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ORIGINAL RESEARCH| Volume 103, ISSUE 4, P688-695, April 2022

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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      References

      1. National Spinal Cord Injury Statistical Center. Available at: https://www.nscisc.uab.edu/. Accessed August 31, 2021.

        • Hall KM
        • Cohen ME
        • Wright J
        • Call M
        • Werner P.
        Characteristics of the functional independence measure in traumatic spinal cord injury.
        Arch Phys Med Rehabil. 1999; 80: 1471-1476
        • Centers for Medicare & Medicaid Services, HHS
        Medicare Program; inpatient rehabilitation facility prospective payment system for federal fiscal year 2019.
        Final rule. Fed Regist. 2018; 83: 38514-38573
        • Dorans NJ.
        Linking scores from multiple health outcome instruments.
        Qual Life Res. 2007; 16: 85-94
        • Choi SW
        • Podrabsky T
        • McKinney N
        • Schalet BD
        • Cook KF
        • Cella D.
        PROSetta Stone® analysis report: a Rosetta Stone for patient reported outcomes. Chicago: Department of Medical Social Sciences.
        Feinberg School of Medicine, Northwestern University, 2012
      2. World Health Organization. Towards a common language for functioning, disability and health: ICF. Available at: http://www.who.int/classifications/icf/training/icfbeginnersguide.pdf/. Accessed August 31, 2021.

        • Jette AM
        • Slavin MD
        • Ni P
        • et al.
        Development and initial evaluation of the SCI-FI/AT.
        J Spinal Cord Med. 2015; 38: 409-418
        • Keeney T
        • Slavin M
        • Kisala P
        • et al.
        Sensitivity of the SCI-FI/AT in individuals with traumatic spinal cord injury.
        Arch Phys Med Rehabil. 2018; 99: 1783-1788
        • Slavin MD
        • Ni P
        • Tulsky DS
        • et al.
        Spinal Cord Injury-Functional Index/Assistive Technology short forms.
        Arch Phys Med Rehabil. 2016; 97 (e7): 1745-1752
      3. American Spinal Injury Association Impairment Scale (AIS): international standards for neurological classification of spinal cord injury (ISNCSCI). Available at:https://scireproject.com/outcome-measures/list-sci/neurological-impairment-and-autonomic-dysfunction/american-spinal-injury-association-impairment-scale-ais-international-standards-for-neurological-classification-of-spinal-cord-injury-isncsci/. Accessed August 31, 2021.

        • Kolen MJ
        • Brennan RL.
        Test equating, scaling, and linking.
        Springer, New York2004
        • Dorans NJ
        • Holland PW.
        Population invariance and the equitability of tests: basic theory and the linear case.
        J Educ Meas. 2000; 37: 281-306
        • Fayers PM
        • Hays RD.
        Should linking replace regression when mapping from profile-based measures to preference-based measures?.
        Value Health. 2014; 17: 261-265
        • Tulsky DS
        • Kisala PA
        • Boulton AJ
        • et al.
        Determining a transitional scoring link between PROMIS® pediatric and adult physical health measures.
        Qual Life Res. 2019; 28: 1217-1229
        • Dorans NJ.
        Equating, concordance, and expectation.
        Appl Psychol Meas. 2004; 28: 227-246
        • Linn RL
        • McLaughlin D
        • Thissen D.
        Utility and validity of NAEP linking efforts.
        American Institutes for Research, Palo Alto2009
        • Holland PW
        • Dorans NJ.
        Linking and equating.
        Educ Meas. 2006; 4: 187-220
      4. Dorans NJ, Walker ME. Sizing up linkages. In: Dorans NJ, Pommerich ME, Holland PW, editors. Linking and aligning scores and scales. Princeton: Springer Science + Business Media; 2007. p 179–98.

        • Pommerich M
        • Hanson BA
        • Harris DJ
        • Sconing JA.
        Issues in conducting linkages between distinct tests.
        Appl Psychol Meas. 2004; 28: 247-273
        • Brennan R.
        Linking with equivalent group or single group design (LEGS) (version 2.0) [computer software].
        University of Iowa: Center for Advanced Studies in Measurement and Assessment, Iowa City2004
        • Andersson B
        • Bränberg K
        • Wiberg M.
        Performing the kernel method of test equating with the package kequate.
        J Stat Softw. 2013; 55: 1-25
        • von Davier AA
        • Holland PW
        • Thayer DT.
        The kernel method of test equating.
        Springer, New York2004
        • Wang Y
        • Byers KL
        • Velozo C.
        Validation of FIM-MDS crosswalk conversion algorithm.
        J Rehabil Res Dev. 2008; 45: 1065-1076
        • Marino RJ
        • Cohen ME.
        Comparison of the self report and observational methods of the functional independence measure at discharge from rehabilitation for spinal cord injury [abstract].
        J Spinal Cord Inj Med. 1998; 21: 152