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Computerized adaptive testing (CAT) is a widely embraced approach for delivering personalized educational assessments, tailoring each test to the real‐time performance of individual examinees. Despite its potential advantages, CAT�s application in small‐scale assessments has been limited due to the complexities associated with calibrating the item bank using sparse response data and small sample sizes. This study addresses these challenges by developing a two‐step item bank calibration strategy that leverages the 1‐bit matrix completion method in conjunction with two distinct incomplete pretesting designs. We introduce two novel 1‐bit matrix completion‐based imputation methods specifically designed to tackle the issues associated with item calibration in the presence of sparse response data and limited sample sizes. To demonstrate the effectiveness of these approaches, we conduct a comparative assessment against several established item parameter estimation methods capable of handling missing data. This evaluation is carried out through two sets of simulation studies, each featuring different pretesting designs, item bank structures, and sample sizes. Furthermore, we illustrate the practical application of the methods investigated, using empirical data collected from small‐scale assessments. [ABSTRACT FROM AUTHOR]

Item position effect (IPE) refers to situations where an item performs differently when it is administered in different positions on a test. The majority of previous research studies have focused on investigating IPE under linear testing. There is a lack of IPE research under adaptive testing. In addition, the existence of IPE might violate Item Response Theory (IRT)’s item parameter invariance assumption, which facilitates applications of IRT in various psychometric tasks such as computerized adaptive testing (CAT). Ignoring IPE might lead to issues such as inaccurate ability estimation in CAT. This article extends research on IPE by proposing and evaluating approaches to controlling position effects under an item‐level computerized adaptive test via a simulation study. The results show that adjusting IPE via a pretesting design (approach 3) or a pool design (approach 4) results in better ability estimation accuracy compared to no adjustment (baseline approach) and item‐level adjustment (approach 2). Practical implications of each approach as well as future research directions are discussed as well. [ABSTRACT FROM AUTHOR]

The article discusses the importance of subscores in educational and psychological testing, particularly in response to demands for more detailed information about examinees' knowledge and skills. It highlights the challenges and limitations of subscores, such as their reliance on few items and high correlation with total scores. The article reviews a book that provides a comprehensive guide to producing and interpreting subscores, offering practical recommendations for testing practitioners. The book covers the history of subscores, methods of reporting them, evaluating their quality, and making decisions about their use based on psychometric standards. It also addresses the issue of subscore equating and provides a flowchart for decision-making on reporting subscores. [Extracted from the article]

This study provides an overview of the effect of differential item functioning (DIF) on measurement precision, test information function (TIF), and test effectiveness in computer adaptive tests (CATs). Simulated data for the study was produced and analyzed with the Rstudio. During the data generation process, item pool size, DIF type, DIF percentage, item selection method for CAT, and the test termination rules were considered changed conditions. Sample size and ability parameter distribution, Item Response Theory (IRT) model, DIF size, ability estimation method, test starting rule, and item usage frequency method regarding CAT conditions were considered fixed conditions. To examine the effect of DIF, measurement precision, TIF and test effectiveness were calculated. Results show DIF has negative effects on measurement precision, TIF, and test effectiveness. In particular, statistically significant effects of the percentage DIF items and DIF type are observed on measurement precision. [ABSTRACT FROM AUTHOR]

Digital transformations within educational systems are recurrently justified by their promise to enhance learning activities and outcomes. We examine this claim in a study of pupils' perception and experiences with computer-based adaptive tests in higher classes in Danish public primary schools. The study relies on survey and interview data and addresses whether pupils perceive their participation in computer-based adaptive tests as contributing to their learning and the degree to which the perception of teachers' attitude to the test influences their learning. A majority perceives their learning as low or non-existing. However, the perception of a more positive teacher attitude is related to more substantial learning. Theoretically, we attribute this relationship to the effect of self-fulfilling prophecies in the classroom. Learning also differs for subgroups related to gender and ability level. The findings contribute to discussions about educational policy, management, and the digital transformation of educational systems. [ABSTRACT FROM AUTHOR]

The ability to rapidly provide examinees with detailed and effective diagnostic information is a critical topic in psychology. Knowing what diagnostic criteria the examinees have met enables the practitioner to seek the solution to help them in a timely manner, and this can be achieved by cognitive diagnostic computerized adaptive testing (CD-CAT). However, the pervasive challenge of replenishing items in the CD-CAT item bank limits its practical application. Online calibration is a means to address item replenishment, but in CD-CAT, most existing online calibration methods that jointly calibrate the Q-matrix and item parameters of the new items are developed only for dichotomous responses and are time-consuming. Notably, previous studies pay no attention to polytomously scored items that are frequently observed in testing, even though they can offer additional evidence for the examinees' diagnosis. To fill this gap, we propose a SCAD-based method (SCAD-EM) to calibrate the Q-matrix and item parameters of the new items with polytomous response data in order to promote the application of CD-CAT in practice. The performance of the SCAD-EM was investigated in two comprehensive simulation studies and compared against the revised single-item estimation method (SIE-BIC). Results indicated that the SCAD-EM produces a higher calibration accuracy for the category-level Q-matrix and is computationally more efficient across all conditions, but it produces a lower calibration accuracy for the item-level Q-matrix. An empirical study further demonstrated the utility of the SCAD-EM and the SIE-BIC methods in calibrating new items with a real dataset. The advantages of the proposed method, its limitations, and possible future research directions are offered at the end. [ABSTRACT FROM AUTHOR]

Background: Computerized adaptive testing (CAT) is an effective way to reduce time, repetitious redundancy, and respond burden, and has been used to measure outcomes in many diseases. This study aimed to develop and validate a comprehensive disease-specific CAT for chronic obstructive pulmonary disease (COPD) patient-reported outcome measurement. Methods: The discrimination and difficulty of the items from the modified patient-reported outcome scale for COPD (mCOPD-PRO) were analyzed using item response theory. Then the initial item, item selection method, ability estimation method, and stopping criteria were further set based on Concerto platform to form the CAT. Finally, the reliability and validity were validated. Results: The item discrimination ranged from 1.05 to 2.71, and the item difficulty ranged from − 3.08 to 3.65. The measurement reliability of the CAT ranged from 0.910 to 0.922 using random method, while that ranged from 0.910 to 0.924 using maximum Fisher information (MFI) method. The content validity was good. The correlation coefficient between theta of the CAT and COPD assessment test and modified Medical Research Council dyspnea scale scores using random method was 0.628 and 0.540 (P < 0.001; P < 0.001) respectively, while that using MFI method was 0.347 and 0.328 (P = 0.007; P = 0.010) respectively. About 11 items (reducing by 59.3%) on average were tested using random method, while about seven items (reducing by 74.1%) on average using MFI method. The correlation coefficient between theta of the CAT and mCOPD-PRO total scores using random method was 0.919 (P < 0.001), while that using MFI method was 0.760 (P < 0.001). Conclusions: The comprehensive disease-specific CAT for COPD patient-reported outcome measurement is well developed with good psychometric properties, which can provide an efficient, accurate, and user-friendly measurement for patient-reported outcome of COPD. [ABSTRACT FROM AUTHOR]

The National Council on Measurement in Education (NCME) has released a report that provides guidance for graduate programs and professionals in the field of educational measurement. The report emphasizes the importance of technical skills and understanding the social and cultural contexts that influence measurement. It also highlights the need for professionals to evaluate the fairness of test scores and adapt to real-world constraints. The report discusses the importance of ethics and applying measurement expertise at both the individual and institutional levels. It provides recommendations for employers to support the development of competencies and foster a sense of belonging. The authors call for continued collaboration in cultivating professionals in educational measurement. [Extracted from the article]

Assessment is central to teaching and learning, and recently there has been a substantive shift from paper-and-pencil assessments towards technology delivered assessments such as computer-adaptive tests. Fairness is an important aspect of the assessment process, including design, administration, test-score interpretation, and data utility. The Universal Design for Learning (UDL) guidelines can inform assessment development to promote fairness; however, it is not explicitly clear how UDL and fairness may be linked through students' conceptualizations of assessment fairness. This phenomenological study explores how middle grades students conceptualize and reason about the fairness of mathematics tests, including paper-and-pencil and technology-delivered assessments. Findings indicate that (a) students conceptualize fairness through unique notions related to educational opportunities and (b) students' reason about fairness non-linearly. Implications of this study have potential to inform test developers and users about aspects of test fairness, as well as educators data usage from fixed-form, paper-and-pencil tests, and computer-adaptive, technology-delivered tests. [ABSTRACT FROM AUTHOR]

