RASCH ANALYSIS OF THE UK FUNCTIONAL ASSESSMENT MEASURE IN PATIENTS WITH COMPLEX DISABILITY AFTER STROKE
RASCH ANALYSIS OF THE UK FUNCTIONAL ASSESSMENT MEASURE IN PATIENTS WITH COMPLEX DISABILITY AFTER STROKE
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DOI：
10.2340/16501977-2324
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发表时间：
2018-05-01
影响因子：
3.5
通讯作者：
Siegert, Richard J.
中科院分区：
文献类型：
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作者：
Medvedev, Oleg N.;Turner-Stokes, Lynne;Siegert, Richard J.
目的：确定英国功能评估测量 (UK FIM +FAM) 是否适合患有复杂残疾的中风患者的 Rasch 模型，如果适合，则导出 Rasch 变换区间水平评分的转换表。 方法：样本包括英国多中心队列，其中 1,318 名中风后入院接受专科康复治疗的患者。 Rasch 分析针对 30 个项目量表进行，包括测量身体、沟通和社会心理功能的 3 个项目领域。使用被称为“路径”的 3 种不同的分析方法来检查项目与 Rasch 模型的拟合。结果：在路径中实现了最佳拟合，其中来自运动、沟通和社会心理领域的反应被总结为 3 个超级项目，并且由于相对于左右半球位置的差异项目功能 (DIF)，一些项目被分割 (X-2 (10) = 14.48，p = 0.1 5）。对显示无序阈值的项目重新评分并没有显着改善整体模型拟合。结论：具有域超级项目的英国 FIM+FAM 满足一维 Rasch 模型的期望，无需重新评分。根据 Rasch 模型的个人估计，制作了一个转换表，将总量表分数转换为区间水平数据。区间转换评分的临床益处需要进一步评估。
Objectives: To determine whether the UK Functional Assessment Measure (UK FIM +FAM) fits the Rasch model in stroke patients with complex disability and, if so, to derive a conversion table of Rasch-transformed interval level scores.Methods: The sample included a UK multicentre cohort of 1,318 patients admitted for specialist rehabilitation following a stroke. Rasch analysis was conducted for the 30-item scale including 3 domains of items measuring physical, communication and psychosocial functions. The fit of items to the Rasch model was examined using 3 different analytical approaches referred to as "pathways".Results: The best fit was achieved in the pathway where responses from motor, communication and psychosocial domains were summarized into 3 super-items and where some items were split because of differential item functioning (DIF) relative to left and right hemisphere location (X-2 (10) = 14.48, p = 0.1 5). Re-scoring of items showing disordered thresholds did not significantly improve the overall model fit.Conclusion: The UK FIM+FAM with domain super-items satisfies expectations of the unidimensional Rasch model without the need for re-scoring. A conversion table was produced to convert the total scale scores into interval-level data based on person estimates of the Rasch model. The clinical benefits of interval-transformed scores require further evaluation.