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A multidimensional Rasch analysis of the functional independence measure based on the National Institute on Disability, Independent Living, and Rehabilitation Research Traumatic Brain Injury Model Systems National Database
Journal of Neurotrauma (2016)
  • Christopher R Pretz, Craig Hospital, Englewood CO, US
  • Jacob Kean, Richard L. Roudebush VA Medical Center, Indianapolis, IN, US
  • Allen W Heinemann, Rehabilitation Institute of Chicago, Chicago, IL, US
  • Allan J Kozlowski, Icahn School of Medicine at Mount Sinai, New York, NY, US
  • Rita K Bode, Rehabilitation Institute of Chicago, Chicago, IL, US
  • Eveline Gebhardt, Australian Council for Educational Research (ACER)
Abstract
A number of studies have evaluated the psychometric properties of the Functional Independence Measure (FIM™) using Rasch analysis, although none has done so using the National Institute on Disability, Independent Living, and Rehabilitation Research Traumatic Brain Injury Model Systems National Database, a longitudinal database that captures demographic and outcome information on persons with moderate to severe traumatic brain injury across the United States. In the current study, we examine the psychometric properties of the FIM as represented by persons within this database and demonstrate that the FIM comprises three subscales representing cognitive, self-care, and mobility domains. These subscales were analyzed simultaneously using a multivariate Rasch model in combination with a time dependent concurrent calibration scheme with the goal of creating a raw score-to-logit transformation that can be used to improve the accuracy of parametric statistical analyses. The bowel and bladder function items were removed because of misfit with the motor and cognitive items. Some motor items exhibited step disorder, which was addressed by collapsing Categories 1–3 for Toileting, Stairs, Locomotion, Tub/Shower Transfers; Categories 1 and 2 for Toilet and Bed Transfers; and Categories 2 and 3 for Grooming. The strong correlations (r = 0.82-0.96) among the three subscales suggest they should be modeled together. Coefficient alpha of 0.98 indicates high internal consistency. Keyform maps are provided to enhance clinical interpretation and application of study results.
Keywords
  • Psychometrics,
  • Rehabilitation,
  • Test Reliability,
  • Traumatic Brain Injury.,
  • Measurement,
  • Rasch analysis
Publication Date
2016
DOI
10.1089/neu.2015.4138
Citation Information
Christopher R Pretz, Jacob Kean, Allen W Heinemann, Allan J Kozlowski, et al.. "A multidimensional Rasch analysis of the functional independence measure based on the National Institute on Disability, Independent Living, and Rehabilitation Research Traumatic Brain Injury Model Systems National Database" Journal of Neurotrauma Vol. 33 Iss. 14 (2016) p. 1358 - 1362 ISSN: 1557-9042
Available at: http://works.bepress.com/eveline_gebhardt/21/