. A.} } @article {171, title = {A computer adaptive testing approach for assessing physical functioning in children and adolescents}, journal = {Developmental Medicine and Child Neuropsychology}, volume = {47}, number = {2}, year = {2005}, note = {Haley, Stephen MNi, PengshengFragala-Pinkham, Maria ASkrinar, Alison MCorzo, DeyaniraComparative StudyResearch Support, Non-U.S. Gov{\textquoteright}tEnglandDevelopmental medicine and child neurologyDev Med Child Neurol. 2005 Feb;47(2):113-20.}, month = {Feb}, pages = {113-120}, edition = {2005/02/15}, abstract = {The 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{\textquoteright}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.}, keywords = {*Computer Systems, Activities of Daily Living, Adolescent, Age Factors, Child, Child Development/*physiology, Child, Preschool, Computer Simulation, Confidence Intervals, Demography, Female, Glycogen Storage Disease Type II/physiopathology, Health Status Indicators, Humans, Infant, Infant, Newborn, Male, Motor Activity/*physiology, Outcome Assessment (Health Care)/*methods, Reproducibility of Results, Self Care, Sensitivity and Specificity}, isbn = {0012-1622 (Print)}, author = {Haley, S. M. and Ni, P. and Fragala-Pinkham, M. A. and Skrinar, A. M. and Corzo, D.} } @article {211, title = {Contemporary measurement techniques for rehabilitation outcomes assessment}, journal = {Journal of Rehabilitation Medicine}, volume = {37}, number = {6}, year = {2005}, note = {1650-1977 (Print)Journal ArticleReview}, pages = {339-345}, abstract = {In this article, we review the limitations of traditional rehabilitation functional outcome instruments currently in use within the rehabilitation field to assess Activity and Participation domains as defined by the International Classification of Function, Disability, and Health. These include a narrow scope of functional outcomes, data incompatibility across instruments, and the precision vs feasibility dilemma. Following this, we illustrate how contemporary measurement techniques, such as item response theory methods combined with computer adaptive testing methodology, can be applied in rehabilitation to design functional outcome instruments that are comprehensive in scope, accurate, allow for compatibility across instruments, and are sensitive to clinically important change without sacrificing their feasibility. Finally, we present some of the pressing challenges that need to be overcome to provide effective dissemination and training assistance to ensure that current and future generations of rehabilitation professionals are familiar with and skilled in the application of contemporary outcomes measurement.}, keywords = {*Disability Evaluation, Activities of Daily Living/classification, Disabled Persons/classification/*rehabilitation, Health Status Indicators, Humans, Outcome Assessment (Health Care)/*methods/standards, Recovery of Function, Research Support, N.I.H., Extramural, Research Support, U.S. Gov{\textquoteright}t, Non-P.H.S., Sensitivity and Specificity computerized adaptive testing}, author = {Jette, A. M. and Haley, S. M.} } @article {121, title = {Data pooling and analysis to build a preliminary item bank: an example using bowel function in prostate cancer}, journal = {Evaluation and the Health Professions}, volume = {28}, number = {2}, year = {2005}, note = {0163-2787 (Print)Journal Article}, pages = {142-59}, abstract = {Assessing bowel function (BF) in prostate cancer can help determine therapeutic trade-offs. We determined the components of BF commonly assessed in prostate cancer studies as an initial step in creating an item bank for clinical and research application. We analyzed six archived data sets representing 4,246 men with prostate cancer. Thirty-one items from validated instruments were available for analysis. Items were classified into domains (diarrhea, rectal urgency, pain, bleeding, bother/distress, and other) then subjected to conventional psychometric and item response theory (IRT) analyses. Items fit the IRT model if the ratio between observed and expected item variance was between 0.60 and 1.40. Four of 31 items had inadequate fit in at least one analysis. Poorly fitting items included bleeding (2), rectal urgency (1), and bother/distress (1). A fifth item assessing hemorrhoids was poorly correlated with other items. Our analyses supported four related components of BF: diarrhea, rectal urgency, pain, and bother/distress.}, keywords = {*Quality of Life, *Questionnaires, Adult, Aged, Data Collection/methods, Humans, Intestine, Large/*physiopathology, Male, Middle Aged, Prostatic Neoplasms/*physiopathology, Psychometrics, Research Support, Non-U.S. Gov{\textquoteright}t, Statistics, Nonparametric}, author = {Eton, D. T. and Lai, J. S. and Cella, D. and Reeve, B. B. and Talcott, J. A. and Clark, J. A. and McPherson, C. P. and Litwin, M. S. and Moinpour, C. M.} } @article {357, title = {Measuring physical function in patients with complex medical and postsurgical conditions: a computer adaptive approach}, journal = {American Journal of Physical Medicine and Rehabilitation}, volume = {84}, number = {10}, year = {2005}, note = {0894-9115 (Print)Comparative StudyJournal ArticleResearch Support, N.I.H., ExtramuralResearch Support, U.S. Gov{\textquoteright}t, P.H.S.}, month = {Oct}, pages = {741-8}, abstract = {OBJECTIVE: 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.}, keywords = {Activities of Daily Living/*classification, Adult, Aged, Cohort Studies, Continuity of Patient Care, Disability Evaluation, Female, Health Services Research, Humans, Male, Middle Aged, Postoperative Care/*rehabilitation, Prognosis, Recovery of Function, Rehabilitation Centers, Rehabilitation/*standards, Sensitivity and Specificity, Sickness Impact Profile, Treatment Outcome}, author = {Siebens, H. and Andres, P. L. and Pengsheng, N. and Coster, W. J. and Haley, S. M.