Computer Adaptive Tests (CATs)
Types of CATs
For some domains, multiple types of CATs are available.
CAT
- Items from an item bank (a large collection of items) are dynamically selected for administration based on a person’s previous answers.
- Between 4-12 items administered with a high level of measurement precision (low error).
- Produces one score.
- Stops based on specific stopping rules (e.g., minimum and maximum items to administer).
“Recommended” CAT
- Uses slightly different rules for selecting items and stopping the CAT that make them briefer and very precise.
- Between 4-8 items administered with a high level of measurement precision (low error).
- Available for some adult PROMIS® domains.
- Identified by the word “recommended” in the measure name.
Screen-to-CAT
- Uses the first item as a screener to determine if the respondent should continue with the rest of the CAT.
- Ends for respondents who answer with the healthiest response.
- Continues for respondents who answer the first item with any other response.
- All respondents receive a score.
- Based on the same item bank as the standard CAT.
- Respondents answer 1-8 items.
Profile CAT
- A fixed collection of CATs from multiple domains.
- Produces one score for each domain.
Recommended PROMIS® CATs for Core Domains
All of the PROMIS CATs for core domains are great choices to use. For the adult PROMIS core domains there are standard CATs and “recommended” CATs. Recommended CATs are identified by the word “recommended” in the measure name. They use slightly different rules for selecting items and stopping the CAT that make them briefer and very precise. When there is more than one CAT, use the CAT named “recommended.”
- View the adult PROMIS CATs for core domains here.
- View the pediatric self-report PROMIS CATs for core domains here.
- View the parent proxy report PROMIS CATs for core domains here.
For comprehensive measurement across 7 core domains, use the PROMIS Profile CAT v1.0 – 29. This Profile CAT provides the advantages of CATs with only 29 items across 7 domains (Ability to Participate in Social Roles & Activities, Anxiety, Depression, Fatigue, Pain Interference, Physical Function, Sleep Disturbance) plus one pain intensity item.
Recommended PROMIS CATs for Additional Domains
All of the PROMIS CATs for additional PROMIS domains are great choices to use. In most cases, only one CAT is available per domain. Use it!
When to Use CATs and Screen-to-CATs
CATs
- Good for screening (e.g., screen patients for depression).
- Good when evaluating an individual person such as monitoring a patient as part of their care.
- Good for comparing large groups to each other (like those with more than 75 people in each subgroup).
- Good for comparing small groups to each other (like those with 50-75 people in each subgroup).
Screen-to-CATs
- Good for when you want to precisely measure symptomatic individuals but don’t need as precise a measure for asymptomatic individuals.
- Good for when assessment time is very limited.
Recommended Neuro-QoL™, NIH Toolbox®, and ASCQ-Me® CATs
All Neuro-QoL, NIH Toolbox, and ASCQ-Me CATs are recommended. These measurement systems have only one CAT per domain. If you know you want a CAT from one of these systems, use the one that is available.
Examples
Monitoring Outcomes in Total Joint Replacement Surgery
A clinic wants to monitor physical function in patients during their first year after total joint replacement surgery. The PROMIS Physical Function “recommended” CAT is the best choice. This offers a brief but very precise measure for all patients.
Screening and Evaluating Depressive Symptoms
A clinic wants to screen their patients to identify those who are experiencing a concerning level of depressive symptoms. For people who are experiencing those symptoms, the clinic would like to gauge the severity of those symptoms (e.g., mild, moderate, severe) to help them decide what follow-up is most appropriate. In this case, the PROMIS Depression Screen-to-CAT is recommended. For individuals who are not experiencing symptoms, the assessment will stop after one item and they will receive a score showing they are in the “within normal limits” range. For individuals who are having any level of depressive symptoms, the CAT will be administered. This will be another 3-7 items. At the end, a very precise score will indicate the severity of their depressive symptoms.
Last updated: September 14, 2026