Dear Editor
Multiple-choice tests are the most common type of tests used to evaluate medical education. These tests have long been used in the written format for specialized boards and residency promotion tests in Iran and Kermanshah University of Medical Sciences (KUMS) (1). Multiple-choice tests are being analyzed using quantitative method (test level, difficulty level and discrimination level) and qualitative method (percentage of items free from structural problems and taxonomy of cognitive domain) (2).
The most common method of analyzing structural problems of multiple-choice items is using Millman table which determines the construct validity of each item. Disregarding the testing principles by test makers can cause difficulty or ease of items, which directly affects the validity and difficulty and discrimination levels (3).