Objectives: This research simulates an adaptive version of the IDAS‐II (IDAS‐CAT). Methods: 2021 participants from both community (n = 1692) and patients (n = 329) samples completed the IDAS‐II. Item response theory metric properties of the IDAS‐II full test and the 20‐items of the general depression (GD) scale were obtained. The efficiency and accuracy of different computerized adaptive algorithms were simulated. Different subsamples completed additional external measures in order to gather evidence of validity of the scores estimated with the simulated adaptive algorithms selected. Results: Both unidimensional computerized adaptive testing algorithm selected for the GD scale and the bifactor model chosen for the full test, allow 70% reduction in the length of administration, maintaining a measurement error below 0.30 on the general and 0.50 on the specific factors. Results show high correlations of the scores estimated with the adaptive algorithms and the estimates based on the full test, as well as correlations with external criteria almost equal to those generated with the full test. Conclusions: IDAS‐CAT could be a reliable and fast tool for measuring internalizing spectrum. [ABSTRACT FROM AUTHOR]

Objective We describe the development of a new computer adaptive vocabulary test, Mobile Toolbox (MTB) Word Meaning, and validity evidence from 3 studies. Method Word Meaning was designed to be a multiple-choice synonym test optimized for self-administration on a personal smartphone. The items were first calibrated online in a sample of 7,525 participants to create the computer-adaptive test algorithm for the Word Meaning measure within the MTB app. In Study 1, 92 participants self-administered Word Meaning on study-provided smartphones in the lab and were administered external measures by trained examiners. In Study 2, 1,021 participants completed the external measures in the lab and Word Meaning was self-administered remotely on their personal smartphones. In Study 3, 141 participants self-administered Word Meaning remotely twice with a 2-week delay on personal iPhones. Results The final bank included 1363 items. Internal consistency was adequate to good across samples (ρxx = 0.78 to 0.81, p  < .001). Test–retest reliability was good (ICC = 0.65, p  < .001), and the mean theta score was not significantly different upon the second administration. Correlations were moderate to large with measures of similar constructs (ρ = 0.67–0.75, p  < .001) and non-significant with measures of dissimilar constructs. Scores demonstrated small to moderate correlations with age (ρ = 0.35 to 0.45, p  < .001) and education (ρ = 0.26, p  < .001). Conclusion The MTB Word Meaning measure demonstrated evidence of reliability and validity in three samples. Further validation studies in clinical samples are necessary. [ABSTRACT FROM AUTHOR]

Computational thinking (CT) is a set of problem-solving skills with high relevance in education and work contexts. The present paper explores the role of key cognitive factors underlying CT performance in non-programming university students. We collected data from 97 non-programming adults in higher education in a supervised setting. Fluid intelligence, crystallized intelligence, and visuospatial ability were assessed using computerized adaptive tests; CT was measured using the Computational Thinking test. The direct and indirect effects of gender and visuospatial ability through fluid intelligence on CT were tested in a serial multiple mediator model. Fluid intelligence predicted CT when controlling for the effects of gender, age, and visuospatial ability, while crystallized intelligence did not predict CT. Men had a small advantage in CT performance when holding the effects of cognitive abilities constant. Despite its large correlation with gender and CT, visuospatial ability did not directly influence CT performance. Overall, we found that programming-naive computational thinkers draw on their reasoning ability that does not rely on previously acquired knowledge to solve CT problems. Visuospatial ability and CT were spuriously associated. Drawing on the process overlap theory we propose that tests of fluid intelligence and CT sample an overlapping set of underlying visuospatial processes. [ABSTRACT FROM AUTHOR]

Purpose: This article describes DigiSpan, a new computer-controlled auditory test of forward and reverse digit span, designed to be administered by clinicians, and presents normative and test-retest reliability data for adults. Method: DigiSpan mimics conventional live-voice tests in that it commences with trials that ascend in length until a stopping criterion is met, giving rise to a conventional scaled score. It then administers five additional adaptive trials, the length of which depends on the correctness of the response to the previous trial. Each of these two segments of the measurement gives rise to a scaled score. The ascending and adaptive scores are averaged to give an overall score and subtracted to produce an internal measure of consistency, and hence reliability. Young adults with an Mage of 25 years (N = 163) were tested, of whom 65 were retested on a separate day. Results: The scaled scores from the conventional ascending trials were highly consistent with existing normative data based on live-voice tests. Combination of the conventional scaled score with a scaled score based on the adaptive trials led to 44% reduction in error variance for forward memory span and 20% reduction for reverse memory span. The average of these (32%) is similar to but (insignificantly) less than the 42% reduction in error variance that can be predicted based on adding the five adaptive trials. Conclusions: Replacing live-voice production of digits by a clinician with recorded, computer-controlled production has not affected the difficulty of the test. Adding five additional trials around the sequence length that a test participant can just remember has produced a decrease in measurement error. In addition, the availability of separate scaled scores for the ascending and adaptive phases enables the reliability of the combined score to be checked, for both forward and reverse measurements. The combination of standardized delivery, increased accuracy, internal reliability check, and fast automated scoring makes the test highly suitable for clinical use. [ABSTRACT FROM AUTHOR]

Aim Method Results Interpretation To refine the Gross Motor Family Report (GM‐FR) using parents' input and to evaluate its psychometric properties.In this measurement study, 12 parents of children and adolescents with cerebral palsy (CP), aged 2 to 18 years, classified in all levels of the Gross Motor Function Classification System (GMFCS), were interviewed about their experience completing the GM‐FR (content validity). Parents' feedback was used to refine the measure which was then completed by 146 families to evaluate internal consistency, and discriminative and concurrent validity. Forty‐six parents completed the GM‐FR again, 7 to 30 days later, to evaluate test–retest reliability.GM‐FR scoring, pictures, descriptions, and the total number of items were revised based on parents' feedback. The GM‐FR version 2.0 demonstrated high internal consistency (Cronbach's α = 0.99), no floor/ceiling effects, and excellent test–retest reliability (intraclass correlation coefficient = 0.99). GM‐FR scores discriminated between GMFCS levels (p < 0.05) and were strongly negatively correlated with GMFCS level (r = −0.92; p < 0.001). GM‐FR scores correlated positively and strongly with the Gross Motor Function Measure‐66 (r = 0.94; p < 0.001) and the Pediatric Evaluation of Disability Inventory – Computer Adaptive Test mobility domain (r = 0.93; p < 0.001).Active participation of families in the GM‐FR's development facilitated creation of a family‐friendly instrument. This study provides strong evidence of reliability and validity to support GM‐FR use in clinical practice and research for assessing gross motor performance of children and adolescents with CP. [ABSTRACT FROM AUTHOR]

We administered a computerized adaptive test of vocabulary three times to assess the verbal intelligence of chatGPT (GPT 3.5) and Bing (based on GPT 4). There was no difference between their performance; both performed at a high level, outperforming approximately 95% of humans and scoring above the level of native speakers with a doctoral degree. In 42% of test items that were administered more than once these large language models provided different answers to the same question in different sessions. They never engaged in guessing, but provided hallucinations: answers that were not among the options. Such hallucinations were not triggered by the inability to answer correctly as the same questions evoked correct answers in other sessions. The results implicate that psychometric tools developed for humans have limitations when assessing AI, but they also imply that computerised adaptive testing of verbal ability is an appropriate tool to critically evaluate the performance of large language models. [ABSTRACT FROM AUTHOR]

This article examines whether the relationship between the members of the United Nations' Treaty Bodies' (TB) home countries and the countries reviewed by these bodies is significant to the amount and style of criticism the reviewed country receives. This article explains why the source–target relationship is significant to shaming. It defines two shaming styles – Socializing shaming and Disciplining shaming and defines elements that enable the identification of shaming styles. Utilizing data on CAT shaming from 2001 to 2022 and on TB members' country of origin it shows through regression analysis that the existence of a trade partnership between TB members' home countries and reviewed countries results in more criticism. This article qualitatively identifies elements of Socializing versus Disciplining shaming in the communications with countries that are trade partners of the TB members' home countries. It finds that Socializing shaming elements are more prevalent. This article draws theoretical, empirical and policy conclusions. [ABSTRACT FROM AUTHOR]

