Questionnaires to detect emotional and behavioral problems (EBP) in Preventive Child Healthcare (PCH) should be short which potentially affects validity and reliability. Simulation studies have shown that Computerized Adaptive Testing (CAT) could overcome these weaknesses. We studied the applicability (using the measures participation rate, satisfaction, and efficiency) and the validity of CAT in routine PCH practice. We analyzed data on 461 children aged 10–11 years (response 41%), who were assessed during routine well-child examinations by PCH professionals. Before the visit, parents completed the CAT and the Child Behavior Checklist (CBCL). Satisfaction was measured by parent- and PCH professional-report. Efficiency of the CAT procedure was measured as number of items needed to assess whether a child has serious problems or not. Its validity was assessed using the CBCL as the criterion. Parents and PCH professionals rated the CAT on average as good. The procedure required at average 16 items to assess whether a child has serious problems or not. Agreement of scores on the CAT scales with corresponding CBCL scales was high (range of Spearman correlations 0.59–0.72). Area Under Curves (AUC) were high (range: 0.95–0.97) for the Psycat total, externalizing, and hyperactivity scales using corresponding CBCL scale scores as criterion. For the Psycat internalizing scale the AUC was somewhat lower but still high (0.86). CAT is a valid procedure for the identification of emotional and behavioral problems in children aged 10–11 years. It may support the efficient and accurate identification of children with overall, and potentially also specific, emotional and behavioral problems in routine PCH.

中文翻译：

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通过预防性儿童保健，对儿童进行情感和行为问题筛查的计算机自适应测试

预防儿童保健（PCH）中用于检测情绪和行为问题（EBP）的调查表应简短，这可能会影响有效性和可靠性。仿真研究表明，计算机自适应测试（CAT）可以克服这些弱点。我们研究了常规PCH实践中CAT的适用性（使用参与率，满意度和效率）。我们分析了461名10-11岁儿童（占41％）的数据，这些数据是由PCH专业人士在例行的儿童健康检查中评估的。探视之前，父母必须完成CAT和儿童行为清单（CBCL）。满意度是通过家长和PCH专业报告来衡量的。评估CAT程序的效率是评估孩子是否有严重问题所需的项目数量。使用CBCL作为标准评估其有效性。家长和PCH专业人员平均将CAT评为好。该程序平均需要16个项目来评估孩子是否有严重问题。CAT量表的分数与相应的CBCL量表的一致性很高（Spearman相关性范围为0.59–0.72）。使用相应的CBCL量表评分作为标准，Psycat总体，外在和活动过度量表的曲线下面积（AUC）较高（范围：0.95-0.97）。对于Psycat内部化规模，AUC较低，但仍较高（0.86）。CAT是识别10-11岁儿童情绪和行为问题的有效程序。它可以支持对儿童进行有效，准确的识别，使他们具有整体的，甚至可能是特定的，