FIM–Minimum Data Set Motor Item Bank: Short Forms Development and Precision Comparison in Veterans



      To improve the practical use of the short forms (SFs) developed from the item bank, we compared the measurement precision of the 4- and 8-item SFs generated from a motor item bank composed of the FIM and the Minimum Data Set (MDS).


      The FIM-MDS motor item bank allowed scores generated from different instruments to be co-calibrated. The 4- and 8-item SFs were developed based on Rasch analysis procedures. This article compared person strata, ceiling/floor effects, and test SE plots for each administration form and examined 95% confidence interval error bands of anchored person measures with the corresponding SFs. We used 0.3 SE as a criterion to reflect a reliability level of .90.


      Veterans' inpatient rehabilitation facilities and community living centers.


      Veterans (N=2500) who had both FIM and the MDS data within 6 days during 2008 through 2010.


      Not applicable.

      Main Outcome Measures

      Four- and 8-item SFs of FIM, MDS, and FIM-MDS motor item bank.


      Six SFs were generated with 4 and 8 items across a range of difficulty levels from the FIM-MDS motor item bank. The three 8-item SFs all had higher correlations with the item bank (r=.82-.95), higher person strata, and less test error than the corresponding 4-item SFs (r=.80-.90). The three 4-item SFs did not meet the criteria of SE <0.3 for any theta values.


      Eight-item SFs could improve clinical use of the item bank composed of existing instruments across the continuum of care in veterans. We also found that the number of items, not test specificity, determines the precision of the instrument.


      List of abbreviations:

      CI (confidence interval), IRT (item response theory), MDS (Minimum Data Set), PAC (postacute care), SF (short form), SNF (skilled nursing facility), VA (Veterans Administration)
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        • Li C.Y.
        • Romero R.
        • Bonilha H.
        • et al.
        Linking existing instruments to develop an activity of daily living item bank.
        Eval Health Prof. 2016; : 1-19
      1. Department of Veterans Affairs. Physical medicine and rehabilitation outcomes for acute stroke, traumatic brain injury, and lower-extremity amputation patients. Veterans Health Administration Directive 2011-017. Washington: Department of Veterans Affairs.

      2. Department of Veterans Affairs. Rehabilitation continuum of care. Veterans Health Administration handbook 1170.04. Washington (DC); 2014. Available at: Accessed June 1, 2015.