} } @article {185, title = {Simulated computerized adaptive tests for measuring functional status were efficient with good discriminant validity in patients with hip, knee, or foot/ankle impairments}, journal = {Journal of Clinical Epidemiology}, volume = {58}, number = {6}, year = {2005}, note = {0895-4356 (Print)Journal ArticleMulticenter StudyValidation Studies}, pages = {629-38}, abstract = {BACKGROUND 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.}, keywords = {*Health Status Indicators, Activities of Daily Living, Adolescent, Adult, Aged, Aged, 80 and over, Ankle Joint/physiopathology, Diagnosis, Computer-Assisted/*methods, Female, Hip Joint/physiopathology, Humans, Joint Diseases/physiopathology/*rehabilitation, Knee Joint/physiopathology, Lower Extremity/*physiopathology, Male, Middle Aged, Research Support, N.I.H., Extramural, Research Support, U.S. Gov{\textquoteright}t, P.H.S., Retrospective Studies}, author = {Hart, D. L. and Mioduski, J. E. and Stratford, P. W.} } @article {168, title = {Activity outcome measurement for postacute care}, journal = {Medical Care}, volume = {42}, number = {1 Suppl}, year = {2004}, note = {0025-7079Journal ArticleMulticenter Study}, pages = {I49-161}, abstract = {BACKGROUND: 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{\textquoteright}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.}, keywords = {*Self Efficacy, *Sickness Impact Profile, Activities of Daily Living/*classification/psychology, Adult, Aftercare/*standards/statistics \& numerical data, Aged, Boston, Cognition/physiology, Disability Evaluation, Factor Analysis, Statistical, Female, Human, Male, Middle Aged, Movement/physiology, Outcome Assessment (Health Care)/*methods/statistics \& numerical data, Psychometrics, Questionnaires/standards, Rehabilitation/*standards/statistics \& numerical data, Reproducibility of Results, Sensitivity and Specificity, Support, U.S. Gov{\textquoteright}t, Non-P.H.S., Support, U.S. Gov{\textquoteright}t, P.H.S.}, author = {Haley, S. M. and Coster, W. J. and Andres, P. L. and Ludlow, L. H. and Ni, P. and Bond, T. L. and Sinclair, S. J. and Jette, A. M.} } @booklet {201, title = {The AMC Linear Disability Score project in a population requiring residential care: psychometric properties}, journal = {Health and Quality of Life Outcomes}, volume = {2}, year = {2004}, note = {Holman, RebeccaLindeboom, RobertVermeulen, Marinusde Haan, Rob JResearch Support, Non-U.S. Gov{\textquoteright}tValidation StudiesEnglandHealth and quality of life outcomesHealth Qual Life Outcomes. 2004 Aug 3;2:42.}, month = {Aug 3}, pages = {42}, edition = {2004/08/05}, abstract = {BACKGROUND: 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.}, keywords = {*Disability Evaluation, *Health Status Indicators, Activities of Daily Living/*classification, Adult, Aged, Aged, 80 and over, Data Collection/methods, Female, Humans, Logistic Models, Male, Middle Aged, Netherlands, Pilot Projects, Probability, Psychometrics/*instrumentation, Questionnaires/standards, Residential Facilities/*utilization, Severity of Illness Index}, isbn = {1477-7525 (Electronic)1477-7525 (Linking)}, author = {Holman, R. and Lindeboom, R. and Vermeulen, M. and de Haan, R. J.} } @article {147, title = {Computerized adaptive measurement of depression: A simulation study}, journal = {BMC Psychiatry}, volume = {4}, number = {1}, year = {2004}, pages = {13-23}, abstract = {Background: 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.}, keywords = {*Computer Simulation, Adult, Algorithms, Area Under Curve, Comparative Study, Depressive Disorder/*diagnosis/epidemiology/psychology, Diagnosis, Computer-Assisted/*methods/statistics \& numerical data, Factor Analysis, Statistical, Female, Humans, Internet, Male, Mass Screening/methods, Patient Selection, Personality Inventory/*statistics \& numerical data, Pilot Projects, Prevalence, Psychiatric Status Rating Scales/*statistics \& numerical data, Psychometrics, Research Support, Non-U.S. Gov{\textquoteright}t, Research Support, U.S. Gov{\textquoteright}t, P.H.S., Severity of Illness Index, Software}, author = {Gardner, W. and Shear, K. and Kelleher, K. J. and Pajer, K. A. and Mammen, O. and Buysse, D. and Frank, E.} } @article {10, title = {Constructing rotating item pools for constrained adaptive testing}, journal = {Journal of Educational Measurement}, volume = {41}, number = {4}, year = {2004}, pages = {345-359}, publisher = {Blackwell Publishing: United Kingdom}, abstract = {Preventing items in adaptive testing from being over- or underexposed is one of the main problems in computerized adaptive testing. Though the problem of overexposed items can be solved using a probabilistic item-exposure control method, such methods are unable to deal with the problem of underexposed items. Using a system of rotating item pools, on the other hand, is a method that potentially solves both problems. In this method, a master pool is divided into (possibly overlapping) smaller item pools, which are required to have similar distributions of content and statistical attributes. These pools are rotated among the testing sites to realize desirable exposure rates for the items. A test assembly model, motivated by Gulliksen{\textquoteright}s matched random subtests method, was explored to help solve the problem of dividing a master pool into a set of smaller pools. Different methods to solve the model are proposed. An item pool from the Law School Admission Test was used to evaluate the performances of computerized adaptive tests from systems of rotating item pools constructed using these methods. (PsycINFO Database Record (c) 2007 APA, all rights reserved)}, keywords = {computerized adaptive tests, constrained adaptive testing, item exposure, rotating item pools}, isbn = {0022-0655 (Print)}, author = {Ariel, A. and Veldkamp, B. P. and van der Linden, W. J.