Towards the development of clinical measures for spinal cord injury based on the International Classification of Functioning, Disability and Health with Rasch analyses

Ballert, S.C., Stucki, G., Biering-Sørensen, F. and Cieza, A. (2014) Towards the development of clinical measures for spinal cord injury based on the International Classification of Functioning, Disability and Health with Rasch analyses. Archives of Physical Medicine and Rehabilitation, 95 (9), 1685-1694. (doi:10.1016/j.apmr.2014.05.006). (PMID:24882520)

Abstract

OBJECTIVES: To determine whether ICF categories relevant to SCI can be integrated in clinical measures and get insights to guide their future operationalization. Specific aims are to find out whether the ICF categories relevant to SCI [1] fit a Rasch model taking into consideration the dimensionality found in previous investigations, [2] show local item dependencies (LID), or [3] differential item functioning (DIF).

DESIGN: All second level ICF categories collected in 'Development of ICF Core Sets for SCI' project in specialized centers within fourteen countries from 2006-2008.

SETTING: Secondary data analysis PARTICIPANTS: 1048 adults with SCI from the early post-acute and the long-term living context.

MAIN OUTCOME MEASURES: Two unidimensional Rasch analyses one for the ICF categories from body functions and body structures components and another for the ICF categories from the activities and participation component. Results: [1] Results support good reliability and targeting of the ICF categories in both dimensions. In each dimension few ICF categories were subject to misfit. [2] Local item dependency was observed between ICF categories of same chapters, [3] and group effects for age and gender only to a small extent.

CONCLUSION: The validity of ICF categories to develop measures of functioning in SCI for clinical practice and research is to some extent supported. Model adjustments were suggested to further improve their operationalization and psychometrics.

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