Measurement Precision and Efficiency of Multidimensional Computer Adaptive Testing of Physical Functioning Using the Pediatric Evaluation of Disability Inventory

Haley SM, Ni P, Ludlow LH, Fragala-Pinkham MA. Measurement precision and efficiency of multidimensional computer adaptive testing of physical functioning using the Pediatric Evaluation of Disability Inventory.

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.