TY - JOUR T1 - Computer adaptive testing improved accuracy and precision of scores over random item selection in a physical functioning item bank JF - Journal of Clinical Epidemiology Y1 - 2006 A1 - Haley, S. M. A1 - Ni, P. A1 - Hambleton, R. K. A1 - Slavin, M. D. A1 - Jette, A. M. KW - *Recovery of Function KW - Activities of Daily Living KW - Adolescent KW - Adult KW - Aged KW - Aged, 80 and over KW - Confidence Intervals KW - Factor Analysis, Statistical KW - Female KW - Humans KW - Male KW - Middle Aged KW - Outcome Assessment (Health Care)/*methods KW - Rehabilitation/*standards KW - Reproducibility of Results KW - Software AB - 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. VL - 59 SN - 0895-4356 (Print) N1 - 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't, Non-P.H.S.EnglandJournal of clinical epidemiologyJ Clin Epidemiol. 2006 Nov;59(11):1174-82. Epub 2006 Jul 11. ER -