Original Article
Spinal Cord advance online publication 20 October 2009; doi: 10.1038/sc.2009.131
Developing a contemporary functional outcome measure for spinal cord injury research
M D Slavin1, P A Kisala2, A M Jette1 and D S 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
- 3Physical Medicine and Rehabilitation, University of Medicine and Dentistry of New Jersey, Newark, NJ, USA
Correspondence: Dr MD Slavin, Health and Disability Research Institute, Boston University School of Public Health, 715 Albany Street T5W, Boston, MA 02118, USA. E-mail: mslavin@bu.edu
Received 25 March 2009; Revised 26 August 2009; Accepted 4 September 2009; Published online 20 October 2009.
Abstract
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.
Keywords:
spinal cord injury, outcome measure, functional assessment, item response theory, computer adaptive testing
