Creating a common metric based on existing activities of daily living tools to enable standardized reporting of functioning outcomes achieved during rehabilitation

Abstract

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.

Keywords

• outcome assessment (healthcare)
• psychometrics
• rehabilitation
• activities of daily living
• rasch measurement model
• functional independence measure
• barthel index
• quality in healthcare.