Abstract
Objective
To evaluate the internal construct validity and dimensionality of a new patient-reported
outcome measure for people with traumatic brachial plexus injury (BPI) based on the
International Classification of Functioning, Disability and Health definition of activity.
Design
Cross-sectional study.
Setting
Outpatient clinics.
Participants
Adults (age range, 18–82y) with a traumatic BPI (N=106).
Interventions
There were 106 people with BPI who completed a 51-item 5-response questionnaire. Responses
were analyzed in 4 phases (missing responses, item correlations, exploratory factor
analysis, and Rasch analysis) to evaluate the properties of fit to the Rasch model,
threshold response, local dependency, dimensionality, differential item functioning,
and targeting.
Main Outcome Measures
Not applicable, as this study addresses the development of an outcome measure.
Results
Six items were deleted for missing responses, and 10 were deleted for high interitem
correlations >.81. The remaining 35 items, while demonstrating fit to the Rasch model,
showed evidence of local dependency and multidimensionality. Items were divided into
3 subscales: dressing and grooming (8 items), arm and hand (17 items), and no hand
(6 items). All 3 subscales demonstrated fit to the model with no local dependency,
minimal disordered thresholds, no unidimensionality or differential item functioning
for age, time postinjury, or self-selected dominance. Subscales were combined into
3 subtests and demonstrated fit to the model, no misfit, and unidimensionality, allowing
calculation of a summary score.
Conclusions
This preliminary analysis supports the internal construct validity of the Brachial
Assessment Tool, a unidimensional targeted 4-response patient-reported outcome measure
designed to solely assess activity after traumatic BPI regardless of level of injury,
age at recruitment, premorbid limb dominance, and time postinjury. Further examination
is required to determine test-retest reliability and responsiveness.
Keywords
List of abbreviations:
BPI (brachial plexus injury), BrAT (Brachial Assessment Tool), DASH (Disabilities of the Arm, Shoulder, and Hand), DIF (differential item functioning), ICF (International Classification of Functioning, Disability and Health), PROM (patient-reported outcome measure)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: July 29, 2016
Footnotes
Disclosures: none.
Identification
Copyright
© 2016 by the American Congress of Rehabilitation Medicine
