(Reminds me of a really nerdy computer science joke: There are ten kinds of people in this world, those who understand binary and those who don't.)
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You see, I use MS Word to create math test items. Regular, standard-aligned, standardized assessment is a top priority, and so far I haven't found anything to match the power and flexibility of the word processor. I have searched in vain for an adequate database tool, but none has the ability to insert the graphics and equations the way that I'd like. I've used ExamView for more language-based items, but in math, I need to insert graphics and equations as stems and distractors.
So I've designed an elegant little template for my math items to match that of the California Standards Test items.
I keep looking. In the meantime, Word works adequately.