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A Concordance Table to Convert FIM Basic Mobility and Self-Care Scale Scores to SCI-FI/AT Scores

Published:August 02, 2021DOI:https://doi.org/10.1016/j.apmr.2021.06.023

      Abstract

      Objective

      To estimate Spinal Cord Injury Functional Index Assistive Technology (SCI-FI/AT) scores from FIM motor items.

      Design

      Secondary data analysis.

      Setting

      Fourteen Spinal Cord Injury Model Systems (SCIMS) programs.

      Participants

      Persons with traumatic spinal cord injury (SCI) discharged from inpatient rehabilitation at 14 SCIMS programs (N=1237).

      Interventions

      Not applicable.

      Main Outcome Measures

      FIM motor items were matched to SCI-FI/AT domains and summary scores for each measure were developed. The kernel-based method was employed to develop a concordance table to estimate SCI-FI/AT domain summary scores from content-matched FIM motor item summary scores. We conducted analyses to compare agreement between actual SCI-FI/AT summary scores (actual SCI-FI/AT_S) and estimated SCI-FI/AT summary scores (est-SCI-FI/AT_S) for the total sample and for participants with different SCI injury categories.

      Results

      Nine FIM items matched SCI-FI/AT basic mobility and self-care domain content. Pearson correlations for actual and est-SCI-FI/AT_S scores (0.79) were adequate for using concordance linking methods. Intraclass correlation coefficient values (0.79; 95% confidence interval, 0.77-0.81) indicated moderate reliability. t tests revealed no significant differences between actual and est-SCI-FI/AT_S scores in the total sample. For almost 60% of the sample, actual and est-SCI-FI/AT_S score differences were <5 points (half of a SD). Greater differences between actual and est-SCI-FI/AT_S scores were noted for persons with tetraplegia American Spinal Injury Association Impairment Scales (AISs) A, B, and C.

      Conclusions

      Despite differences between the FIM and SCI-FI/AT assessments, we developed a concordance table to estimate self-care and basic mobility SCI-FI/AT scores from content-matched FIM motor item scores. This concordance table allows researchers to merge FIM data with SCI-FI/AT data to analyze SCI functional outcomes at the group level. However, owing to greater differences between actual and estimated scores, the concordance table should be used with caution to interpret scores for those with cervical-level injuries AISs A, B, C.

      Keywords

      List of abbreviations:

      AIS (American Spinal Injury Association Impairment Scale), CARE (Continuity Assessment Record and Assessment item set), CAT (computerized adaptive test), CI (confidence interval), est-SCI-FI/AT_S (estimated SCI-FI/AT summary score), ICC (intraclass correlation coefficient), REMSD (root expected mean square difference), SCI (spinal cord injury), SCI-FI/AT (Spinal Cord Injury Functional Index/Assistive Technology), SCI-FI/AT_S (SCI-FI/AT summary score), SCIMS (Spinal Cord Injury Model Systems), SF (short form)
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