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Spinal Cord (2010) 48, 262267
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ORIGINAL ARTICLEDeveloping a contemporary functional outcome measure for spinal
cord injury research
MD Slavin1, PA Kisala2, AM Jette1 and DS Tulsky2,3
1Health and Disability Research Institute, Boston University School of Public Health, Boston, MA, USA; 2Spinal Cord Injury Research Laboratory, Kessler Foundation Research Center, West Orange, NJ, USA and 3Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA
Study design: This study used qualitative analysis of focus group discussions.
Objective: The primary objective was to select functional activities to include in an item pool, which is the first step in developing a spinal cord injury computer adaptive test (SCI-CAT).
Setting: This multisite study was conducted at six US National Spinal Cord Injury Model Systems Programs.
Methods: Focus group discussions, which included persons with tetraplegia and paraplegia and clinicians, were conducted. Transcripts were analyzed using a grounded theory approach. Functional activities were identified, binned, winnowed, written as functional items, and cognitively tested. Results: Focus group discussion analysis identified 326 functional activity items that fit into categories outlined in the International Classification of Functioning, Disability and Health (ICF) framework: Mobility (193 items), including assessment of functioning in a manual (44 items) and power wheelchair (19 items); self-care (109 items); and communication (19 items). Items related to sexual function were also identified (5 items).
Conclusion: The SCI-CAT item pool includes items that assess functional activities important to persons with SCI. Items cover a wide range of functional ability and reflect most ICF categories. The SCI-CAT pool is currently being field tested to develop a calibrated item bank. Further development will yield a CAT of functional activities appropriate for SCI research.
Spinal Cord (2010) 48, 262267; doi:http://dx.doi.org/10.1038/sc.2009.131
Web End =10.1038/sc.2009.131 ; published online 20 October 2009
Keywords: spinal cord injury; outcome measure; functional assessment; item response theory; computer adaptive testing
Introduction
Spinal cord injury (SCI) research efforts would benefit from a comprehensive, precise, and sensitive functional measure. Recommendations from the International Campaign for Cures of Spinal Cord Injury Paralysis Clinical Guidelines Panel, an international panel established to review the methodology for clinical trials in SCI, emphasize the urgent need for accurate and sensitive...