TY - JOUR T1 - Efficiency and sensitivity of multidimensional computerized adaptive testing of pediatric physical functioning JF - Disability & Rehabilitation Y1 - 2008 A1 - Allen, D. D. A1 - Ni, P. A1 - Haley, S. M. KW - *Disability Evaluation KW - Child KW - Computers KW - Disabled Children/*classification/rehabilitation KW - Efficiency KW - Humans KW - Outcome Assessment (Health Care) KW - Psychometrics KW - Reproducibility of Results KW - Retrospective Studies KW - Self Care KW - Sensitivity and Specificity AB - 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. VL - 30 SN - 0963-8288 (Print)0963-8288 (Linking) N1 - 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. ER -