Computer adaptive testing (CAT) is an increasingly common mode of test administration offering improved test security, better measurement precision, and the potential for shorter testing experiences. This article presents a new item selection algorithm based on a generalized objective function to support multiple types of testing conditions and principled assessment design. The generalized nature of the algorithm permits a wide array of test requirements allowing experts to define what to measure and how to measure it and the algorithm is simply a means to an end to support better construct representation. This work also emphasizes the computational algorithm and its ability to scale to support faster computing and better cost‐containment in real‐world applications than other CAT algorithms. We make a significant effort to consolidate all information needed to build and scale the algorithm so that expert psychometricians and software developers can use this document as a self‐contained resource and specification document to build and deploy an operational CAT platform. [ABSTRACT FROM AUTHOR]

Background: The Forgotten Joint Score (FJS), a commonly used patient-reported outcome measure, was developed without fully confirming assumptions such as unidimensionality (all items reflect 1 underlying factor), appropriate weighting of each item in scoring, absence of differential item functioning (in which different groups, e.g., men and women, respond differently), local dependence (pairs of items are measuring only 1 underlying factor), and monotonicity (persons with higher function have a higher score). We applied item response theory (IRT) to perform validation of the FJS according to contemporary standards, and thus support its ongoing use. We aimed to confirm that the FJS reflects a single latent trait. In addition, we aimed to determine whether an IRT model could be fitted to the FJS. Methods: Participants undergoing primary total knee replacement provided responses to the FJS items preoperatively and at 6 and 12 months postoperatively. An exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and Mokken analysis were conducted. A graded response model (GRM) was fitted to the data. Results: A total of 1,774 patient responses were analyzed. EFA indicated a 1-factor model (all 12 items reflecting 1 underlying trait). CFA demonstrated an excellent model fit. Items did not have equal weighting. The FJS demonstrated good monotonicity and no differential item functioning by sex, age, or body mass index. GRM parameters are reported in this paper. Conclusions: The FJS meets key validity assumptions, supporting its use in clinical practice and research. The IRT-adapted FJS has potential advantages over the traditional FJS: it provides continuous measurements with finer granularity between health states, includes individual measurement error, and can compute scores despite more missing data (with only 1 response required to estimate a score). It can be applied retrospectively to existing data sets or used to deliver individualized computerized adaptive tests. Level of Evidence: Prognostic Level II. See Instructions for Authors for a complete description of levels of evidence. [ABSTRACT FROM AUTHOR]

This study presents a novel method to investigate test fairness and differential item functioning combining psychometrics and machine learning. Test unfairness manifests itself in systematic and demographically imbalanced influences of confounding constructs on residual variances in psychometric modeling. Our method aims to account for resulting complex relationships between response patterns and demographic attributes. Specifically, it measures the importance of individual test items, and latent ability scores in comparison to a random baseline variable when predicting demographic characteristics. We conducted a simulation study to examine the functionality of our method under various conditions such as linear and complex impact, unfairness and varying number of factors, unfair items, and varying test length. We found that our method detects unfair items as reliably as Mantel–Haenszel statistics or logistic regression analyses but generalizes to multidimensional scales in a straight forward manner. To apply the method, we used random forests to predict migration backgrounds from ability scores and single items of an elementary school reading comprehension test. One item was found to be unfair according to all proposed decision criteria. Further analysis of the item's content provided plausible explanations for this finding. Analysis code is available at: https://osf.io/s57rw/?view_only=47a3564028d64758982730c6d9c6c547. [ABSTRACT FROM AUTHOR]

Multidimensional achievement tests are recently gaining more importance in educational and psychological measurements. For example, multidimensional diagnostic tests can help students to determine which particular domain of knowledge they need to improve for better performance. To estimate the characteristics of candidate items (calibration) for future multidimensional achievement tests, we use optimal design theory. We generalize a previously developed exchange algorithm for optimal design computation to the multidimensional setting. We also develop an asymptotic theorem saying which item should be calibrated by examinees with extreme abilities. For several examples, we compute the optimal design numerically with the exchange algorithm. We see clear structures in these results and explain them using the asymptotic theorem. Moreover, we investigate the performance of the optimal design in a simulation study. [ABSTRACT FROM AUTHOR]

'Single Session Therapy' (SST) is a service delivery model that seeks to provide an evidence-based, solution-focused, brief intervention within a single therapy session. The stand-alone session affords the opportunity to provide brief psychological interventions while clients await access to longer-term services. The COVID-19 pandemic has adversely impacted individuals' mental health. However, the majority of research has investigated patient mental health within hospital settings and community organizations that offer long-term services, whereas minimal research has focused on mental health concerns during COVID-19 within an SST model. The primary aim of the study was to measure client experiences of a brief mental health service. The nature of client mental health concerns who access such services at various points during a pandemic was also investigated. The current study utilized client feedback forms and the Computerized Adaptive Testing—Mental Health (CAT-MH) to measure client experiences and mental health concerns. Qualitative analysis of client feedback forms revealed themes of emotional (e.g., safe space) and informational support (e.g., referrals). Clients also reported reduced barriers to accessing services (e.g., no appointment necessary, no cost), as well as limitations (e.g., not enough sessions) of the Walk-in clinic. Profile analysis of the CAT-MH data indicated that clients had higher rates of depression before COVID-19 (M = 64.2, SD = 13.07) as compared to during the pandemic (M = 59.78, SD = 16.87). In contrast, higher rates of positive suicidality flags were reported during the pandemic (n = 54) as compared to before (n = 29). The lower reported rates of depression but higher rate of suicidality during the pandemic was an unanticipated finding that contradicted prior research, to which possible explanations are explored. Taken together, the results demonstrate the positive experiences of clients who access a single session therapy. [ABSTRACT FROM AUTHOR]

The relationship between confidence and accuracy and the reliability of eyewitness identifications has attracted a lot of attention. In contrast, relatively little is known about the relationship between eyewitness confidence and the accuracy of recall memory in interview contexts. Here, we manipulated questioning approaches to investigate the impact of Free‐Recall and Cued‐Recall questions, whereby the latter were witness‐compatible (questions concerning details reported in the preceding Free‐Recall) or witness‐incompatible questions. We also manipulated the order these questions were asked. A sample of 124 mock witness participants watched a crime‐video and subsequently recalled the event to understand the impact of question type and order on confidence‐accuracy calibration. Our results show that a Free‐Recall invitation and compatible (compared to incompatible) questions promoted more stable confidence. Compatible questions yielded fewer errors, more accurate details, and promoted more reliable confidence‐accuracy calibration and discrimination, especially when they preceded the incompatible questions. Implications are discussed. [ABSTRACT FROM AUTHOR]

Computerized adaptive tests (CATs) are highly efficient assessment tools that couple low patient and clinician time burden with high diagnostic accuracy. A CAT for substance use disorders (CAT-SUD-E) has been validated in adult populations but has yet to be tested in adolescents. The purpose of this study was to perform initial evaluation of the K-CAT-SUD-E (i.e., Kiddy-CAT-SUD-E) in an adolescent sample compared to a gold-standard diagnostic interview. Adolescents (N = 156; aged 11–17) with diverse substance use histories completed the K-CAT-SUD-E electronically and the substance related disorders portion of a clinician-conducted diagnostic interview (K-SADS) via tele-videoconferencing platform. The K-CAT-SUD-E assessed both current and lifetime overall SUD and substance-specific diagnoses for nine substance classes. Using the K-CAT-SUD-E continuous severity score and diagnoses to predict the presence of any K-SADS SUD diagnosis, the classification accuracy ranged from excellent for current SUD (AUC = 0.89, 95% CI = 0.81, 0.95) to outstanding (AUC = 0.93, 95% CI = 0.82, 0.97) for lifetime SUD. Regarding current substance-specific diagnoses, the classification accuracy was excellent for alcohol (AUC = 0.82), cannabis (AUC = 0.83) and nicotine/tobacco (AUC = 0.90). For lifetime substance-specific diagnoses, the classification accuracy ranged from excellent (e.g., opioids, AUC = 0.84) to outstanding (e.g., stimulants, AUC = 0.96). K-CAT-SUD-E median completion time was 4 min 22 s compared to 45 min for the K-SADS. This study provides initial support for the K-CAT-SUD-E as a feasible accurate diagnostic tool for assessing SUDs in adolescents. Future studies should further validate the K-CAT-SUD-E in a larger sample of adolescents and examine its acceptability, feasibility, and scalability in youth-serving settings. [ABSTRACT FROM AUTHOR]

