%0 Journal Article %J Disability & Rehabilitation %D 2008 %T Efficiency and sensitivity of multidimensional computerized adaptive testing of pediatric physical functioning %A Allen, D. D. %A Ni, P. %A Haley, S. M. %K *Disability Evaluation %K Child %K Computers %K Disabled Children/*classification/rehabilitation %K Efficiency %K Humans %K Outcome Assessment (Health Care) %K Psychometrics %K Reproducibility of Results %K Retrospective Studies %K Self Care %K Sensitivity and Specificity %X 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. %B Disability & Rehabilitation %7 2008/02/26 %V 30 %P 479-84 %@ 0963-8288 (Print)0963-8288 (Linking) %G eng %M 18297502 %0 Journal Article %J Archives of Physical Medicine and Rehabilitation %D 2006 %T Measurement precision and efficiency of multidimensional computer adaptive testing of physical functioning using the pediatric evaluation of disability inventory %A Haley, S. M. %A Ni, P. %A Ludlow, L. H. %A Fragala-Pinkham, M. A. %K *Disability Evaluation %K *Pediatrics %K Adolescent %K Child %K Child, Preschool %K Computers %K Disabled Persons/*classification/rehabilitation %K Efficiency %K Humans %K Infant %K Outcome Assessment (Health Care) %K Psychometrics %K Self Care %X OBJECTIVE: To compare the measurement efficiency and precision of a multidimensional computer adaptive testing (M-CAT) application to a unidimensional CAT (U-CAT) comparison using item bank data from 2 of the functional skills scales of the Pediatric Evaluation of Disability Inventory (PEDI). DESIGN: Using existing PEDI mobility and self-care item banks, we compared the stability of item calibrations and model fit between unidimensional and multidimensional Rasch models and compared the efficiency and precision of the U-CAT- and M-CAT-simulated assessments to a random draw of items. SETTING: Pediatric rehabilitation hospital and clinics. PARTICIPANTS: Clinical and normative samples. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Not applicable. RESULTS: The M-CAT had greater levels of precision and efficiency than the separate mobility and self-care U-CAT versions when using a similar number of items for each PEDI subdomain. Equivalent estimation of mobility and self-care scores can be achieved with a 25% to 40% item reduction with the M-CAT compared with the U-CAT. CONCLUSIONS: M-CAT applications appear to have both precision and efficiency advantages compared with separate U-CAT assessments when content subdomains have a high correlation. Practitioners may also realize interpretive advantages of reporting test score information for each subdomain when separate clinical inferences are desired. %B Archives of Physical Medicine and Rehabilitation %7 2006/08/29 %V 87 %P 1223-9 %8 Sep %@ 0003-9993 (Print) %G eng %M 16935059