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    Development and Simulation Testing of a Computerized Adaptive Measure of Communicative Functioning in Aphasia

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    Computerized adaptive testing (CAT), based on the mathematical framework of item response theory (IRT), has increasingly been implemented in patient reported outcome measures over the past decade (Fries, Bruce, & Cella, 2005). Given a calibrated item pool fit by an appropriate IRT measurement model, a CAT can produce reliable ability estimates more efficiently than traditional paper-and-pencil tests by administering items that are most informative given the examinee’s estimated ability level (Wainer, 2000). As conventional measures employed in the measurement of aphasia were developed under traditional measurement theory, many of these measures are long and inefficient, and are consequently unsuitable for regular clinical care. In addition, these conventional measures often fail to meet the needs of many community-dwelling stroke survivors whose impairments falls outside the range reliably measured by these tests (Doyle et al. 2012). IRT-based and in particular CAT patient reported outcome measures offer the possibility of substantial improvements in measurement technology for persons with aphasia
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