(from the journal abstract) Multidimensional item response theory (MIRT) computerized adaptive testing, building on a recent work by D. O. Segall (1996), is applied in a licensing/certification context. An example of a medical licensure test is used to demonstrate situations in which complex, integrated content must be balanced at the total test level for validity reasons, but items assigned to reportable subscore categories may be used under a MIRT adaptive paradigm to improve the reliability of the subscores. A heuristic optimization framework is outlined that generalizes to both univariate and multivariate statistical objective functions, with additional systems of constraints included to manage the content balancing or other test specifications on adaptively constructed test forms. Simulation results suggested that a multivariate treatment of the problem, although complicating somewhat the objective function used and the estimation of traits, nonetheless produces advantages from a psychometric perspective. (PsycINFO Database Record (c) 2003 APA, all rights reserved).