A computer adaptive testing approach for assessing physical functioning in children and adolescents.

Area of Science:

• Pediatric Physical Function Assessment
• Computer-Adaptive Testing (CAT)
• Health Outcomes Measurement

Background:

• Traditional assessments of physical functioning in children and adolescents can be time-consuming and effort-intensive.
• Accurate measurement of self-care and mobility is crucial for pediatric health monitoring and intervention.
• Computer-adaptive testing (CAT) offers a potential solution for efficient and precise assessments.

Purpose of the Study:

• To evaluate the accuracy of computer-adaptive testing (CAT) for assessing physical functioning in children and adolescents.
• To determine the reduction in time and effort required for physical functioning assessments using CAT.
• To compare CAT-derived scores with full-length assessment scores.

Main Methods:

• Developed simulated 5-, 10-, 15-, and 20-item CAT versions for self-care and mobility domains.
• Tested CAT accuracy using computer simulations in a normative sample (n=373) and a Pompe disease sample (n=26).
• Analyzed score estimates to determine the number of items needed for comparable results to full-length assessments.

Main Results:

• A 20-item CAT version achieved comparable score estimates to full-length tests across all age ranges and both normative and clinical samples.
• CAT required only 13-16% of the items from full-length tests for accurate assessment.
• Simulations demonstrated the feasibility of accurate and efficient physical functioning evaluations.

Conclusions:

• Computer-adaptive testing (CAT) is an accurate and efficient method for assessing physical functioning (self-care and mobility) in pediatric populations.
• CAT significantly reduces the number of items required for assessment, saving time and effort.
• These findings support the broader adoption of CAT for clinical physical functioning evaluations in children and adolescents.