This evaluation study explored a two-year literacy reform effort in a school district with 10 of its 13 elementary schools in the improvement process. Schools were placed in three groups. Group 1 (four schools, 80 teachers) implemented new instructional practices in Year 1 and then added a new curriculum. Group 2 (four schools, 102 teachers) changed both the pedagogy and curriculum for both years. Group 3 (five schools, 107 teachers) did not make any changes in Year 1 and then implemented both components. After propensity score matching students, reading scores were analyzed with three-level change score models. Results suggested that two years of the combined reforms generally were effective at improving students' oral reading fluency, and two years of the pedagogical changes were effective at improving students' performance on a computer-adaptive test of overall reading ability. However, improvements on the computer-adaptive test as well as the state reading test were small, which might reflect the stability in reading comprehension found in other studies. [ABSTRACT FROM AUTHOR]

Community correction institutions in China frequently employ the Symptom Checklist-90 (SCL-90) and the health survey brief (SF-12) as primary tools for psychological assessment of community correctional prisoners. However, in practical application, the SCL-90 Checklist faces issues such as complex item numbers, overall low cultural level of the subjects, and insufficient professional level of the administrators. The SF-12 health survey brief, as a preliminary screening tool, although only has 12 questions, to some extent simplifies the evaluation process and improves work efficiency, it is prone to missed screening. The research team collected 17-dimensional basic characteristic data and corresponding SCL-90 and SF-12 data from 25,480 samples of community correctional prisoners in Zhejiang Province, China. This study explored the application of multi-label multi-classification algorithms and oversampling techniques in building machine learning models to delve into the correlation between the psychological health risks of community correctional prisoners and their characteristic data. Inspired by computerized adaptive testing (CAT), we constructed an adaptive and efficient screening model for community correctional prisoners through experimental comparisons, based on the binary relevance algorithm with sample oversampling. This screening model personalize the assessment process by dynamically matching participants with the most relevant subset (s) of the nine dimensions of the SCL-90 based on their individual characteristics. Thus, adaptive dynamic simplification and personalized recommendation of the SCL-90 scale between question groups were achieved for the specific group of community correctional prisoners. As a screening tool for psychological symptoms of community correctional prisoners, this model significantly simplifies the number of questions compared to SCL-90, with a simplification rate of up to 65%. However, it achieves this simplification while maintaining excellent performance. The accuracy reached 0.66, with a sensitivity of 0.754, and an F1 score of 0.649. This innovation simplified the assessment process, reduced the assessment time, improved work efficiency, and enhanced the ability to judge the specificity of community correctional prisoners population. Compared to the SF-12, although the simplification rate and accuracy of the model are slightly lower than those of the SF-12, the sensitivity increased by 42.26%, and the F1 score improved by 15.28%. This means the model greatly reduces the possibility of missed screening, effectively preventing prisoners with abnormal psychological or mental states from losing control due to missed screening, and even committing suicide, self injury, or injuring others. [ABSTRACT FROM AUTHOR]

The present study compared the diagnostic accuracy of a single computer adaptive test (CAT), Star Reading or Star Math, and a combination of the two in a gated screening framework to predict end‐of‐year proficiency in reading and math. Participants included 13,009 students in Grades 3–8 who had at least one fall screening score and end‐of‐year state test score in reading and math. First, diagnostic accuracy statistics were evaluated for a single screening measure to predict proficiency on end‐of‐year tests. Second, a gated screening framework was simulated to examine the diagnostic accuracy of a combination of screening measures (i.e., scores from the CATs and the end‐of‐year test). The diagnostic accuracy of each screening method was compared. Results suggest that diagnostic accuracy did not improve for the gated screening method when compared to the single screening method. The gated screening method tended to yield low sensitivity values (M = 0.42, range = 0.35–0.48) and high specificity values (M = 0.97, range = 0.95–0.99). The only condition to reach acceptable sensitivity and specificity (>0.70) was a single reading screener predicting reading outcomes. Sample specific cut‐scores from receiver operating curve (ROC) analyses led to improved diagnostic accuracy outcomes relative to all other methods. Practitioner Points: The diagnostic accuracy did not improve for the gated screening method when compared to the single screening method.Across the screening conditions, the only method to yield acceptable diagnostic accuracy was when a single reading screener predicted reading outcomes.Utilizing multiple assessment measures cannot be justified according to the results of the study. [ABSTRACT FROM AUTHOR]

Stroke survivors frequently experience difficulties in daily activities, such as bathing, feeding, and mobility. This study aimed to evaluate the reliability and validity of a computer-adaptive test-Longshi scale (CAT-LS) for assessing activities of daily living (ADL) in stroke survivors. This cross-sectional study collected data using an electronic application. The ADL function of stroke survivors in rehabilitation departments of hospitals was assessed using both the CAT-LS and BI. Correlations between the CAT-LS and Barthel index (BI) and concurrent validity were evaluated using Pearson's correlation test and multiple linear regression. Interrater reliability was evaluated using the intraclass correlation coefficient based on a two-way random effect. The internal consistency of the CAT-LS was assessed using Cronbach's coefficient (α) and corrected item-total correlations. Overall, 103 medical institutions in China were used in this study. In total, 7151 patients with stroke were included in this study. The CAT-LS classified patients into three ADL groups (bedridden, domestic, and community) with significantly different BI scores (P < 0.05). The CAT-LS results obtained using the decision-tree scoring model were consistent with the scores for each BI item. A strong correlation was observed between CAT-LS and BI (Pearson's r: 0.6–0.894, P < 0.001). The CAT-LS demonstrated good internal consistency (Cronbach's α, 0.803–0.894) and interrater reliability (ICC, 0.928–0.979). CAT-LS is time-efficient and requires < 1 min to administer. The CAT-LS is a reliable and valid tool for assessing ADL function in stroke survivors and can provide rapid and accurate assessments that reduce the burden on healthcare professionals. Further validation of this tool in other populations and settings is necessary. Study registration number: No.: ChiCTR2000034067; http://www.chictr.org.cn/showproj.aspx?proj=54770. [ABSTRACT FROM AUTHOR]

U.S. elementary schools administer reading screeners to identify students in need of remedial instruction. However, the administration of additional assessments comes with a cost. It is unclear the extent to which multiple types of reading screeners warrant the increase in resources that could be used for instruction. This study compared cost–accuracy ratios for three types of reading screeners in Grade 3: curriculum-based measurement (Acadience), computer adaptive assessment (Star), informal reading inventory (Fountas and Pinnell Benchmark Assessment System), and the cost–accuracy of using all three in conjunction. We used classification and regression tree analysis to identify local cut-scores and identify how measures could be combined to maximize classification accuracy. Results suggested that oral reading fluency score (Acadience) yielded the best cost–accuracy ratio, but the combination of Star and oral reading fluency identified important instructional groups. Cost tables provide additional insight to schools on critical decision points for choosing and implementing reading screeners. [ABSTRACT FROM AUTHOR]

The questionnaire method has always been an important research method in psychology. The increasing prevalence of multidimensional trait measures in psychological research has led researchers to use longer questionnaires. However, questionnaires that are too long will inevitably reduce the quality of the completed questionnaires and the efficiency of collection. Computer adaptive testing (CAT) can be used to reduce the test length while preserving the measurement accuracy. However, it is more often used in aptitude testing and involves a large number of parametric assumptions. Applying CAT to psychological questionnaires often requires question-specific model design and preexperimentation. The present article proposes a nonparametric and item response theory (IRT)-independent CAT algorithm. The new algorithm is simple and highly generalizable. It can be quickly used in a variety of questionnaires and tests without being limited by theoretical assumptions in different research areas. Simulation and empirical studies were conducted to demonstrate the validity of the new algorithm in aptitude tests and personality measures. [ABSTRACT FROM AUTHOR]

