Activities of daily living instruments

Robert Lindeboom · M. Vermeulen · Rebecca Holman · Rob J. de Haan

72 citations0/0 files storedNeurology

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

Abstract

The ability to perform activities of daily living (ADL) is an important part of assessment in neurologic patients. A literature search was carried out to identify multi-item ADL scales developed for the assessment of neurologic patients, comparing item content, range, and detail of ADL scales. Of the 113 ADL scales identified, 27 (24%) were designed for use in neurology. In the basic ADL (BADL) domains (basic mobility and self-care), individual items were present in 44% to 81% of instruments. In the extended ADL (EADL) domains (e.g., outdoor mobility, housekeeping), items were present in up to 67% of the instruments identified. A typical trade-off was observed between the range, the detail (number of items), and hence the practicality of a scale. In general, scales focus on either BADL or EADL domains or, on occasion, some of both, rather than measuring the full range of functioning. There are many ADL scales in neurology, with much overlap in item content, leading to redundancy. New scales developed with the traditional methods will not solve the existing difficulties associated with range and detail, ordinal scale scores, and cross-instrument comparability. The possibilities of a modern psychometric method known as item response theory that was designed to solve these problems are discussed.

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References

2000Item Response Theory and Health Outcomes Measurement in the 21st Century 1997Generic Health Measurement: Past Accomplishments and a Measurement Paradigm for the 21st Century

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2005The Academic Medical Center Linear Disability Score (ALDS) item bank: item response theory analysis in a mixed patient population 2015Measuring engagement with music: development of an informant-report questionnaire 2004The AMC Linear Disability Score project in a population requiring residential care: psychometric properties 2004Practical methods for dealing with 'not applicable' item responses in the AMC Linear Disability Score project.2003Constructing an Item Bank Using Item Response Theory: The AMC Linear Disability Score Project 2009The use of an item response theory–based disability item bank across diseases: accounting for differential item functioning

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