%0 Journal Article %J Quality of Life Research %D 2009 %T Measuring global physical health in children with cerebral palsy: Illustration of a multidimensional bi-factor model and computerized adaptive testing %A Haley, S. M. %A Ni, P. %A Dumas, H. M. %A Fragala-Pinkham, M. A. %A Hambleton, R. K. %A Montpetit, K. %A Bilodeau, N. %A Gorton, G. E. %A Watson, K. %A Tucker, C. A. %K *Computer Simulation %K *Health Status %K *Models, Statistical %K Adaptation, Psychological %K Adolescent %K Cerebral Palsy/*physiopathology %K Child %K Child, Preschool %K Factor Analysis, Statistical %K Female %K Humans %K Male %K Massachusetts %K Pennsylvania %K Questionnaires %K Young Adult %X PURPOSE: The purposes of this study were to apply a bi-factor model for the determination of test dimensionality and a multidimensional CAT using computer simulations of real data for the assessment of a new global physical health measure for children with cerebral palsy (CP). METHODS: Parent respondents of 306 children with cerebral palsy were recruited from four pediatric rehabilitation hospitals and outpatient clinics. We compared confirmatory factor analysis results across four models: (1) one-factor unidimensional; (2) two-factor multidimensional (MIRT); (3) bi-factor MIRT with fixed slopes; and (4) bi-factor MIRT with varied slopes. We tested whether the general and content (fatigue and pain) person score estimates could discriminate across severity and types of CP, and whether score estimates from a simulated CAT were similar to estimates based on the total item bank, and whether they correlated as expected with external measures. RESULTS: Confirmatory factor analysis suggested separate pain and fatigue sub-factors; all 37 items were retained in the analyses. From the bi-factor MIRT model with fixed slopes, the full item bank scores discriminated across levels of severity and types of CP, and compared favorably to external instruments. CAT scores based on 10- and 15-item versions accurately captured the global physical health scores. CONCLUSIONS: The bi-factor MIRT CAT application, especially the 10- and 15-item versions, yielded accurate global physical health scores that discriminated across known severity groups and types of CP, and correlated as expected with concurrent measures. The CATs have potential for collecting complex data on the physical health of children with CP in an efficient manner. %B Quality of Life Research %7 2009/02/18 %V 18 %P 359-370 %8 Apr %@ 0962-9343 (Print)0962-9343 (Linking) %G eng %M 19221892 %2 2692519 %0 Journal Article %J Medical Care %D 2007 %T Psychometric evaluation and calibration of health-related quality of life item banks: plans for the Patient-Reported Outcomes Measurement Information System (PROMIS) %A Reeve, B. B. %A Hays, R. D. %A Bjorner, J. B. %A Cook, K. F. %A Crane, P. K. %A Teresi, J. A. %A Thissen, D. %A Revicki, D. A. %A Weiss, D. J. %A Hambleton, R. K. %A Liu, H. %A Gershon, R. C. %A Reise, S. P. %A Lai, J. S. %A Cella, D. %K *Health Status %K *Information Systems %K *Quality of Life %K *Self Disclosure %K Adolescent %K Adult %K Aged %K Calibration %K Databases as Topic %K Evaluation Studies as Topic %K Female %K Humans %K Male %K Middle Aged %K Outcome Assessment (Health Care)/*methods %K Psychometrics %K Questionnaires/standards %K United States %X BACKGROUND: The construction and evaluation of item banks to measure unidimensional constructs of health-related quality of life (HRQOL) is a fundamental objective of the Patient-Reported Outcomes Measurement Information System (PROMIS) project. OBJECTIVES: Item banks will be used as the foundation for developing short-form instruments and enabling computerized adaptive testing. The PROMIS Steering Committee selected 5 HRQOL domains for initial focus: physical functioning, fatigue, pain, emotional distress, and social role participation. This report provides an overview of the methods used in the PROMIS item analyses and proposed calibration of item banks. ANALYSES: Analyses include evaluation of data quality (eg, logic and range checking, spread of response distribution within an item), descriptive statistics (eg, frequencies, means), item response theory model assumptions (unidimensionality, local independence, monotonicity), model fit, differential item functioning, and item calibration for banking. RECOMMENDATIONS: Summarized are key analytic issues; recommendations are provided for future evaluations