Questionnaires to detect emotional and behavioral (EB) problems in preventive child healthcare (PCH) should be short; this potentially affects their validity and reliability. Computerized adaptive testing (CAT) could overcome this weakness. The aim of this study was to (1) develop a CAT to measure EB problems among pre-school children and (2) assess the efficiency and validity of this CAT. We used a Dutch national dataset obtained from parents of pre-school children undergoing a well-child care assessment by PCH (n = 2192, response 70%). Data regarded 197 items on EB problems, based on four questionnaires, the Strengths and Difficulties Questionnaire (SDQ), the Child Behavior Checklist (CBCL), the Ages and Stages Questionnaire: Social Emotional (ASQ:SE), and the Brief Infant–Toddler Social and Emotional Assessment (BITSEA). Using 80% of the sample, we calculated item parameters necessary for a CAT and defined a cutoff for EB problems. With the remaining part of the sample, we used simulation techniques to determine the validity and efficiency of this CAT, using as criterion a total clinical score on the CBCL. Item criteria were met by 193 items. This CAT needed, on average, 16 items to identify children with EB problems. Sensitivity and specificity compared to a clinical score on the CBCL were 0.89 and 0.91, respectively, for total problems; 0.80 and 0.93 for emotional problems; and 0.94 and 0.91 for behavioral problems. Conclusion: A CAT is very promising for the identification of EB problems in pre-school children, as it seems to yield an efficient, yet high-quality identification. This conclusion should be confirmed by real-life administration of this CAT. What is Known: • Studies indicate the validity of using computerized adaptive test (CAT) applications to identify emotional and behavioral problems in school-aged children. • Evidence is as yet limited on whether CAT applications can also be used with pre-school children. What is New: • The results of this study show that a computerized adaptive test is very promising for the identification of emotional and behavior problems in pre-school children, as it appears to yield an efficient and high-quality identification. [ABSTRACT FROM AUTHOR]

The computerized adaptive form of cognitive diagnostic testing, CD-CAT, has gained increasing attention in the domain of personalized measurements for its ability to categorize individual mastery status of fine-grained attributes more accurately and efficiently through administering items tailored to one's ability progressively. How to select the next item based on previous response(s) is crucial for the success of CD-CAT. Previous item selection strategies for CD-CAT have often followed a greedy or semi-greedy approach, which makes it difficult to strike a balance between diagnostic performance and item bank utilization. To address this issue, this study takes a graph perspective and transforms the item selection problem in CD-CAT into a path-searching problem, in which paths refer to possible test construction and nodes refer to individual items. A heuristic function is defined to predict the prospect of a path, indicating how well the corresponding test can diagnose the current examinee. Two search mechanisms with different biases towards item exposure control are proposed to approximate the optimal path with the best prospect. The first unused item on the resulting path is selected as the next item. The above components compose a novel CD-CAT item selection framework based on heuristic search. Simulation studies are conducted under a variety of conditions regarding bank designs, bank-quality conditions, and testing scenarios. The results are compared with different types of classic item selection strategies in CD-CAT, showing that the proposed framework can enhance bank utilization at a smaller cost of diagnostic performance. [ABSTRACT FROM AUTHOR]

Given the premise that dance is an activity suitable for integration in Physical Education and Sport classes, we aimed to test this by implementing teaching projects incorporating elements of Street Dance. Similar to other sports, which rely on motor skills and actions, only in this case mostly performed to music, Street Dance can bring countless benefits to a person's life. Whether we are talking about psychomotor or cognitive skills, the literature argues that dance can be a valuable tool for improving them. Considering the novelty that Street Dance represents, and its ongoing evolution, coupled with the increasing attraction of young people to this dance style, we considered this research to be beneficial. The study was carried out in a secondary school in Bucharest, Sector 3, and the 17 participants were 8th grade students. As part of the research, we used the RCMV computerized test, which helped us to investigate the reactivity, hand-foot coordination and vigilance of the subjects. Also, creativity was explored through a test consisting of geometric figures, adapted by Mihaela Roco. The statistically significant differences (Wilcoxon test was used) allow us to say that the improvements achieved are not random, but are also due to the exercise programme intervention. [ABSTRACT FROM AUTHOR]

• Biostimulants T. harzianum, C. gloubosum protected tomato plants against early blight disease caused by Alternaria alternata. • Soil application of biostimulants reduced disease incidence and severity. • Treatments enhanced the photosynthetic pigments, NPK uptake and tomato growth attributes. • All stress hallmarks H2O2, electrolyte leakage and MDA were reduced. • The plant defense enzymes peroxidases (POX) and polyphenoloxidase (PPO) activities were improved. Early blight disease caused by Alternaria alternata severely affects tomato growth and productivity. Therefore, to substantiate the increasing demand for tomato fruits, it is essential to explore new strategies to combat the negative effects of the disease. The objectives of this study were to (1) evaluate the effectiveness of Trichoderma harzianum and Chaetomium globosum on disease suppression, (2) determine the influence of the biostimulants on tomato physiological and biochemical traits, and (3) assess the plant innate defense response. In pot experiment, fungal agents were applied to tomato-challenged plants as soil drenches in 8 different treatments. Results revealed that all inoculated plants (T3, T4, T5) exhibited a substantial reduction of disease incidence and severity reached 34 %, 35 %, 26 % and 31 %, 31 %, 16 % respectively compared to infected plants (T2). Such disease stress tolerance was correlated with a significant escalation of tomato growth attributes i.e. plant length, plant FW and DW. The obtained results were consolidated with a noticeable enhancement of the photosynthetic pigments (chlorophyll a, b, and carotenoids) as well as the nitrogen, phosphorus, and potassium (NPK) uptake. Furthermore, a significant reduction in cell stress markers like hydrogen peroxide (H 2 O 2) production, membrane ion leakage and lipid peroxidation (MDA) was detected. Moreover, all enhancements of tomato physiological traits were significantly concurred with up-regulation of plant defense enzymes like peroxidase (POX), polyphenol oxidase (PPO), superoxide dismutase (SOD) and catalase (CAT) 24 h post inoculation reached 3.4, 1.3 1.2, 1.2 folds respectively. Furthermore, both biostimulants were examined for extracellular indole-3-acetic acid (IAA) production. T. harzianum expressed a significant ability for IAA production over C. globosum. Remarkably, the biostimulants consortium showed a significant ability to protect tomato plants. Hence, application of the biostimulants could be a feasible approach for achieving early blight disease resistance. [ABSTRACT FROM AUTHOR]

This article explores the significance of the clinical interview in psychiatry, despite the growing reliance on screening tests and questionnaires. It highlights the valuable information that can be obtained through the clinical interview, such as the patient's symptoms, experiences, and the clinician's emotional reaction. The article also discusses the different types of interviews, including structured, semi-structured, and unstructured, and acknowledges the limitations of fully structured interviews in capturing the complexity of a patient's subjective experience. It emphasizes the need for comprehensive interviews to inform effective clinical decision-making. Additionally, the article touches on the use of questionnaires and rating scales in clinical practice, noting their usefulness but also the importance of direct questioning to capture the full range of a patient's experience. Overall, the article underscores the significance of the clinician-patient interaction and the need for empathic and thoughtful clinical information gathering. [Extracted from the article]

Computerized adaptive testing (CAT) has gained deserved popularity in the administration of educational and professional assessments, but continues to face test security challenges. To ensure sustained quality assurance and testing integrity, it is imperative to establish and maintain multiple stable item pools that are consistent in terms of psychometric characteristics and content specifications. This study introduces the Honeycomb Pool Assembly (HPA) framework, an innovative solution for the construction of multiple parallel item pools for CAT that maximizes item utilization in the item bank. The HPA framework comprises two stages—cell assembly and pool assembly—and uses a mixed integer programming modeling approach. An empirical study demonstrated HPA's effectiveness in creating a large number of parallel pools using a real‐world high‐stakes CAT assessment item bank. The HPA framework offers several advantages, including (a) simultaneous creation of multiple parallel pools, (b) simplification of item pool maintenance, and (c) flexibility in establishing statistical and operational constraints. Moreover, it can help testing organizations efficiently manage and monitor the health of their item banks. Thus, the HPA framework is expected to be a valuable tool for testing professionals and organizations to address test security challenges and maintain the integrity of high‐stakes CAT assessments. [ABSTRACT FROM AUTHOR]

Culturally responsive assessments have been proposed as potential tools to ensure equity and fairness for examinees from all backgrounds including those from traditionally underserved or minoritized groups. However, these assessments are relatively new and, with few exceptions, are yet to be implemented in large scale. Consequently, there is a lack of guidance on how one can compute comparable scores on various versions of these assessments. In this paper, the multigroup multidimensional Rasch model is repurposed for modeling data originating from various versions of a culturally responsive assessment and for analyzing such data to compute comparable scores. Two simulation studies are performed to evaluate the performance of the model for data simulated from hypothetical culturally responsive assessments and to find the conditions under which the computed scores are accurate. Recommendations are made for measurement practitioners interested in culturally responsive assessments. [ABSTRACT FROM AUTHOR]

