ORIGINAL RESEARCH| Volume 102, ISSUE 11, P2157-2164.e1, November 2021

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Linking AM-PAC Cognition to PROMIS Cognitive Function



      To link the Activity Measure for Post-Acute Care (AM-PAC) Applied Cognition to the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function, allowing for a common metric across scales.


      Cross-sectional survey study.


      Outpatient rehabilitation clinics.


      Consecutive sample of 500 participants (N=500) aged ≥18 years presenting for outpatient therapy (physical, occupation, speech).


      Not applicable.

      Main Outcome Measures

      AM-PAC Medicare and Generic Cognition short forms and PROMIS Cognitive Function items representing the PROMIS Cognitive Function item bank.


      The calibration of 25 AM-PAC cognition items with 11 fixed PROMIS cognitive function item parameters using item-response theory indicated that items were measuring the same underlying construct (cognition). Both scales measured a wide range of functioning. The AM-PAC Generic Cognitive assessment showed more reliability with lower levels of cognition, whereas the PROMIS Cognitive Function full-item bank was more reliable across a larger distribution of scores. Data were appropriate for a fixed-anchor item response theory–based crosswalk and AM-PAC Cognition raw scores were mapped onto the PROMIS metric.


      The crosswalk developed in this study allows for converting scores from the AM-PAC Applied Cognition to the PROMIS Cognitive Function scale.


      List of abbreviations:

      AM-PAC (Activity Measure for Post-Acute Care), GRM (graded response model), IRT (item response theory), PROMIS (Patient-Reported Outcomes Measurement Information System), REDCap (Research Electronic Data Capture)
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