of item banks in HRQOL assessment. %B Medical Care %7 2007/04/20 %V 45 %P S22-31 %8 May %@ 0025-7079 (Print) %G eng %M 17443115 %0 Journal Article %J Journal of Clinical Epidemiology %D 2006 %T Computer adaptive testing improved accuracy and precision of scores over random item selection in a physical functioning item bank %A Haley, S. M. %A Ni, P. %A Hambleton, R. K. %A Slavin, M. D. %A Jette, A. M. %K *Recovery of Function %K Activities of Daily Living %K Adolescent %K Adult %K Aged %K Aged, 80 and over %K Confidence Intervals %K Factor Analysis, Statistical %K Female %K Humans %K Male %K Middle Aged %K Outcome Assessment (Health Care)/*methods %K Rehabilitation/*standards %K Reproducibility of Results %K Software %X 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. %B Journal of Clinical Epidemiology %7 2006/10/10 %V 59 %P 1174-82 %8 Nov %@ 0895-4356 (Print) %G eng %M 17027428 %0 Journal Article %J Applied Measurement in Education %D 2006 %T Optimal and nonoptimal computer-based test designs for making pass-fail decisions %A Hambleton, R. K. %A Xing, D. %K adaptive test %K credentialing exams %K Decision Making %K Educational Measurement %K multistage tests %K optimal computer-based test designs %K test form %X Now that many credentialing exams are being routinely administered by computer, new computer-based test designs, along with item response theory models, are being aggressively researched to identify specific designs that can increase the decision consistency and accuracy of pass-fail decisions. The purpose of this study was to investigate the impact of optimal and nonoptimal multistage test (MST) designs, linear parallel-form test designs (LPFT), and computer adaptive test (CAT) designs on the decision consistency and accuracy of pass-fail decisions. Realistic testing situations matching those of one of the large credentialing agencies were simulated to increase the generalizability of the findings. The conclusions were clear: (a) With the LPFTs, matching test information functions (TIFs) to the mean of the proficiency distribution produced slightly better results than matching them to the passing score; (b) all of the test designs worked better than test construction using random selection of items, subject to content constraints only; (c) CAT performed better than the other test designs; and (d) if matching a TIP to the passing score, the MST design produced a bit better results than the LPFT design. If an argument for the MST design is to be made, it can be made on the basis of slight improvements over the LPFT design and better expected item bank utilization, candidate preference, and the potential for improved diagnostic feedback, compared with the feedback that is possible with fixed linear test forms. (PsycINFO Database Record (c) 2007 APA, all rights reserved) %B Applied Measurement in Education %I Lawrence Erlbaum: US %V 19 %P 221-239 %@ 0895-7347 (Print); 1532-4818 (Electronic) %G eng %M 2006-08493-004 %0 Book Section %B Outcomes assessment in cancer %D 2005 %T Applications of item response theory to improve health outcomes assessment: Developing item banks, linking instruments, and computer-adaptive testing %A Hambleton, R. K. %E C. C. Gotay %E C. Snyder %K Computer Assisted Testing %K Health %K Item Response Theory %K Measurement %K Test Construction %K Treatment Outcomes %X (From the chapter) The current chapter builds on Reise's introduction to the basic concepts, assumptions, popular models, and important features of IRT and discusses the applications of item response theory (IRT) modeling to health outcomes assessment. In particular, we highlight the critical role of IRT modeling in: developing an instrument to match a study's population; linking two or more instruments measuring similar constructs on a common metric; and creating item banks that provide the foundation for tailored short-form instruments or for computerized adaptive assessments. (PsycINFO Database Record (c) 2005 APA ) %B Outcomes assessment in cancer %I Cambridge University Press %C Cambridge, UK %P 445-464 %G eng %0 Journal Article %J Medical Care %D 2000 %T Emergence of item response modeling in instrument development and data analysis %A Hambleton, R. K. %K Computer Assisted Testing %K Health %K Item Response Theory %K Measurement %K Statistical Validity computerized adaptive testing %K Test Construction %K Treatment Outcomes %B Medical Care %V 38 %P II60-II65 %G eng