} } @article {381, title = {Pre-equating: a simulation study based on a large scale assessment model}, journal = {Journal of Applied Measurement}, volume = {5}, number = {3}, year = {2004}, note = {1529-7713Journal Article}, pages = {301-18}, abstract = {Although post-equating (PE) has proven to be an acceptable method in the scaling and equating of items and forms, there are times when the turn-around period for equating and converting raw scores to scale scores is so small that PE cannot be undertaken within the prescribed time frame. In such cases, pre-equating (PrE) could be considered as an acceptable alternative. Assessing the feasibility of using item calibrations from the item bank (as in PrE) is conditioned on the equivalency of the calibrations and the errors associated with it vis a vis the results obtained via PE. This paper creates item banks over three periods of item introduction into the banks and uses the Rasch model in examining data with respect to the recovery of item parameters, the measurement error, and the effect cut-points have on examinee placement in both the PrE and PE situations. Results indicate that PrE is a viable solution to PE provided the stability of the item calibrations are enhanced by using large sample sizes (perhaps as large as full-population) in populating the item bank.}, keywords = {*Databases, *Models, Theoretical, Calibration, Human, Psychometrics, Reference Values, Reproducibility of Results}, author = {Taherbhai, H. M. and Young, M. J.} } @article {87, title = {Refining the conceptual basis for rehabilitation outcome measurement: personal care and instrumental activities domain}, journal = {Medical Care}, volume = {42}, number = {1 Suppl}, year = {2004}, note = {0025-7079Journal Article}, month = {Jan}, pages = {I62-172}, abstract = {BACKGROUND: 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.}, keywords = {*Self Efficacy, *Sickness Impact Profile, Activities of Daily Living/*classification/psychology, Adult, Aged, Aged, 80 and over, Disability Evaluation, Factor Analysis, Statistical, Female, Humans, Male, Middle Aged, Outcome Assessment (Health Care)/*methods/statistics \& numerical data, Questionnaires/*standards, Recovery of Function/physiology, Rehabilitation/*standards/statistics \& numerical data, Reproducibility of Results, Research Support, U.S. Gov{\textquoteright}t, Non-P.H.S., Research Support, U.S. Gov{\textquoteright}t, P.H.S., Sensitivity and Specificity}, author = {Coster, W. J. and Haley, S. M. and Andres, P. L. and Ludlow, L. H. and Bond, T. L. and Ni, P. S.} } @article {167, title = {Score comparability of short forms and computerized adaptive testing: Simulation study with the activity measure for post-acute care}, journal = {Archives of Physical Medicine and Rehabilitation}, volume = {85}, number = {4}, year = {2004}, note = {Haley, Stephen MCoster, Wendy JAndres, Patricia LKosinski, MarkNi, PengshengR01 hd43568/hd/nichdComparative StudyMulticenter StudyResearch Support, U.S. Gov{\textquoteright}t, Non-P.H.S.Research Support, U.S. Gov{\textquoteright}t, P.H.S.United StatesArchives of physical medicine and rehabilitationArch Phys Med Rehabil. 2004 Apr;85(4):661-6.}, month = {Apr}, pages = {661-6}, edition = {2004/04/15}, abstract = {OBJECTIVE: 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{\textquoteright}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.}, keywords = {Boston, Factor Analysis, Statistical, Humans, Outcome Assessment (Health Care)/*methods, Prospective Studies, Questionnaires/standards, Rehabilitation/*standards, Subacute Care/*standards}, isbn = {0003-9993 (Print)}, author = {Haley, S. M. and Coster, W. J. and Andres, P. L. and Kosinski, M. and Ni, P.} } @article {275, title = {A Bayesian method for the detection of item preknowledge in computerized adaptive testing}, journal = {Applied Psychological Measurement}, volume = {27}, number = {2}, year = {2003}, pages = {121-137}, abstract = {With the increased use of continuous testing in computerized adaptive testing, new concerns about test security have evolved, such as how to ensure that items in an item pool are safeguarded from theft. In this article, procedures to detect test takers using item preknowledge are explored. When test takers use item preknowledge, their item responses deviate from the underlying item response theory (IRT) model, and estimated abilities may be inflated. This deviation may be detected through the use of person-fit indices. A Bayesian posterior log odds ratio index is proposed for detecting the use of item preknowledge. In this approach to person fit, the estimated probability that each test taker has preknowledge of items is updated after each item response. These probabilities are based on the IRT parameters, a model specifying the probability that each item has been memorized, and the test taker{\textquoteright}s item responses. Simulations based on an operational computerized adaptive test (CAT) pool are used to demonstrate the use of the odds ratio index. (PsycINFO Database Record (c) 2005 APA )}, keywords = {Adaptive Testing, Cheating, Computer Assisted Testing, Individual Differences computerized adaptive testing, Item, Item Analysis (Statistical), Mathematical Modeling, Response Theory}, author = {McLeod, L. and Lewis, C. and Thissen, D.