02560nas a2200313   4500008004100000020004100041245011500082210006900197250001500266300001100281490000700292520149300299653002701792653001001819653001401829653005301843653001501896653001101911653003701922653001801959653003101977653002602008653001402034653003202048100001502080700001002095700001502105856012602120       2008                        eng d  a0963-8288 (Print)0963-8288 (Linking)00aEfficiency and sensitivity of multidimensional computerized adaptive testing of pediatric physical functioning0 aEfficiency and sensitivity of multidimensional computerized adap  a2008/02/26  a479-840 v303 aPURPOSE: 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.10a*Disability Evaluation10aChild10aComputers10aDisabled Children/*classification/rehabilitation10aEfficiency10aHumans10aOutcome Assessment (Health Care)10aPsychometrics10aReproducibility of Results10aRetrospective Studies10aSelf Care10aSensitivity and Specificity1 aAllen, D D1 aNi, P1 aHaley, S M  uhttp://www.iacat.org/content/efficiency-and-sensitivity-multidimensional-computerized-adaptive-testing-pediatric-physical