In this paper, we develop a mixed stochastic approximation expectation‐maximization (MSAEM) algorithm coupled with a Gibbs sampler to compute the marginalized maximum a posteriori estimate (MMAPE) of a confirmatory multidimensional four‐parameter normal ogive (M4PNO) model. The proposed MSAEM algorithm not only has the computational advantages of the stochastic approximation expectation‐maximization (SAEM) algorithm for multidimensional data, but it also alleviates the potential instability caused by label‐switching, and then improved the estimation accuracy. Simulation studies are conducted to illustrate the good performance of the proposed MSAEM method, where MSAEM consistently performs better than SAEM and some other existing methods in multidimensional item response theory. Moreover, the proposed method is applied to a real data set from the 2018 Programme for International Student Assessment (PISA) to demonstrate the usefulness of the 4PNO model as well as MSAEM in practice. [ABSTRACT FROM AUTHOR]

Purpose: The persistent gap between population indicators of poor mental health and the uptake of services raises questions about similarities and differences between social and medical/psychiatric constructions. Rarely do studies have assessments from different perspectives to examine whether and how lay individuals and professionals diverge. Methods: Data from the Person-to-Person Health Interview Study (P2P), a representative U.S. state sample (N ~ 2700) are used to examine the overlap and correlates of three diverse perspectives—self-reported mental health, a self/other problem recognition, and the CAT-MH™ a validated, computer adaptive test for psychopathology screening. Descriptive and multinominal logit analyses compare the presence of mental health problems across stakeholders and their association with respondents' sociodemographic characteristics. Results: Analyses reveal a set of socially constructed patterns. Two convergent patterns indicate whether there is (6.9%, The "Sick") or is not (64.6%, The "Well") a problem. The "Unmet Needers" (8.7%) indicates that neither respondents nor those around them recognize a problem identified by the screener. Two patterns indicate clinical need where either respondents (The "Self Deniers", 2.9%) or others (The "Network Deniers", 6.0%) do not. Patterns where the diagnostic indicator does not suggest a problem include The "Worried Well" (4.9%) where only the respondent does, The "Network Coerced" (4.6%) where only others do, and The "Prodromal" (1.4%) where both self and others do. Education, gender, race, and age are associated with social constructions of mental health problems. Conclusions: The implications of these results hold the potential to improve our understanding of unmet need, mental health literacy, stigma, and treatment resistance. [ABSTRACT FROM AUTHOR]

Background: The Communicative Participation Item Bank (CPIB) is a patient‐reported outcome measure (PROM) designed to measure the extent of interference, or difficulty, experienced by adults with communication disorders participating in their day‐to‐day communication activities. To date, there is limited evidence regarding sensitivity of the CPIB for capturing change with intervention in people with Parkinson's disease (PwPD). Aims: The purpose of this study was to examine the following measurement properties of the CPIB in PwPD who received community‐based, standard care, speech‐language therapy focusing on motor speech concerns: Change over time between treatment and observation groups, comparison to patient‐defined ideal and satisfactory targets, comparison of static short form to computerised adaptive testing (CAT), comparison of self to proxy‐rated scores, and comparison to other common PROMs. Methods and Procedures: Forty‐six PwPD (20 treatment/26 observation) completed data collection upon enrolment (pre‐treatment) and 6 months later. In addition to the CPIB, PROMs included the Voice Handicap Index 10‐item short form (VHI‐10), PROMIS Global Health‐Related Quality of Life, Levels of Speech Usage, self‐rated speech severity, and Patient Health Questionnaire‐9 (PHQ‐9). Participants also engaged in qualitative interviews. Forty‐four family members completed proxy CPIB ratings. Outcomes and Results: There were no significant differences between treatment and observation groups on the CPIB pre‐treatment, but there were significant differences post‐treatment. The differences appeared to be largely due to significant gains in the treatment group. No participants reached their ideal CPIB target, and few reached their satisfactory target. Static CPIB short form and CAT scores were not significantly different, with an average of five CAT items administered per participant. Overall group similarities between patient and proxy scores may have obscured wide variability across individual patient‐proxy pairs. Associations between CPIB and VHI‐10, health‐related quality of life, self‐reported speech severity, and depression ranged from weak to moderate. Conclusions and Implications: The CPIB appears to be sensitive to capturing change with intervention, and similar results are obtained with the static short form and CAT formats. One clinical caution is that even with gains observed in the treatment group, no participants obtained their ideal communicative participation goals, and few obtained a satisfactory level of communicative participation. Thus, while current interventions are beneficial, they may not meet the full range of clients' communication needs. While responding to the CPIB through a proxy rater may be feasible, caution is warranted due to concerns about maintaining the autonomy of PwPD. What this paper adds: What is already known on this subject: The communication disorders associated with Parkinson's disease (PD) can have a negative impact on quality of life and life participation as measured by patient (or person)‐reported outcome measures (PROMs). The Communicative Participation Item Bank (CPIB) is one PROM available to use with adults with communication disorders. However, little is known about whether the CPIB captures changes in communicative participation as a result of standard care treatment for people with Parkinson's disease (PwPD). Use of computerised adaptive testing (CAT), proxy report and comparison to targeted participation outcomes have not been explored. What this study adds to existing knowledge: As a result of this study, we know that the CPIB captured differences between treatment and observation groups after community‐based, standard care speech therapy intervention focusing on motor speech production in PwPD. Static short form and CAT scores did not differ significantly, so the CAT option provides better efficiency requiring, on average, five items to administer compared to the 10‐item short form. Proxy and PwPD scores did not differ as a group, but wide variability was noted. What are the potential or actual clinical implications of this work?: The CPIB may be a clinically sensitive instrument for capturing changes in communicative participation after treatment. No participants met their ideal CPIB target, and few reached their satisfactory target, suggesting that while current interventions contribute to gains in communicative participation, there are still unmet needs that may call for support and interventions addressing the more complex array of factors affecting communicative participation outcomes for PwPD. [ABSTRACT FROM AUTHOR]

Background: The Patient-Reported Outcomes Measurement Information System® (PROMIS®) may be used to assess an individual patient's perspective of their physical, mental, and social health through either standard or computer adaptive testing (CAT) patient questionnaires. These questionnaires are used across disciplines; however, they have seen considerable application in orthopaedic surgery. Patient characteristics associated with PROMIS CAT completion have not been examined within the context of social determinants of health, such as social deprivation or health literacy, nor has patient understanding of the content of PROMIS CAT been assessed. Questions/purposes: (1) What patient demographics, including social deprivation, are associated with completion of PROMIS CAT questionnaires? (2) Is health literacy level associated with completion of PROMIS CAT questionnaires? (3) Do patients with lower health literacy have a higher odds of completing PROMIS CAT without fully understanding the content? Methods: Between June 2022 and August 2022, a cross-sectional study was performed via a paper survey administered to patients at a single, urban, quaternary academic medical center in orthopaedic subspecialty clinics of foot and ankle, trauma, and hand/upper extremity surgeons. We considered all English-speaking patients aged 18 or older, including those with limited reading and/or writing abilities, as eligible provided they received an iPad in clinic to complete the PROMIS CAT questionnaire as part of their routine standard clinical care or they completed the questionnaire via a patient portal before the visit. In all, 946 patients were considered eligible during the study period and a convenience sample of 36% (339 of 946) of patients was approached for inclusion due to clinic time constraints. Fifteen percent (52 of 339) declined to participate, leaving 85% (287 of 339) of patients for analysis here. Median (range) age of study participants was 49 years (35 to 64). Fifty-eight percent (167 of 287) of study participants self-identified as non-Hispanic Black or African American and 26% (75 of 287) as non-Hispanic White. Even proportions were observed across education levels (high school graduate or less, 29% [82 of 287]; some college, 25% [73 of 287]; college graduate, 25% [71 of 287]; advanced degree, 20% [58 of 287]). Eighteen percent (52 of 287) of patients reported an annual income bracket of USD 0 to 13,000, and 17% (48 of 287) reported more than USD 120,000. Forty-six percent (132 of 287) of patients worked full-time, 21% (59 of 287) were retired, and 23% (66 of 287) were unemployed or on disability. The primary outcome of interest was self-reported PROMIS CAT questionnaire completion grouped as: fully completed, partially completed, or no part completed. Overall, self-reported PROMIS CAT questionnaire completion proportions were: 80% (229 of 287) full completion, 13% (37 of 287) partial completion, and 7% (21 of 287) no part completed. We collected the National Area Deprivation Index (ADI) score and the Brief Health Literacy Screening Tool (BRIEF) as part of the study survey to associate with level of completion. Additionally, patient understanding of PROMIS CAT was assessed through Likert-scaled responses to a study survey question that directly asked whether the patient understood all of the questions on the PROMIS CAT questionnaire. Responses to this question may have been limited by social desirability bias, and hence may overestimate how many individuals genuinely understood the questionnaire content. However, the benefit of this approach was it efficiently allowed us to estimate the ceiling effect of patient comprehension of PROMIS CAT and likely had a high degree of specificity for detecting lack of comprehension. Results: ADI score adjusted for age was not associated with PROMIS CAT completion (partial completion OR 1.00 [95% CI 0.98 to 1.01]; p = 0.72, no part completed OR 1.01 [95% CI 0.99 to 1.03]; p = 0.45). Patients with lower health literacy scores, however, were more likely to not complete any part of their assigned questionnaires than patients with higher scores (no part completed OR 0.85 [95% CI 0.75 to 0.97]; p = 0.02). Additionally, 74% (26 of 35) of patients who did not fully understand all of the PROMIS CAT questionnaire questions still fully completed them—hence, 11% (26 of 229) of all patients who fully completed PROMIS CAT did not fully understand the content. Among patients self-reporting full completion of PROMIS CAT with health literacy data (99% [227 of 229]), patients with inadequate/marginal health literacy were more likely than patients with adequate health literacy to not fully understand all of the questions (21% [14 of 67] versus 8% [12 of 160], OR 3.26 [95% CI 1.42 to 7.49]; p = 0.005). Conclusion: Within an urban, socioeconomically diverse, orthopaedic patient population, health literacy was associated with PROMIS CAT questionnaire completion. Lower health literacy levels increased the likelihood of not completing any part of the assigned PROMIS CAT questionnaires. Additionally, patients completed PROMIS CAT without fully understanding the questions. This indicates that patient completion does not guarantee comprehension of the questions nor validity of their scores, even more so among patients with low health literacy. This is a substantive concern for fidelity of data gathered from PROMIS CAT. Clinical Relevance: Clinical implementation of the PROMIS CAT in orthopaedic populations will benefit from further research into health literacy to increase questionnaire completion and to ensure that patients understand the content of the questions they are answering, which will increase the internal validity of the outcome measure. [ABSTRACT FROM AUTHOR]

