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Multistage adaptive testing (MST) has become one of the most popular test designs for large-scale testing. However, it has some weaknesses such as a larger estimation bias compared to computerized adaptive testing (CAT). On-the-fly multistage adaptive testing (OMST) can balance the advantages and limitations of CAT and MST. Several CAT item selection methods that incorporate RT have been proposed. However, incorporating RT into OMST to select items was rarely studied. The study explored the possibility of applying OMST with RT to the large-scale test to solve the issue of large estimation bias and improve test efficiency. A simulation study was conducted, and results suggested that OMST incorporating RT was more accurate and efficient in estimating examinees’ abilities than MST.