Tracking Spinal Cord Injury Functional Outcomes Across the Lifespan: Validation of Linking Coefficients

Pengsheng Ni; M J Mulcahey; Mary D Slavin; Christina Calhoun Thielen; Lawrence C Vogel; Cristina Sadowsky; Loren T Davidson; Alan M Jette

doi:10.1016/j.apmr.2019.05.022

Tracking Spinal Cord Injury Functional Outcomes Across the Lifespan: Validation of Linking Coefficients

Arch Phys Med Rehabil. 2019 Oct;100(10):1924-1931. doi: 10.1016/j.apmr.2019.05.022. Epub 2019 May 30.

Authors

Pengsheng Ni¹, M J Mulcahey², Mary D Slavin³, Christina Calhoun Thielen⁴, Lawrence C Vogel⁵, Cristina Sadowsky⁶, Loren T Davidson⁷, Alan M Jette⁸

Affiliations

¹ Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA. Electronic address: psni@bu.edu.
² Department of Occupational Therapy, College of Rehabilitation Science, Thomas Jefferson University, Philadelphia, PA; Shriners Hospitals for Children, Philadelphia, PA.
³ Department of Health Law, Policy and Management, Boston University School of Public Health, Boston, MA.
⁴ Department of Occupational Therapy, College of Rehabilitation Science, Thomas Jefferson University, Philadelphia, PA.
⁵ Shriners Hospitals for Children, Chicago, IL; Rush Medical College, Chicago, IL.
⁶ Kennedy Krieger Rehabilitation Institute, Baltimore, MD.
⁷ Shriners Hospitals for Children, Sacramento, CA.
⁸ MGH Institute of Health Professions, Boston, MA.

PMID: 31153853
DOI: 10.1016/j.apmr.2019.05.022

Abstract

Objective: Validation of linking coefficients to transform Pediatric Spinal Cord Injury Activity Measure (PEDI-SCI/AM) scores to adult Spinal Cord Injury-Functional Index (SCI-FI) scores.

Design: This cross-sectional study administered PEDI-SCI/AM and SCI-FI computerized adaptive tests (CATs) and short forms (SFs) to children with SCI and parents or caregivers.

Setting: Hospitals, university, and rehabilitation institute.

Participants: About 107 children with SCI and 96 parent or caregivers.

Interventions: Not applicable.

Main outcome measures: Linking coefficients estimated SCI-FI (est-SCI-FI) scores from PEDI-SCI/AM scores for matched domains. Correlations between est-SCI-FI and actual SCI-FI scores were calculated. If correlations exceeded the criterion linking (0.866), the following analyses to compare est-SCI-FI and actual SCI-FI scores were conducted: paired t tests, intraclass correlation coefficients (ICCs 3, 1), percent of cases with absolute score differences at different thresholds.

Results: Two matched domains, PEDI-SCI/AM Daily Routine/SCI-FI Self-Care and PEDI-SCI/AM General Mobility/SCI-FI Basic Mobility, met the linking criterion for both respondent-types (parent and child) and administration modes (CAT and SF). PEDI-SCI/AM Daily Routine and SCI-FI Fine Motor Function did not meet linking criterion for respondent type or mode. The linking criterion was met for wheelchair domains (child SF and CAT) and ambulation domains (child SF only). Significant differences between est-SCI-FI and actual SCI-FI scores were noted for all matched domains except Daily Routine/Self-Care (child SF only; parent SF and CAT). ICC values showed excellent agreement (range=0.75-0.89). Absolute differences between est-SCI-FI and actual SCI-FI scores were less than 1 standard deviation (except wheelchair CAT child).

Conclusions: Linking coefficients applied to PEDI-SCI/AM scores can provide valid SCI-FI estimates that vary by domain, mode, and respondent type.

Keywords: Rehabilitation; Spinal cord injuries.

Publication types

Research Support, N.I.H., Extramural
Validation Study

MeSH terms

Activities of Daily Living
Adolescent
Child
Cross-Sectional Studies
Disability Evaluation*
Female
Humans
Male
Mobility Limitation
Patient Reported Outcome Measures
Self Care
Spinal Cord Injuries / physiopathology*
Wheelchairs