} } @article {349, title = {Computerized adaptive rating scales for measuring managerial performance}, journal = {International Journal of Selection and Assessment}, volume = {11}, number = {2-3}, year = {2003}, pages = {237-246}, abstract = {Computerized adaptive rating scales (CARS) had been developed to measure contextual or citizenship performance. This rating format used a paired-comparison protocol, presenting pairs of behavioral statements scaled according to effectiveness levels, and an iterative item response theory algorithm to obtain estimates of ratees{\textquoteright} citizenship performance (W. C. Borman et al, 2001). In the present research, we developed CARS to measure the entire managerial performance domain, including task and citizenship performance, thus addressing a major limitation of the earlier CARS. The paper describes this development effort, including an adjustment to the algorithm that reduces substantially the number of item pairs required to obtain almost as much precision in the performance estimates. (PsycINFO Database Record (c) 2005 APA )}, keywords = {Adaptive Testing, Algorithms, Associations, Citizenship, Computer Assisted Testing, Construction, Contextual, Item Response Theory, Job Performance, Management, Management Personnel, Rating Scales, Test}, author = {Schneider, R. J. and Goff, M. and Anderson, S. and Borman, W. C.} } @article {34, title = {Developing an initial physical function item bank from existing sources}, journal = {Journal of Applied Measurement}, volume = {4}, number = {2}, year = {2003}, note = {1529-7713Journal Article}, pages = {124-36}, abstract = {The objective of this article is to illustrate incremental item banking using health-related quality of life data collected from two samples of patients receiving cancer treatment. The kinds of decisions one faces in establishing an item bank for computerized adaptive testing are also illustrated. Pre-calibration procedures include: identifying common items across databases; creating a new database with data from each pool; reverse-scoring "negative" items; identifying rating scales used in items; identifying pivot points in each rating scale; pivot anchoring items at comparable rating scale categories; and identifying items in each instrument that measure the construct of interest. A series of calibrations were conducted in which a small proportion of new items were added to the common core and misfitting items were identified and deleted until an initial item bank has been developed.}, keywords = {*Databases, *Sickness Impact Profile, Adaptation, Psychological, Data Collection, Humans, Neoplasms/*physiopathology/psychology/therapy, Psychometrics, Quality of Life/*psychology, Research Support, U.S. Gov{\textquoteright}t, P.H.S., United States}, author = {Bode, R. K. and Cella, D. and Lai, J. S. and Heinemann, A. W.} } @article {96, title = {An examination of exposure control and content balancing restrictions on item selection in CATs using the partial credit model}, journal = {Journal of Applied Measurement}, volume = {4}, number = {1}, year = {2003}, note = {1529-7713Journal Article}, pages = {24-42}, abstract = {The purpose of the present investigation was to systematically examine the effectiveness of the Sympson-Hetter technique and rotated content balancing relative to no exposure control and no content rotation conditions in a computerized adaptive testing system (CAT) based on the partial credit model. A series of simulated fixed and variable length CATs were run using two data sets generated to multiple content areas for three sizes of item pools. The 2 (exposure control) X 2 (content rotation) X 2 (test length) X 3 (item pool size) X 2 (data sets) yielded a total of 48 conditions. Results show that while both procedures can be used with no deleterious effect on measurement precision, the gains in exposure control, pool utilization, and item overlap appear quite modest. Difficulties involved with setting the exposure control parameters in small item pools make questionable the utility of the Sympson-Hetter technique with similar item pools.}, keywords = {*Computers, *Educational Measurement, *Models, Theoretical, Automation, Decision Making, Humans, Reproducibility of Results}, author = {Davis, L. L. and Pastor, D. A. and Dodd, B. G. and Chiang, C. and Fitzpatrick, S. J.} } @article {238, title = {Item banking to improve, shorten and computerized self-reported fatigue: an illustration of steps to create a core item bank from the FACIT-Fatigue Scale}, journal = {Quality of Life Research}, volume = {12}, number = {5}, year = {2003}, note = {0962-9343Journal Article}, month = {Aug}, pages = {485-501}, abstract = {Fatigue 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{\textquoteright}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.}, keywords = {*Health Status Indicators, *Questionnaires, Adult, Fatigue/*diagnosis/etiology, Female, Humans, Male, Middle Aged, Neoplasms/complications, Psychometrics, Research Support, Non-U.S. Gov{\textquoteright}t, Research Support, U.S. Gov{\textquoteright}t, P.H.S., Sickness Impact Profile}, author = {Lai, J-S. and Crane, P. K. and Cella, D. and Chang, C-H. and Bode, R. K. and Heinemann, A. W.