Original research Featured article| Volume 102, ISSUE 1, P106-114, January 2021

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Combining Items From 3 Federally Mandated Assessments Using Rasch Measurement to Reliably Measure Cognition Across Postacute Care Settings

Published:August 01, 2020DOI:



      To combine items from the Functional Independence Measure, Minimum Data Set (MDS) 2.0, and the Outcome and Assessment Information Set (OASIS)-B to reliably measure cognition across postacute care settings and facilitate future studies of patient cognitive recovery.


      Rasch analysis of data from a prospective, observational cohort study.


      Postacute care inclusive of inpatient rehabilitation facilities, skilled nursing facilities, and home health agencies.


      Patients (N=147) receiving rehabilitation services.


      Not applicable.

      Main Outcome Measures

      Functional Independence Measure, MDS 2.0, and the OASIS-B.


      Six cognition items demonstrated good construct validity with no misfitting items, unidimensionality, good precision (person separation reliability, 0.95), and an item hierarchy that reflected a clinically meaningful continuum of cognitive challenge.


      This is the first attempt to combine the cognition items from the 3 historically, federally mandated assessments to create a common metric for cognition. These 6 items could be adopted as standardized patient assessment data elements to improve cognitive assessment across postacute care settings.


      List of abbreviations:

      FIM (Functional Independence Measure), HH (home health), IRF (inpatient rehabilitation facility), LTM (long-term memory), MDS (Minimum Data Set), OASIS (Outcome and Assessment Information Set), PAC (postacute care), SPADE (standardized patient assessment data elements), STM (short-term memory), SNF (skilled nursing facility)
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