Scoring alternatives for FIM in neurological disorders applying Rasch analysis

Åsa Lundgren Nilsson · Katharina Stibrant Sunnerhagen · Gunnar Grimby

83 citations0/0 files storedActa Neurologica Scandinavica

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Psychometric Methodologies and Testing Stroke Rehabilitation and Recovery Medical Practices and Rehabilitation

Abstract

OBJECTIVE: The Functional Independence Measure (FIM) is an internationally widely used outcome measure. The aim of this study was to evaluate the structural properties of FIM using the Rasch model, with regard to scoring within rehabilitation centres in Scandinavia. MATERIALS AND METHODS: FIM data from 1660 patients with stroke, traumatic brain injury and spinal cord injury were analysed. The best models with respect to person separation were determined, together with person reliability, item separation, disordered categories, distance of more than 1.4 logits between categories and item fit to the model. RESULTS: Analysis showed disordering using seven categories in all three diagnoses. After collapsing of categories a four-category scale was the best solution. CONCLUSIONS: Decreasing the categories from seven to four may be one way of dealing with problems of disordered thresholds. Further studies are also needed in order to try the suggested scale in clinical settings and to compare it with the original FIM scale.

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1982A Rasch Model for Partial Credit Scoring 1982Probabilistic Models for some Intelligence and Attainment Tests.1988Rasch Models for Measurement 2003Rasch analysis of a new stroke-specific outcome scale: the stroke impact scale11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.1989Observations are always ordinal; measurements, however, must be interval.2003MEASURING BEHAVIOURS AND PERCEPTIONS: RASCH ANALYSIS AS A TOOL FOR REHABILITATION RESEARCH 2001GUIDELINES TO STATISTICAL EVALUATION OF DATA FROM RATING SCALES AND QUESTIONNAIRES 2003Assessing and Adjusting for Cross-Cultural Validity of Impairment and Activity Limitation Scales Through Differential Item Functioning Within the Framework of the Rasch Model

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2011Formulating the Rasch Differential Item Functioning Model Under the Marginal Maximum Likelihood Estimation Context and Its Comparison With Mantel–Haenszel Procedure in Short Test and Small Sample Conditions 2009Using Rasch analysis to establish the construct validity of rehabilitation assessment tools 2006Cross-diagnostic validity in a generic instrument: an example from the Functional Independence Measure in Scandinavia

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