} } @article {94, title = {Item exposure constraints for testlets in the verbal reasoning section of the MCAT}, journal = {Applied Psychological Measurement}, volume = {27}, number = {5}, year = {2003}, pages = {335-356}, abstract = {The current study examined item exposure control procedures for testlet scored reading passages in the Verbal Reasoning section of the Medical College Admission Test with four computerized adaptive testing (CAT) systems using the partial credit model. The first system used a traditional CAT using maximum information item selection. The second used random item selection to provide a baseline for optimal exposure rates. The third used a variation of Lunz and Stahl{\textquoteright}s randomization procedure. The fourth used Luecht and Nungester{\textquoteright}s computerized adaptive sequential testing (CAST) system. A series of simulated fixed-length CATs was run to determine the optimal item length selection procedure. Results indicated that both the randomization procedure and CAST performed well in terms of exposure control and measurement precision, with the CAST system providing the best overall solution when all variables were taken into consideration. (PsycINFO Database Record (c) 2005 APA ) (journal abstract)}, keywords = {Adaptive Testing, Computer Assisted Testing, Entrance Examinations, Item Response Theory, Random Sampling, Reasoning, Verbal Ability computerized adaptive testing}, author = {Davis, L. L. and Dodd, B. G.} } @article {274, title = {Ten recommendations for advancing patient-centered outcomes measurement for older persons}, journal = {Annals of Internal Medicine}, volume = {139}, number = {5 Pt 2}, year = {2003}, note = {1539-3704Journal ArticleReview}, month = {Sep 2}, pages = {403-409}, abstract = {The past 50 years have seen great progress in the measurement of patient-based outcomes for older populations. Most of the measures now used were created under the umbrella of a set of assumptions and procedures known as classical test theory. A recent alternative for health status assessment is item response theory. Item response theory is superior to classical test theory because it can eliminate test dependency and achieve more precise measurement through computerized adaptive testing. Computerized adaptive testing reduces test administration times and allows varied and precise estimates of ability. Several key challenges must be met before computerized adaptive testing becomes a productive reality. I discuss these challenges for the health assessment of older persons in the form of 10 "Ds": things we need to deliberate, debate, decide, and do.}, keywords = {*Health Status Indicators, Aged, Geriatric Assessment/*methods, Humans, Patient-Centered Care/*methods, Research Support, U.S. Gov{\textquoteright}t, Non-P.H.S.}, author = {McHorney, C. A.} } @article {321, title = {Timing behavior in computerized adaptive testing: Response times for correct and incorrect answers are not related to general fluid intelligence/Zum Zeitverhalten beim computergest{\"u}tzten adaptiveb Testen: Antwortlatenzen bei richtigen und falschen L{\"o}sun}, journal = {Zeitschrift f{\"u}r Differentielle und Diagnostische Psychologie}, volume = {24}, number = {1}, year = {2003}, pages = {57-63}, abstract = {Examined the effects of general fluid intelligence on item response times for correct and false responses in computerized adaptive testing. After performing the CFT3 intelligence test, 80 individuals (aged 17-44 yrs) completed perceptual and cognitive discrimination tasks. Results show that response times were related neither to the proficiency dimension reflected by the task nor to the individual level of fluid intelligence. Furthermore, the false > correct-phenomenon as well as substantial positive correlations between item response times for false and correct responses were shown to be independent of intelligence levels. (PsycINFO Database Record (c) 2005 APA )}, keywords = {Adaptive Testing, Cognitive Ability, Intelligence, Perception, Reaction Time computerized adaptive testing}, author = {Rammsayer, Thomas and Brandler, Susanne} } @article {407, title = {Using response times to detect aberrant responses in computerized adaptive testing}, journal = {Psychometrika}, volume = {68}, number = {2}, year = {2003}, pages = {251-265}, abstract = {A lognormal model for response times is used to check response times for aberrances in examinee behavior on computerized adaptive tests. Both classical procedures and Bayesian posterior predictive checks are presented. For a fixed examinee, responses and response times are independent; checks based on response times offer thus information independent of the results of checks on response patterns. Empirical examples of the use of classical and Bayesian checks for detecting two different types of aberrances in response times are presented. The detection rates for the Bayesian checks outperformed those for the classical checks, but at the cost of higher false-alarm rates. A guideline for the choice between the two types of checks is offered.}, keywords = {Adaptive Testing, Behavior, Computer Assisted Testing, computerized adaptive testing, Models, person Fit, Prediction, Reaction Time}, author = {van der Linden, W. J. and van Krimpen-Stoop, E. M. L. A.} } @article {187, title = {Development of an index of physical functional health status in rehabilitation}, journal = {Archives of Physical Medicine and Rehabilitation}, volume = {83}, number = {5}, year = {2002}, note = {0003-9993 (Print)Journal Article}, month = {May}, pages = {655-65}, abstract = {OBJECTIVE: 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{\textquoteright}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.}, keywords = {*Health Status Indicators, *Rehabilitation Centers, Adolescent, Adult, Aged, Aged, 80 and over, Female, Health Surveys, Humans, Male, Middle Aged, Musculoskeletal Diseases/*physiopathology/*rehabilitation, Nervous System Diseases/*physiopathology/*rehabilitation, Physical Fitness/*physiology, Recovery of Function/physiology, Reproducibility of Results, Retrospective Studies}, author = {Hart, D. L. and Wright, B. D.