        • Fisher Jr., W.P.
        Physical disability constructs convergence across instruments: towards a universal metric.
        J Outcome Meas. 1997; 1: 87-113
        • Fisher Jr., W.P.
        • Eubanks R.L.
        • Marier R.L.
        Equating the MOS SF36 and the LSU HSI Physical Functioning Scales.
        J Outcome Meas. 1997; 1: 329-362
        • Fisher Jr., W.P.
        • Harvey R.F.
        • Taylor P.
        • Kilgore K.M.
        • Kelly C.K.
        Rehabits: a common language of functional assessment.
        Arch Phys Med Rehabil. 1995; 76: 113-122
        • Haley S.M.
        • Ni P.
        • Lai J.S.
        • et al.
        Linking the activity measure for post acute care and the quality of life outcomes in neurological disorders.
        Arch Phys Med Rehabil. 2011; 92: S37-S43
        • McHorney C.A.
        Use of item response theory to link three modules of functional status items from the Asset and Health Dynamics among the Oldest Old Study.
        Arch Phys Med Rehabil. 2002; 83: 383-394
        • McHorney C.A.
        • Cohen A.S.
        Equating health status measures with item response theory: illustrations with functional status items.
        Med Care. 2000; 38: 43-59
        • Smith R.M.
        • Taylor P.A.
        Equating rehabilitation outcome scales: developing common metrics.
        J Appl Meas. 2004; 5: 229-242
        • Ten Klooster P.M.
        • Oude Voshaar M.A.
        • Gandek B.
        • et al.
        Development and evaluation of a crosswalk between the SF-36 physical functioning scale and Health Assessment Questionnaire disability index in rheumatoid arthritis.
        Health Qual Life Outcomes. 2013; 11: 199
        • Velozo C.A.
        • Byers K.L.
        • Wang Y.C.
        • Joseph B.R.
        Translating measures across the continuum of care: using Rasch analysis to create a crosswalk between the Functional Independence Measure and the Minimum Data Set.
        J Rehabil Res Dev. 2007; 44: 467-478
        • Wang Y.C.
        • Byers K.L.
        • Velozo C.A.
        Validation of FIM™-MDS crosswalk conversion algorithm.
        J Rehabil Res Dev. 2008; 45: 1065-1076
        • Ware Jr., J.E.
        • Kosinski M.
        • Keller S.D.
        A 12-Item Short-Form Health Survey: construction of scales and preliminary tests of reliability and validity.
        Med Care. 1996; 34: 220-233
        • Cella D.
        • Gershon R.
        • Lai J.S.
        • Choi S.
        The future of outcomes measurement: item banking, tailored short-forms, and computerized adaptive assessment.
        Qual Life Res. 2007; 16: 133-141
        • Ware Jr., J.E.
        • Sherbourne C.D.
        The MOS 36-Item Short-Form Health Survey (SF-36). I. Conceptual framework and item selection.
        Med Care. 1992; 30: 473-483
        • Shrout D.
        • Yager T.J.
        Reliability and validity of screening scales: effect of reducing scale length.
        J Clin Epidemiol. 1989; 42: 69-78
        • Haley S.M.
        • Coster W.J.
        • Andres P.L.
        • Kosinski M.
        • Ni P.
        Score comparability of short forms and computerized adaptive testing: simulation study with the activity measure for post-acute care.
        Arch Phys Med Rehabil. 2004; 85: 661-666
        • Fries J.F.
        • Cella D.
        • Rose M.
        • Krishnan E.
        • Bruce B.
        Progress in assessing physical function in arthritis: PROMIS short forms and computerized adaptive testing.
        J Rheumatol. 2009; 36: 2061-2066
        • National Association for the Support of Long Term Care
        Re: proposed rule, Medicare program; prospective payment system and consolidated billing for skilled nursing facilities FY 2016, SNF value-based purchasing program, SNF quality reporting program, and staffing data collection; proposed rule.
        Fed Regist. 2015; 80 (April 20, 2015. CMS-1622-P. Available at:) (Accessed June 17, 2016)
        • Artieda-Urrutia P.
        • Delgado-Gómez D.
        • Ruiz-Hernández D.
        • et al.
        Short Personality and Life Event scale for detection of suicide attempters.
        Rev Psiquiatr Salud Ment. 2015; 8: 199-206
        • Bukstein D.A.
        • McGrath M.M.
        • Buchner D.A.
        • Landgraf J.
        • Goss T.F.
        Evaluation of a short form for measuring health-related quality of life among pediatric asthma patients.
        J Allergy Clin Immunol. 2000; 105: 245-251
        • Andrich D.
        Controversy and the Rasch model: a characteristic of incompatible paradigms?.
        Med Care. 2004; 42: I7-I16
        • Haley S.M.
        • Andres P.L.
        • Coster W.J.
        • Kosinski M.
        • Ni P.
        • Jette A.M.
        Short-form activity measure for post-acute care.
        Arch Phys Med Rehabil. 2004; 85: 649-660
        • Ornstein K.A.
        • Teresi J.A.
        • Ocepek-Welikson K.
        • et al.
        Use of an item bank to develop two short-form FAMCARE scales to measure family satisfaction with care in the setting of serious illness.
        J Pain Symptom Manage. 2015; 49 (e1-e4): 894-903
        • Rose M.
        • Bjorner J.B.
        • Becker J.
        • Fries J.F.
        • Ware J.E.
        Evaluation of a preliminary physical function item bank supported the expected advantages of the Patient-Reported Outcomes Measurement Information System (PROMIS).
        J Clin Epidemiol. 2008; 61: 17-33
        • Yu L.
        • Buysse D.J.
        • Germain A.
        • et al.
        Development of short forms from the PROMIS™ Sleep Disturbance and Sleep-Related Impairment item banks.
        Behav Sleep Med. 2011; 10: 6-24
        • del Toro C.M.
        • Bislick L.P.
        • Comer M.
        • et al.
        Development of a short form of the Boston naming test for individuals with aphasia.
        J Speech Lang Hear Res. 2011; 54: 1089-1100
        • Hsieh Y.W.
        • Hsueh I.P.
        • Chou Y.T.
        • Sheu C.F.
        • Hsieh C.L.
        • Kwakkel G.
        Development and validation of a short form of the Fugl-Meyer motor scale in patients with stroke.
        Stroke. 2007; 38: 3052-3054
        • Wright B.D.
        • Stone M.H.
        Best test design.
        MESA Press, Chicago1979
        • Embretson S.
        • Reise S.
        Item response theory for psychologists.
        Lawrence Erlbaum Associates, Mahwah2000
        • Wang J.
        A new method for estimating effective population sizes from a single sample of multilocus genotypes.
        Mol Ecol. 2009; 18: 2148-2164
        • Granger C.V.
        • Hamilton B.B.
        • Keith R.A.
        • Zielezny M.
        • Sherwin F.S.
        Advances in functional assessment for medical rehabilitation.
        Top Geriatr Rehabil. 1986; 1: 59-74
        • Keith R.A.
        • Granger C.V.
        • Hamilton B.B.
        • Sherwin F.S.
        The Functional Independence Measure: a new tool for rehabilitation.
        Adv Clin Rehabil. 1987; 1: 6-18
        • Morris J.N.
        • Hawes C.
        • Fries B.E.
        • et al.
        Designing the national resident assessment instrument for nursing homes.
        Gerontologist. 1990; 30: 293-307
        • Mukaka M.M.
        Statistics corner: a guide to appropriate use of correlation coefficient in medical research.
        Malawi Med J. 2012; 24: 69-71
        • Masters G.N.
        Common person equating with the Rasch model.
        Appl Psychol Meas. 1985; 9: 73-82
        • McHorney C.A.
        • Tarlov A.R.
        Individual-patient monitoring in clinical practice: are available health status surveys adequate?.
        Qual Life Res. 1995; 4: 293-307