Tracking Functional Status Across the Spinal Cord Injury Lifespan: Linking Pediatric and Adult Patient-Reported Outcome Scores

Short Title:
Tracking Functional Status Across the Spinal Cord Injury Lifespan: Linking Pediatric and Adult Patient-Reported Outcome Scores
Model System:
TBI
Reference Type:
Journal Article
Accession No.:
J70063
Journal:
Archives of Physical Medicine and Rehabilitation
Year, Volume, Issue, Page(s):
2014, vol. 1, issue 95, pp 2078-2085
Publication Website:
Abstract:
Study used item response theory (IRT) methods to link scores from 2 recently developed functional outcome measures for people with spinal cord injury (SCI), the adult Spinal Cord Injury-Functional Index (SCI-FI) and the Pedi SCI (both the parent version and the child version). Linking was conducted so that the adult SCI-FI and Pedi SCI scaled scores could be compared. Pedi SCI items were administered to a sample of 381 children with SCI aged 8 to 21 years, and of 322 parents/caregivers of children with SCI aged 4 to 21 years. Adult SCI-FI items were administered to 855 adults with SCI aged 18 to 92 years. Five scales common to both instruments were included in the analysis: Wheeled Mobility, Daily Routine/Self-care, Daily Routine/Fine Motor, Ambulation, and General MobilityStudy used item response theory (IRT) methods to link scores from 2 recently developed functional outcome measures for people with spinal cord injury (SCI), the adult Spinal Cord Injury-Functional Index (SCI-FI) and the Pedi SCI (both the parent version and the child version). Linking was conducted so that the adult SCI-FI and Pedi SCI scaled scores could be compared. Pedi SCI items were administered to a sample of 381 children with SCI aged 8 to 21 years, and of 322 parents/caregivers of children with SCI aged 4 to 21 years. Adult SCI-FI items were administered to 855 adults with SCI aged 18 to 92 years. Five scales common to both instruments were included in the analysis: Wheeled Mobility, Daily Routine/Self-care, Daily Routine/Fine Motor, Ambulation, and General Mobility. Confirmatory factor analysis and exploratory factor analysis results indicated that the 5 scales are unidimensional. A graded response model was used to calibrate the items. Misfitting items were identified and removed from the item banks. Items that function differently between the adult and child samples were identified and removed from the common items used for linking. Domain scores from the Pedi SCI instruments were transformed onto the adult SCI-FI metric. IRT linking allowed estimation of adult SCI-FI scale scores based on Pedi SCI scale scores and vice versa; therefore, it provides clinicians with a means of tracking long-term functional data for children with SCI across their entire lifespan.
Author(s):
Kumar RG, Bracken MB, Cloark AN, Nick TG, Melguizo MS, Sander AM
Author Address(es):

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