} } @inbook {119, title = {Generating abstract reasoning items with cognitive theory}, booktitle = {Item generation for test development}, year = {2002}, note = {Using Smart Source ParsingItem generation for test development. (pp. 219-250). Mahwah, NJ : Lawrence Erlbaum Associates, Publishers. xxxii, 412 pp}, pages = {219-250}, publisher = {Lawrence Erlbaum Associates, Inc.}, organization = {Lawrence Erlbaum Associates, Inc.}, address = {Mahwah, N.J. USA}, abstract = {(From the chapter) Developed and evaluated a generative system for abstract reasoning items based on cognitive theory. The cognitive design system approach was applied to generate matrix completion problems. Study 1 involved developing the cognitive theory with 191 college students who were administered Set I and Set II of the Advanced Progressive Matrices. Study 2 examined item generation by cognitive theory. Study 3 explored the psychometric properties and construct representation of abstract reasoning test items with 728 young adults. Five structurally equivalent forms of Abstract Reasoning Test (ART) items were prepared from the generated item bank and administered to the Ss. In Study 4, the nomothetic span of construct validity of the generated items was examined with 728 young adults who were administered ART items, and 217 young adults who were administered ART items and the Advanced Progressive Matrices. Results indicate the matrix completion items were effectively generated by the cognitive design system approach. (PsycINFO Database Record (c) 2005 APA )}, keywords = {Cognitive Processes, Measurement, Reasoning, Test Construction, Test Items, Test Validity, Theories}, author = {Embretson, S. E.}, editor = {P. Kyllomen} } @article {50, title = {Measuring quality of life in chronic illness: the functional assessment of chronic illness therapy measurement system}, journal = {Archives of Physical Medicine and Rehabilitation}, volume = {83}, number = {12 Suppl 2}, year = {2002}, note = {0003-9993Journal Article}, month = {Dec}, pages = {S10-7}, abstract = {We focus on quality of life (QOL) measurement as applied to chronic illness. There are 2 major types of health-related quality of life (HRQOL) instruments-generic health status and targeted. Generic instruments offer the opportunity to compare results across patient and population cohorts, and some can provide normative or benchmark data from which to interpret results. Targeted instruments ask questions that focus more on the specific condition or treatment under study and, as a result, tend to be more responsive to clinically important changes than generic instruments. Each type of instrument has a place in the assessment of HRQOL in chronic illness, and consideration of the relative advantages and disadvantages of the 2 options best drives choice of instrument. The Functional Assessment of Chronic Illness Therapy (FACIT) system of HRQOL measurement is a hybrid of the 2 approaches. The FACIT system combines a core general measure with supplemental measures targeted toward specific diseases, conditions, or treatments. Thus, it capitalizes on the strengths of each type of measure. Recently, FACIT questionnaires were administered to a representative sample of the general population with results used to derive FACIT norms. These normative data can be used for benchmarking and to better understand changes in HRQOL that are often seen in clinical trials. Future directions in HRQOL assessment include test equating, item banking, and computerized adaptive testing.}, keywords = {*Chronic Disease, *Quality of Life, *Rehabilitation, Adult, Comparative Study, Health Status Indicators, Humans, Psychometrics, Questionnaires, Research Support, U.S. Gov{\textquoteright}t, P.H.S., Sensitivity and Specificity}, author = {Cella, D. and Nowinski, C. J.} } @article {36, title = {An examination of the comparative reliability, validity, and accuracy of performance ratings made using computerized adaptive rating scales}, journal = {Journal of Applied Psychology}, volume = {86}, number = {5}, year = {2001}, note = {214803450021-9010Journal ArticleValidation Studies}, pages = {965-973}, abstract = {This 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{\textquoteright}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{\textquoteright}s accuracy coefficients showed significantly higher accuracy, with a median effect size of .08. The discussion focuses on possible reasons for the results.}, keywords = {*Computer Simulation, *Employee Performance Appraisal, *Personnel Selection, Adult, Automatic Data Processing, Female, Human, Male, Reproducibility of Results, Sensitivity and Specificity, Support, U.S. Gov{\textquoteright}t, Non-P.H.S., Task Performance and Analysis, Video Recording}, author = {Borman, W. C. and Buck, D. E. and Hanson, M. A. and Motowidlo, S. J. and Stark, S. and F Drasgow} } @article {368, title = {CAT administration of language placement examinations}, journal = {Journal of Applied Measurement}, volume = {1}, number = {3}, year = {2000}, note = {1529-7713Journal Article}, pages = {292-302}, abstract = {This article describes the development of a computerized adaptive test for Cegep de Jonquiere, a community college located in Quebec, Canada. Computerized language proficiency testing allows the simultaneous presentation of sound stimuli as the question is being presented to the test-taker. With a properly calibrated bank of items, the language proficiency test can be offered in an adaptive framework. By adapting the test to the test-taker{\textquoteright}s level of ability, an assessment can be made with significantly fewer items. We also describe our initial attempt to detect instances in which "cheating low" is occurring. In the "cheating low" situation, test-takers deliberately answer questions incorrectly, questions that they are fully capable of answering correctly had they been taking the test honestly.