Matrix reasoning tasks are among the most widely used measures of cognitive ability in the behavioral sciences, but the lack of matrix reasoning tests in the public domain complicates their use. Here, we present an extensive investigation and psychometric validation of the matrix reasoning item bank (MaRs-IB), an open-access set of matrix reasoning items. In a first study, we calibrate the psychometric functioning of the items in the MaRs-IB in a large sample of adult participants (N = 1501). Using additive multilevel item structure models, we establish that the MaRs-IB has many desirable psychometric properties: its items span a wide range of difficulty, possess medium-to-large levels of discrimination, and exhibit robust associations between item complexity and difficulty. However, we also find that item clones are not always psychometrically equivalent and cannot be assumed to be exchangeable. In a second study, we demonstrate how experimenters can use the estimated item parameters to design new matrix reasoning tests using optimal item assembly. Specifically, we design and validate two new sets of test forms in an independent sample of adults (N = 600). We find these new tests possess good reliability and convergent validity with an established measure of matrix reasoning. We hope that the materials and results made available here will encourage experimenters to use the MaRs-IB in their research. [ABSTRACT FROM AUTHOR]

Purpose: We aimed to (1) establish linguistic and ethnic equivalence (i.e. lack of bias) for the items in the English and Chinese versions of the Singapore Health and Well Being (SHAWS) Physical Functioning (PF), Positive Mindset (PM) and Social Relationship (SR) item banks (IBs); and (2) evaluate the preliminary efficiency of these IBs using Computer Adaptive Testing (CAT) simulations. Methods: In this cross-sectional study, 671, 670, and 672 subjects answered 55, 48 and 30 items of the PF, PM, and SR IBs, respectively. Rasch analysis was conducted to assess each IB's psychometric properties, particularly the presence of differential item functioning (DIF) for language and ethnicity. A set of performance criteria related to removing items that displayed notable DIF were employed. CAT simulations determined the mean number of items for high, moderate, and moderate-low measurement precisions (stopping rule: SEM 0.300, 0.387. 0.521, respectively). Results: Half of subjects were >50 years old (40.9% PF, 42.1% PM, 41.4% SR), Chinese (50.7% PF, 51.0% PM, 50.6% SR) and female (50.0% PF. 49.4% PM, 52.8% SR) respectively. Rasch analysis revealed 4 items with DIF for the PF IB, 9 items with DIF for the PM IB and 2 items with DIF for the SR IB. In CAT simulations, the mean number of items administered was 8.5, 21.6 and 14.5 for the PF, PM and SR IBs, respectively (SEM 0.300), 5.1, 13.0, 8.0 for PF, PM and SR IBs, respectively (SEM 0.387) and 3.1, 5.3 and 4.1 for PF, PM and SR IBs, respectively (SEM 0.521). Conclusion: The PF, PM and SR IBs to measure health-related quality of life revealed minimal DIF for language and ethnicity after remedial efforts. CAT simulations demonstrated that these IBs were efficient, especially when the stopping rule was set at moderate precision, and support the implementation of the SHAWS IBs into routine clinical care. [ABSTRACT FROM AUTHOR]

Background: Protein phosphatase 2 regulatory subunit B' Delta (PPP2R5D)-related neurodevelopmental disorder is a rare genetic condition caused by pathogenic variants in the PPP2R5D gene. Clinical signs include hypotonia, gross motor delay, intellectual disability (ID), epilepsy, speech delays, and abnormal gait among other impairments. As this disorder was recognized within the last decade, there are only 103 people published diagnoses to date. A thorough understanding of the motor manifestations of this disorder has not yet been established. Knowledge of the natural history of PPP2R5D related neurodevelopmental disorder will lead to improved standard of care treatments as well as serve as a baseline foundation for future clinical trials. Appropriate outcome measures are necessary for use in clinical trials to uniformly measure function and monitor potential for change. The aim of this study was to validate the gross motor function measure (GMFM) in children and adults with PPP2R5D-related neurodevelopmental disorder in order to better characterize the disorder. Results: Thirty-eight individuals with PPP2R5D pathogenic variants, median age 8.0 years (range 1–27) were evaluated. Gross motor, upper limb and ambulatory function were assessed using the GMFM-66, six-minute walk test (6MWT), 10-meter walk run (10MWR), timed up and go (TUG), and revised upper limb module (RULM). The pediatric disability inventory computer adapted test (PEDI-CAT) captured caregiver reported assessment. Median GMFM-66 score was 60.6 (SD = 17.3, range 21.1–96.0). There were strong associations between the GMFM-66 and related mobility measures, 10MWR (rs = −0.733; p < 0.001), TUG (rs= −0.747; p = 0.003), 6MWT (r = 0.633; p = 0.006), RULM (r = 0.763; p < 0.001), PEDICAT-mobility (r = 0.855; p < 0.001), and daily activities (r = 0.822; p < 0.001) domains. Conclusions: The GMFM is a valid measure for characterizing motor function in individuals with PPP2R5D related neurodevelopmental disorder. The GMFM-66 had strong associations with the RULM and timed function tests which characterized gross motor, upper limb and ambulatory function demonstrating concurrent validity. The GMFM-66 was also able to differentiate between functional levels in PPP2R5D related neurodevelopmental disorder demonstrating discriminant validity. Future studies should examine its sensitivity to change over time, ability to identify sub-phenotypes, and suitability as an outcome measure in future clinical trials in individuals with PPP2R5D variants. [ABSTRACT FROM AUTHOR]

Background. The deterministic fiber tracking method has the advantage of high computational efficiency and good repeatability, making it suitable for the noninvasive estimation of brain structural connectivity in clinical fields. To address the issue of the current classical deterministic method tending to deviate in the tracking direction in the region of crossing fiber region, in this paper, we propose an adaptive correction-based deterministic white matter fiber tracking method, named FTACTD. Methods. The proposed FTACTD method can accurately track white matter fibers by adaptively adjusting the deflection direction strategy based on the tensor matrix and the input fiber direction of adjacent voxels. The degree of correction direction changes adaptively according to the shape of the diffusion tensor, mimicking the actual tracking deflection angle and direction. Furthermore, both forward and reverse tracking techniques are employed to track the entire fiber. The effectiveness of the proposed method is validated and quantified using both simulated and real brain datasets. Various indicators such as invalid bundles (IB), valid bundles (VB), invalid connections (IC), no connections (NC), and valid connections (VC) are utilized to assess the performance of the proposed method on simulated data and real diffusion-weighted imaging (DWI) data. Results. The experimental results of the simulated data show that the FTACTD method tracks outperform existing methods, achieving the highest number of VB with a total of 13 bundles. Additionally, it identifies the least number of incorrect fiber bundles, with only 32 bundles identified as wrong. Compared to the FACT method, the FTACTD method reduces the number of NC by 36.38%. In terms of VC, the FTACTD method surpasses even the best performing SD_Stream method among deterministic methods by 1.64%. Extensive in vivo experiments demonstrate the superiority of the proposed method in terms of tracking more accurate and complete fiber paths, resulting in improved continuity. Conclusion. The FTACTD method proposed in this study indicates superior tracking results and provides a methodological basis for the investigating, diagnosis, and treatment of brain disorders associated with white matter fiber deficits and abnormalities. [ABSTRACT FROM AUTHOR]

