Creating a common metric based on existing activities of daily living tools to enable standardized reporting of functioning outcomes achieved during rehabilitation
Roxanne Maritz, Alan Tennant, Carolina Fellinghauer, Gerold Stucki, Birgit Prodinger
Swiss Paraplegic Research, 6207 Nottwil, Switzerland
Objective: Many different assessment tools are used to assess functioning in rehabilitation; this limits the comparability and aggregation of respective data. The aim of this study was to outline the development of an International Classification of Functioning, Disability and Health (ICF)-based interval-scaled common metric for 2 assessment tools assessing activities of daily living: the Functional Independence Measure (FIMTM) and the Extended Barthel Index (EBI), used in Swiss national rehabilitation quality reports.
Methods: The conceptual equivalence of the 2 tools was assessed through their linking to the ICF. The Rasch measurement model was then applied to create a common metric including FIMTM and EBI.
Subjects: Secondary analysis of a sample of 265 neurological patients from 5 Swiss clinics.
Results: ICF linking found conceptual coherency of the tools. An interval-scaled common metric, including FIMTM and EBI, could be established, given fit to the Rasch model in the related analyses.
Conclusion: The ICF-based and interval-scaled common metric enables comparison of patients and clinics functioning outcomes when different activities of daily living tools are used. The common metric can be included in a Standardized Assessment and Reporting System for functioning information in order to enable data aggregation and comparability.
In our study we developed a common metric serving as a neutral comparator of two assessment tools which are used for assessing activities of daily living in rehabilitation patients in Switzerland. This common metric enables clinicians to use different established assessment tools assessing the same information, while being able to compare the respective information from those different scales on a larger level e.g. comparisons across clinics using different tools. This study is based on the example of Switzerland, where rehabilitation clinics can choose one of two measurement tools assessing activities of daily living, to report their outcome quality. With the common metric, the results from all the clinics can be compared with each other, no matter what tool was used for the assessment, enabling learning and improvement processes.
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