}, keywords = {*Language, *Software, Aptitude Tests/*statistics \& numerical data, Educational Measurement/*statistics \& numerical data, Humans, Psychometrics, Reproducibility of Results, Research Support, Non-U.S. Gov{\textquoteright}t}, author = {Stahl, J. and Bergstrom, B. and Gershon, R. C.} } @article {329, title = {Computerization and adaptive administration of the NEO PI-R}, journal = {Assessment}, volume = {7}, number = {4}, year = {2000}, note = {1073-1911 (Print)Journal Article}, pages = {347-64}, abstract = {This study asks, how well does an item response theory (IRT) based computerized adaptive NEO PI-R work? To explore this question, real-data simulations (N = 1,059) were used to evaluate a maximum information item selection computerized adaptive test (CAT) algorithm. Findings indicated satisfactory recovery of full-scale facet scores with the administration of around four items per facet scale. Thus, the NEO PI-R could be reduced in half with little loss in precision by CAT administration. However, results also indicated that the CAT algorithm was not necessary. We found that for many scales, administering the "best" four items per facet scale would have produced similar results. In the conclusion, we discuss the future of computerized personality assessment and describe the role IRT methods might play in such assessments.}, keywords = {*Personality Inventory, Algorithms, California, Diagnosis, Computer-Assisted/*methods, Humans, Models, Psychological, Psychometrics/methods, Reproducibility of Results}, author = {Reise, S. P. and Henson, J. M.} } @article {41, title = {An examination of the reliability and validity of performance ratings made using computerized adaptive rating scales}, journal = {Dissertation Abstracts International: Section B: The Sciences and Engineering}, volume = {61}, number = {1-B}, year = {2000}, pages = {570}, abstract = {This study compared the psychometric properties of performance ratings made using recently-developed computerized adaptive rating scales (CARS) to the psyc hometric properties of ratings made using more traditional paper-and-pencil rati ng formats, i.e., behaviorally-anchored and graphic rating scales. Specifically, the reliability, validity and accuracy of the performance ratings from each for mat were examined. One hundred twelve participants viewed six 5-minute videotape s of office situations and rated the performance of a target person in each vide otape on three contextual performance dimensions-Personal Support, Organizationa l Support, and Conscientious Initiative-using CARS and either behaviorally-ancho red or graphic rating scales. Performance rating properties were measured using Shrout and Fleiss{\textquoteright}s intraclass correlation (2, 1), Borman{\textquoteright}s differential accurac y measure, and Cronbach{\textquoteright}s accuracy components as indexes of rating reliability, validity, and accuracy, respectively. Results found that performance ratings mad e using the CARS were significantly more reliable and valid than performance rat ings made using either of the other formats. Additionally, CARS yielded more acc urate performance ratings than the paper-and-pencil formats. The nature of the C ARS system (i.e., its adaptive nature and scaling methodology) and its paired co mparison judgment task are offered as possible reasons for the differences found in the psychometric properties of the performance ratings made using the variou s rating formats. (PsycINFO Database Record (c) 2005 APA )}, keywords = {Adaptive Testing, Computer Assisted Testing, Performance Tests, Rating Scales, Reliability, Test, Test Validity}, author = {Buck, D. E.} } @article {364, title = {An exploratory analysis of item parameters and characteristics that influence item level response time}, journal = {Dissertation Abstracts International Section A: Humanities and Social Sciences}, volume = {61}, number = {5-A}, year = {2000}, pages = {1812}, abstract = {This research examines the relationship between item level response time and (1) item discrimination, (2) item difficulty, (3) word count, (4) item type, and (5) whether a figure is included in an item. Data are from the Graduate Management Admission Test, which is currently offered only as a computerized adaptive test. Analyses revealed significant differences in response time between the five item types: problem solving, data sufficiency, sentence correction, critical reasoning, and reading comprehension. For this reason, the planned pairwise and complex analyses were run within each item type. Pairwise curvilinear regression analyses explored the relationship between response time and item discrimination, item difficulty, and word count. Item difficulty significantly contributed to the prediction of response time for each item type; two of the relationships were significantly quadratic. Item discrimination significantly contributed to the prediction of response time for only two of the item types; one revealed a quadratic relationship and the other a cubic relationship. Word count had significant linear relationship with response time for all the item types except reading comprehension, for which there was no significant relationship. Multiple regression analyses using