%0 Journal Article %J Journal of Rehabilitation Medicine %D 2005 %T Contemporary measurement techniques for rehabilitation outcomes assessment %A Jette, A. M. %A Haley, S. M. %K *Disability Evaluation %K Activities of Daily Living/classification %K Disabled Persons/classification/*rehabilitation %K Health Status Indicators %K Humans %K Outcome Assessment (Health Care)/*methods/standards %K Recovery of Function %K Research Support, N.I.H., Extramural %K Research Support, U.S. Gov't, Non-P.H.S. %K Sensitivity and Specificity computerized adaptive testing %X In this article, we review the limitations of traditional rehabilitation functional outcome instruments currently in use within the rehabilitation field to assess Activity and Participation domains as defined by the International Classification of Function, Disability, and Health. These include a narrow scope of functional outcomes, data incompatibility across instruments, and the precision vs feasibility dilemma. Following this, we illustrate how contemporary measurement techniques, such as item response theory methods combined with computer adaptive testing methodology, can be applied in rehabilitation to design functional outcome instruments that are comprehensive in scope, accurate, allow for compatibility across instruments, and are sensitive to clinically important change without sacrificing their feasibility. Finally, we present some of the pressing challenges that need to be overcome to provide effective dissemination and training assistance to ensure that current and future generations of rehabilitation professionals are familiar with and skilled in the application of contemporary outcomes measurement. %B Journal of Rehabilitation Medicine %V 37 %P 339-345 %G eng %M 16287664 %0 Journal Article %J American Journal of Physical Medicine and Rehabilitation %D 2005 %T Measuring physical function in patients with complex medical and postsurgical conditions: a computer adaptive approach %A Siebens, H. %A Andres, P. L. %A Pengsheng, N. %A Coster, W. J. %A Haley, S. M. %K Activities of Daily Living/*classification %K Adult %K Aged %K Cohort Studies %K Continuity of Patient Care %K Disability Evaluation %K Female %K Health Services Research %K Humans %K Male %K Middle Aged %K Postoperative Care/*rehabilitation %K Prognosis %K Recovery of Function %K Rehabilitation Centers %K Rehabilitation/*standards %K Sensitivity and Specificity %K Sickness Impact Profile %K Treatment Outcome %X OBJECTIVE: To examine whether the range of disability in the medically complex and postsurgical populations receiving rehabilitation is adequately sampled by the new Activity Measure--Post-Acute Care (AM-PAC), and to assess whether computer adaptive testing (CAT) can derive valid patient scores using fewer questions. DESIGN: Observational study of 158 subjects (mean age 67.2 yrs) receiving skilled rehabilitation services in inpatient (acute rehabilitation hospitals, skilled nursing facility units) and community (home health services, outpatient departments) settings for recent-onset or worsening disability from medical (excluding neurological) and surgical (excluding orthopedic) conditions. Measures were interviewer-administered activity questions (all patients) and physical functioning portion of the SF-36 (outpatients) and standardized chart items (11 Functional Independence Measure (FIM), 19 Standardized Outcome and Assessment Information Set (OASIS) items, and 22 Minimum Data Set (MDS) items). Rasch modeling analyzed all data and the relationship between person ability estimates and average item difficulty. CAT assessed the ability to derive accurate patient scores using a sample of questions. RESULTS: The 163-item activity item pool covered the range of physical movement and personal and instrumental activities. CAT analysis showed comparable scores between estimates using 10 items or the total item pool. CONCLUSION: The AM-PAC can assess a broad range of function in patients with complex medical illness. CAT achieves valid patient scores using fewer questions. %B American Journal of Physical Medicine and Rehabilitation %V 84 %P 741-8 %8 Oct %G eng %M 16205429