Multidimensional Computerized Adaptive Testing: A Potential Path Toward the Efficient and Precise Assessment of Applied Cognition, Daily Activity, and Mobility for Hospitalized Patients

Termination Criteria for Grid Multiclassification Adaptive Testing With Multidimensional Polytomous Items

Adaptive classification testing (ACT) is a variation of computerized adaptive testing (CAT) that is developed to efficiently classify examinees into multiple groups based on predetermined cutoffs. In multidimensional multiclassification (i.e., more than two categories exist along each dimension), grid classification is proposed to classify each examinee into one of the grids encircled by cutoffs (lines/surfaces) along different dimensions so as to provide clearer information regarding an examinee's relative standing along each dimension and facilitate subsequent treatment and intervention. In this article, the sequential probability ratio test (SPRT) and confidence interval method were implemented in the grid multiclassification ACT. In addition, two new termination criteria, the grid classification generalized likelihood ratio (GGLR) and simplified grid classification generalized likelihood ratio were proposed for grid multiclassification ACT. Simulation studies, using a simulated item bank, and a real item bank with polytomous multidimensional items, show that grid multiclassification ACT is more efficient than classification based on measurement CAT that focuses on trait estimate precision. In the context of a high-quality bank, GGLR was found to most efficiently terminate the grid multiclassification ACT and classify examinees.