The Patient-Reported Outcome Measurement Information System (PROMIS) pediatric measures assess physical, emotional, and social health among children and adolescents. However, their measurement properties have not been systematically examined in youth with chronic pain. A systematic review applying the COnsensus based Standards for the selection of health Measurement INstruments (COSMIN) methodology was conducted to evaluate self-reported PROMIS pediatric measures in youth with chronic pain, assessing 8 measurement properties across all versions (item bank, short form, and computer adaptive testing) from 63 studies covering 25 measures. Moderate or high-quality evidence was most available for content validity, structural validity, internal consistency (measurement precision), and construct validity. Four short-form PROMIS pediatric measures--mobility, anxiety, depressive symptoms, and physical stress experiences--achieved recommendation for the use in chronic pain clinical trials; 7 approached recommendation and 14, including the commonly used PROMIS Pediatric Pain Interference Scale, would be recommended with further evidence. Recommendations were also provided for the use of each measure in observational studies. Overall, based on the existing evidence, a total of 11 self-reported PROMIS pediatric short-form measures, including pain intensity, pain behavior, mobility, sleep disturbance, sleep-related impairment, anxiety, depressive symptoms, psychological stress experiences, physical stress experiences, family relationships, and positive effect, are recommended or approaching recommendation for use in youth ages 8 to 19 years with chronic pain. Research is needed to further establish test--retest reliability, measurement errors, cross-cultural validity, and responsiveness. Future work should expand the evaluation of PROMIS pediatric measures in subpopulations of youth with chronic pain, particularly young children and those with neurodevelopmental disabilities. [ABSTRACT FROM AUTHOR]

Objective: Most neuropsychological tests were developed without the benefit of modern psychometric theory. We used item response theory (IRT) methods to determine whether a widely used test – the 26-item Matrix Reasoning subtest of the WAIS-IV – might be used more efficiently if it were administered using computerized adaptive testing (CAT). Method: Data on the Matrix Reasoning subtest from 2197 participants enrolled in the National Neuropsychology Network (NNN) were analyzed using a two-parameter logistic (2PL) IRT model. Simulated CAT results were generated to examine optimal short forms using fixed-length CATs of 3, 6, and 12 items and scores were compared to the original full subtest score. CAT models further explored how many items were needed to achieve a selected precision of measurement (standard error ≤.40). Results: The fixed-length CATs of 3, 6, and 12 items correlated well with full-length test results (with r =.90,.97 and.99, respectively). To achieve a standard error of.40 (approximate reliability =.84) only 3–7 items had to be administered for a large percentage of individuals. Conclusions: This proof-of-concept investigation suggests that the widely used Matrix Reasoning subtest of the WAIS-IV might be shortened by more than 70% in most examinees while maintaining acceptable measurement precision. If similar savings could be realized in other tests, the accessibility of neuropsychological assessment might be markedly enhanced, and more efficient time use could lead to broader subdomain assessment. [ABSTRACT FROM AUTHOR]

Purpose: The study aimed to explore how memory distrust impacts two kinds of suggestibility: misinformation effect (Experiment 1) and interrogative suggestibility (Experiment 2). We verified whether recognizing discrepancies between personal memories and externally suggested information, along with certain individual differences, moderates the memory distrust‐suggestibility link. Methods: Experiment 1 (N = 306) followed a classic three‐step procedure with a discrepancy awareness test. In Experiment 2 (N = 316) a computerized version of the Gudjonsson Suggestibility Scale with a discrepancy awareness test was utilized. Both experiments manipulated the state of memory distrust and assessed participants' trait memory distrust, compliance, anxiety and self‐esteem. Results: While the effect of memory deterioration due to misinformation and suggestions was replicated, the hypotheses regarding the relationship between memory distrust and suggestibility were not confirmed. However, for interrogative suggestibility, individuals induced to doubt their own memory were more susceptible to suggestions when recognizing inconsistencies between the story and suggestive questions. Conclusions: From the theoretical side, the concept of memory distrust appears to be useful to explain the reasons for succumbing to suggestions. However, our findings indicate that memory distrust toward committing omission errors and the experimentally induced state appear unrelated (misinformation effect paradigm) or marginally related (memory distrust state and interrogative suggestibility) to the tendency to yield to suggestions. This prompts further research using a different operationalisation of this construct. [ABSTRACT FROM AUTHOR]

Purpose: To investigate potential reasons for the mismatch between laboratory/ clinic-based sentence-in-noise performance and real-world listening abilities, we recently developed a corpus of natural, spontaneously spoken speech with three vocal effort levels (Everyday Conversational Sentences in Noise [ECOSiN]). Here, we examined the feasibility of using the ECO-SiN corpus for adaptive speech-in-noise testing, which might be a desirable format in certain situations (e.g., during a clinical visit). Method: Ten young, normal-hearing adults, along with 20 older adults with hearing loss participated in the study. Speech reception thresholds (SRTs) were obtained using ECO-SiN sentences, which were systematically compared to the SRTs obtained using traditional Bamford-Kowal-Bench-like sentences. Results: Results demonstrated the properties of the test compared favorably with those of a standard test based on scripted and clearly spoken sentences. Moreover, whereas normal-hearing listeners received a benefit from an increase in vocal effort, the participants with hearing loss showed a disbenefit that increased with increasing hearing loss. Conclusion: The adaptive version of the ECO-SiN test is feasible for research and clinical testing. [ABSTRACT FROM AUTHOR]

Purpose: To compare the patient-reported outcomes between patients with posterior cruciate ligament (PCL) reconstruction or repair alone versus PCL reconstruction or repair with internal bracing (IB) in the context of multi-ligament knee injuries (MLKI). Methods: All patients who underwent surgical management of MLKI at two institutions between 2006 and 2020 were retrospectively identified and offered participation in the study. Patient reported outcomes were measured via three instruments: Lysholm Knee score, Multiligament Quality of Life (ML-QOL), and the Patient-Reported Outcomes Measurement Information System (PROMIS) computer adaptive testing (CAT). The postoperative outcomes and reoperation rates were compared between the internal bracing and non-internal bracing groups. Results: Fifty-two patients were analyzed; 34 were included in the IB group (17.6% female; age 33.1 ± 1.60 years), and 18 were included in the non-IB group (11.1% female; age 34.1 ± 3.72 years). Mean follow-up time of the entire cohort was 1.44 ± 0.22 years (IB: 1.21 ± 0.18; non-IB: 2.1 ± 0.65). There were no significant differences between PROMIS CAT [PROMIS Pain (54.4 ± 1.78 vs 51.7 ± 1.70, p=0.319), Physical Function (44.3 ± 2.27 vs 47.9 ± 1.52, p=0.294), Mobility (44.0 ± 1.71 vs 46.1 ± 2.10, p=0.463)], ML-QOL [ML-QOL Physical Impairment (40.7 ± 4.21 vs 41.7± 5.10, p=0.884), Emotional Impairment (49.2 ± 4.88 vs 44.7± 5.87, p=0.579), Activity Limitation (43.5 ± 4.56 vs 31.5± 3.62, p=0.087), Societal Involvement (44.9 ± 4.96 vs 37.5 ± 5.30, p=0.345)] and Lysholm knee score (61.8 ± 4.55 vs 61.0 ± 4.95, p=0.916) postoperatively compared to the non-IB group. Conclusion: In this group of patients, function and patient-reported outcomes between patients treated with PCL reconstruction and repair without internal brace versus those with additional internal brace augmentation were not significantly different. Further research encompassing a larger patient sample is necessary to investigate the efficacy of the internal brace for PCL injury in the context of MLKI injuries. [ABSTRACT FROM AUTHOR]