word count, item difficulty, and item discrimination predicted between 35.4\% and 71.4\% of the variability in item response time across item types. The results suggest that response time research should consider the type of item that is being administered and continue to explore curvilinear relationships between response time and its predictor variables. (PsycINFO Database Record (c) 2005 APA )}, keywords = {Item Analysis (Statistical), Item Response Theory, Problem Solving, Reaction Time, Reading Comprehension, Reasoning}, author = {Smith, Russell Winsor} } @article {191, title = {Item response theory and health outcomes measurement in the 21st century}, journal = {Medical Care}, volume = {38}, number = {9 Suppl II}, year = {2000}, note = {204349670025-7079Journal Article}, pages = {II28-II42}, abstract = {Item response theory (IRT) has a number of potential advantages over classical test theory in assessing self-reported health outcomes. IRT models yield invariant item and latent trait estimates (within a linear transformation), standard errors conditional on trait level, and trait estimates anchored to item content. IRT also facilitates evaluation of differential item functioning, inclusion of items with different response formats in the same scale, and assessment of person fit and is ideally suited for implementing computer adaptive testing. Finally, IRT methods can be helpful in developing better health outcome measures and in assessing change over time. These issues are reviewed, along with a discussion of some of the methodological and practical challenges in applying IRT methods.}, keywords = {*Models, Statistical, Activities of Daily Living, Data Interpretation, Statistical, Health Services Research/*methods, Health Surveys, Human, Mathematical Computing, Outcome Assessment (Health Care)/*methods, Research Design, Support, Non-U.S. Gov{\textquoteright}t, Support, U.S. Gov{\textquoteright}t, P.H.S., United States}, author = {Hays, R. D. and Morales, L. S. and Reise, S. P.} } @article {234, title = {Evaluating the usefulness of computerized adaptive testing for medical in-course assessment}, journal = {Academic Medicine}, volume = {74}, number = {10}, year = {1999}, note = {Kreiter, C DFerguson, KGruppen, L DUnited statesAcademic medicine : journal of the Association of American Medical CollegesAcad Med. 1999 Oct;74(10):1125-8.}, month = {Oct}, pages = {1125-8}, edition = {1999/10/28}, abstract = {PURPOSE: This study investigated the feasibility of converting an existing computer-administered, in-course internal medicine test to an adaptive format. METHOD: A 200-item internal medicine extended matching test was used for this research. Parameters were estimated with commercially available software with responses from 621 examinees. A specially developed simulation program was used to retrospectively estimate the efficiency of the computer-adaptive exam format. RESULTS: It was found that the average test length could be shortened by almost half with measurement precision approximately equal to that of the full 200-item paper-and-pencil test. However, computer-adaptive testing with this item bank provided little advantage for examinees at the upper end of the ability continuum. An examination of classical item statistics and IRT item statistics suggested that adding more difficult items might extend the advantage to this group of examinees. CONCLUSIONS: Medical item banks presently used for incourse assessment might be advantageously employed in adaptive testing. However, it is important to evaluate the match between the items and the measurement objective of the test before implementing this format.}, keywords = {*Automation, *Education, Medical, Undergraduate, Educational Measurement/*methods, Humans, Internal Medicine/*education, Likelihood Functions, Psychometrics/*methods, Reproducibility of Results}, isbn = {1040-2446 (Print)}, author = {Kreiter, C. D. and Ferguson, K. and Gruppen, L. D.} } @article {33, title = {A computerized adaptive testing system for speech discrimination measurement: The Speech Sound Pattern Discrimination Test}, journal = {Journal of the Accoustical Society of America}, volume = {101}, number = {4}, year = {1997}, note = {972575560001-4966Journal Article}, pages = {2289-298}, abstract = {A computerized, adaptive test-delivery system for the measurement of speech discrimination, the Speech Sound Pattern Discrimination Test, is described and evaluated. Using a modified discrimination task, the testing system draws on a pool of 130 items spanning a broad range of difficulty to estimate an examinee{\textquoteright}s location along an underlying continuum of speech processing ability, yet does not require the examinee to possess a high level of English language proficiency. The system is driven by a mathematical measurement model which selects only test items which are appropriate in difficulty level for a given examinee, thereby individualizing the testing experience. Test items were administered to a sample of young deaf adults, and the adaptive testing system evaluated in terms of respondents{\textquoteright} sensory and perceptual capabilities, acoustic and phonetic dimensions of speech, and theories of speech perception. Data obtained in this study support the validity, reliability, and efficiency of this test as a measure of speech processing ability.}, keywords = {*Diagnosis, Computer-Assisted, *Speech Discrimination Tests, *Speech Perception, Adolescent, Adult, Audiometry, Pure-Tone, Human, Middle Age, Psychometrics, Reproducibility of Results}, author = {Bochner, J. and Garrison, W. and Palmer, L. and MacKenzie, D. and Braveman, A.} }