Original Paper

Quality of Life Research

, Volume 16, Supplement 1, pp 109-119

First online:

Methodological issues for building item banks and computerized adaptive scales

  • David ThissenAffiliated withUniversity of North Carolina at Chapel Hill Email author 
  • , Bryce B. ReeveAffiliated withNational Cancer Institute, NIH
  • , Jakob Bue BjornerAffiliated withQualityMetric IncHealth Assessment Lab
  • , Chih-Hung ChangAffiliated withNorthwestern University Feinberg School of Medicine

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This paper reviews important methodological considerations for developing item banks and computerized adaptive scales (commonly called computerized adaptive tests in the educational measurement literature, yielding the acronym CAT), including issues of the reference population, dimensionality, dichotomous versus polytomous response scales, differential item functioning (DIF) and conditional scoring, mode effects, the impact of local dependence, and innovative approaches to assessment using CATs in health outcomes research.


Item bank Computerized adaptive scale Computerized adaptive test Item response theory Dimensionality assessment Differential item functioning Local dependence