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In this context, the gap between test-takers' perception of the skills being measured and test developers' intention in developing items is arguably one of the factors that undermines intended positive washback on learning.
Specifically, in the first study, after developing items and examined the content validity, the factorial structure, reliability and discriminant validity of the DMF were tested.
Second, we did not measure health literacy in this phase because we drew upon the responses of a wide range of parents in developing items for the cognitive interview and the subsequent field test.
The same focus groups can review a pool of items collected from prior instruments and aid in developing items that clearly distinguish between dimensions.
At this stage we were over inclusive in developing items from patients' statements.
This data presents the first step in developing items for a disease specific QoL measure for children with OI.
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The main reason for developing item banks is to apply CAT.
Finally, IRT provides the basis for developing item banks and patient-tailored computerized adaptive tests (CATs) [ 9, 19, 20].
As mentioned previously the major US-initiative PROMIS supported by the NIH is developing item banks for major PROs.
The process of developing item banks for PROMIS includes literature review, focus groups, and individual cognitive interviews [ 2- 4].
In addition, the PROMIS project [ 20] is developing item banks for a range of major PROs, for use across multiple fields of medical research.
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