Validity of the Functional Independence Measure in Different Diagnoses
Author Information
Author(s): Å Lundgren-Nilsson, A Tennant, G Grimby, KS Sunnerhagen
Primary Institution: Department of Rehabilitation Medicine, Academic Unit of Musculoskeletal Disease, The University of Leeds
Hypothesis
To analyze the cross-diagnostic validity of the Functional Independence Measure (FIM™) motor items in patients with spinal cord injury, stroke, and traumatic brain injury.
Conclusion
The seven-category response function is problematic for the FIM™ instrument, and reducing the number of response options may enhance its validity.
Supporting Evidence
- The FIM™ motor items showed significant misfit to the Rasch model.
- Cross-diagnostic DIF was identified, complicating comparisons between diagnoses.
- Rescoring of items improved the fit for stroke and TBI but not for SCI.
Takeaway
This study looked at how well a tool called the FIM™ works for different types of brain injuries. It found that the way we score it might need to change to make it better.
Methodology
Data from 471 patients on FIM™ motor items at admission were analyzed using the Rasch model.
Potential Biases
Potential bias due to the differences in how items function across different diagnoses.
Limitations
The study faced issues with the validity of the FIM™ scoring system and the presence of differential item functioning (DIF) across diagnoses.
Participant Demographics
Patients aged 11-90 years, with 70% male representation.
Statistical Information
P-Value
<.0000001
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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