title: Sensitivity of a computer adaptive assessment for measuring functional mobility changes in children enrolled in a community fitness programme.
abstract: OBJECTIVE
  To examine the relative sensitivity to detect functional mobility changes with a full-length parent questionnaire compared with a computerized adaptive testing version of the questionnaire after a 16-week group fitness programme.
  
  
  METHODS
  Prospective, pre- and posttest study with a 16-week group fitness intervention.
  
  
  METHODS
  Three community-based fitness centres.
  
  
  METHODS
  Convenience sample of children (n = 28) with physical or developmental disabilities.
  
  
  METHODS
  A 16-week group exercise programme held twice a week in a community setting.
  
  
  METHODS
  A full-length (161 items) paper version of a mobility parent questionnaire based on the Pediatric Evaluation of Disability Inventory, but expanded to include expected skills of children up to 15 years old was compared with a 15-item computer adaptive testing version. Both measures were administered at pre- and posttest intervals.
  
  
  RESULTS
  Both the full-length Pediatric Evaluation of Disability Inventory and the 15-item computer adaptive testing version detected significant changes between pre- and posttest scores, had large effect sizes, and standardized response means, with a modest decrease in the computer adaptive test as compared with the 161-item paper version. Correlations between the computer adaptive and paper formats across pre- and posttest scores ranged from r = 0.76 to 0.86.
  
  
  CONCLUSIONS
  Both functional mobility test versions were able to detect positive functional changes at the end of the intervention period. Greater variability in score estimates was generated by the computerized adaptive testing version, which led to a relative reduction in sensitivity as defined by the standardized response mean. Extreme scores were generally more difficult for the computer adaptive format to estimate with as much accuracy as scores in the mid-range of the scale. However, the reduction in accuracy and sensitivity, which did not influence the group effect results in this study, is counterbalanced by the large reduction in testing burden.
authors.affiliation: Health and Disability Research Institute, 53 Bay State Road, Boston University, Boston, MA 02215, USA. smhaley@bu.edu
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Haley
authors.forename: Maria
authors.initials: M
authors.lastname: Fragala-Pinkham
authors.forename: Pengsheng
authors.initials: P
authors.lastname: Ni
mesh_terms: D000293:Adolescent; D001185:Artificial Intelligence; D002648:Child; D003936:Diagnosis, Computer-Assisted; D004185:Disability Evaluation; D019988:Children with Disabilities / Q000534:rehabilitation*; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D010290:Parents; D010809:Physical Fitness; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires