Determining the Most Robust Dimensional Structure of Categories from the International Classification of Functioning, Disability and Health Across Subgroups of Persons With Spinal Cord Injury to Build the Basis for Future Clinical Measures

Carolina S Ballert; Gerold Stucki; Fin Biering-Sørensen; Alarcos Cieza

doi:10.1016/j.apmr.2014.07.004

Determining the Most Robust Dimensional Structure of Categories from the International Classification of Functioning, Disability and Health Across Subgroups of Persons With Spinal Cord Injury to Build the Basis for Future Clinical Measures

Carolina S Ballert, Gerold Stucki, Fin Biering-Sørensen, Alarcos Cieza

Department of Clinical Medicine

2 Citations (Scopus)

Abstract

Objective To determine the most robust dimensional structure of the International Classification of Functioning, Disability and Health (ICF) categories relevant to spinal cord injury (SCI) across subgroups of lesion level, health care context, sex, age, and resources of the country.

Design A multidimensional between-item response Rasch model was used. The choice of the dimensions was conceptually driven using the ICF components from the functioning chapters and splits of the activity and participation component described in the ICF.

Setting Secondary analysis of data from an international, cross-sectional, multicentric study for the Development of ICF Core Sets for Spinal Cord Injury.

Participantsg Persons with SCI (N=1048) from the early postacute and long-term living context from 14 middle/low- and high-resource countries.

Interventions Not applicable. Main Outcome Measure Ratings of categories of the ICF relevant for SCI were analyzed.

Results Five models were tested on the complete sample and 5 subgroups. The overall reliability of all models and reliability within dimensions of the unidimensional and 2-dimensional models were good to excellent. The ICF categories spread well along the disability scale. The model fit improvement from the unidimensional to the 2-dimensional and from the 2-dimensional to the 3-dimensional model was significant in all groups (P<.0001). The improvement, however, from a unidimensional to a 2-dimensional structure was markedly better than from a 2-dimensional to a 3-dimensional one.

Conclusions We propose that a 2-dimensional structure separating body functions and body structures from the activity and participation categories should serve as a basis for developing clinical measures in SCI in the future.

Original language	English
Journal	Archives of Physical Medicine and Rehabilitation
Volume	95
Issue number	11
Pages (from-to)	2111–2119.e12
Number of pages	21
ISSN	0003-9993
DOIs	https://doi.org/10.1016/j.apmr.2014.07.004
Publication status	Published - 1 Nov 2014

Keywords

Asia
Australia
Brazil
Canada
Cross-Sectional Studies
Developing Countries
Disability Evaluation
Disabled Persons
Europe
Female
Health Resources
Health Status
Humans
International Classification of Functioning, Disability and Health
Israel
Male
Models, Theoretical
New Zealand
Paraplegia
Psychometrics
Quadriplegia
Spinal Cord Injuries
United States

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Ballert, C. S., Stucki, G., Biering-Sørensen, F., & Cieza, A. (2014). Determining the Most Robust Dimensional Structure of Categories from the International Classification of Functioning, Disability and Health Across Subgroups of Persons With Spinal Cord Injury to Build the Basis for Future Clinical Measures. Archives of Physical Medicine and Rehabilitation, 95(11), 2111–2119.e12. https://doi.org/10.1016/j.apmr.2014.07.004

Determining the Most Robust Dimensional Structure of Categories from the International Classification of Functioning, Disability and Health Across Subgroups of Persons With Spinal Cord Injury to Build the Basis for Future Clinical Measures. / Ballert, Carolina S; Stucki, Gerold; Biering-Sørensen, Fin et al.

In: Archives of Physical Medicine and Rehabilitation, Vol. 95, No. 11, 01.11.2014, p. 2111–2119.e12.

Research output: Contribution to journal › Journal article › Research › peer-review

Ballert, CS, Stucki, G, Biering-Sørensen, F & Cieza, A 2014, 'Determining the Most Robust Dimensional Structure of Categories from the International Classification of Functioning, Disability and Health Across Subgroups of Persons With Spinal Cord Injury to Build the Basis for Future Clinical Measures', Archives of Physical Medicine and Rehabilitation, vol. 95, no. 11, pp. 2111–2119.e12. https://doi.org/10.1016/j.apmr.2014.07.004

Ballert CS, Stucki G, Biering-Sørensen F, Cieza A. Determining the Most Robust Dimensional Structure of Categories from the International Classification of Functioning, Disability and Health Across Subgroups of Persons With Spinal Cord Injury to Build the Basis for Future Clinical Measures. Archives of Physical Medicine and Rehabilitation. 2014 Nov 1;95(11):2111–2119.e12. doi: 10.1016/j.apmr.2014.07.004

Ballert, Carolina S ; Stucki, Gerold ; Biering-Sørensen, Fin et al. / Determining the Most Robust Dimensional Structure of Categories from the International Classification of Functioning, Disability and Health Across Subgroups of Persons With Spinal Cord Injury to Build the Basis for Future Clinical Measures. In: Archives of Physical Medicine and Rehabilitation. 2014 ; Vol. 95, No. 11. pp. 2111–2119.e12.

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title = "Determining the Most Robust Dimensional Structure of Categories from the International Classification of Functioning, Disability and Health Across Subgroups of Persons With Spinal Cord Injury to Build the Basis for Future Clinical Measures",

abstract = "Objective To determine the most robust dimensional structure of the International Classification of Functioning, Disability and Health (ICF) categories relevant to spinal cord injury (SCI) across subgroups of lesion level, health care context, sex, age, and resources of the country.Design A multidimensional between-item response Rasch model was used. The choice of the dimensions was conceptually driven using the ICF components from the functioning chapters and splits of the activity and participation component described in the ICF.Setting Secondary analysis of data from an international, cross-sectional, multicentric study for the Development of ICF Core Sets for Spinal Cord Injury.Participantsg Persons with SCI (N=1048) from the early postacute and long-term living context from 14 middle/low- and high-resource countries.Interventions Not applicable. Main Outcome Measure Ratings of categories of the ICF relevant for SCI were analyzed.Results Five models were tested on the complete sample and 5 subgroups. The overall reliability of all models and reliability within dimensions of the unidimensional and 2-dimensional models were good to excellent. The ICF categories spread well along the disability scale. The model fit improvement from the unidimensional to the 2-dimensional and from the 2-dimensional to the 3-dimensional model was significant in all groups (P<.0001). The improvement, however, from a unidimensional to a 2-dimensional structure was markedly better than from a 2-dimensional to a 3-dimensional one.Conclusions We propose that a 2-dimensional structure separating body functions and body structures from the activity and participation categories should serve as a basis for developing clinical measures in SCI in the future.",

keywords = "Asia, Australia, Brazil, Canada, Cross-Sectional Studies, Developing Countries, Disability Evaluation, Disabled Persons, Europe, Female, Health Resources, Health Status, Humans, International Classification of Functioning, Disability and Health, Israel, Male, Models, Theoretical, New Zealand, Paraplegia, Psychometrics, Quadriplegia, Spinal Cord Injuries, United States",

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T1 - Determining the Most Robust Dimensional Structure of Categories from the International Classification of Functioning, Disability and Health Across Subgroups of Persons With Spinal Cord Injury to Build the Basis for Future Clinical Measures

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AU - Biering-Sørensen, Fin

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N2 - Objective To determine the most robust dimensional structure of the International Classification of Functioning, Disability and Health (ICF) categories relevant to spinal cord injury (SCI) across subgroups of lesion level, health care context, sex, age, and resources of the country.Design A multidimensional between-item response Rasch model was used. The choice of the dimensions was conceptually driven using the ICF components from the functioning chapters and splits of the activity and participation component described in the ICF.Setting Secondary analysis of data from an international, cross-sectional, multicentric study for the Development of ICF Core Sets for Spinal Cord Injury.Participantsg Persons with SCI (N=1048) from the early postacute and long-term living context from 14 middle/low- and high-resource countries.Interventions Not applicable. Main Outcome Measure Ratings of categories of the ICF relevant for SCI were analyzed.Results Five models were tested on the complete sample and 5 subgroups. The overall reliability of all models and reliability within dimensions of the unidimensional and 2-dimensional models were good to excellent. The ICF categories spread well along the disability scale. The model fit improvement from the unidimensional to the 2-dimensional and from the 2-dimensional to the 3-dimensional model was significant in all groups (P<.0001). The improvement, however, from a unidimensional to a 2-dimensional structure was markedly better than from a 2-dimensional to a 3-dimensional one.Conclusions We propose that a 2-dimensional structure separating body functions and body structures from the activity and participation categories should serve as a basis for developing clinical measures in SCI in the future.

AB - Objective To determine the most robust dimensional structure of the International Classification of Functioning, Disability and Health (ICF) categories relevant to spinal cord injury (SCI) across subgroups of lesion level, health care context, sex, age, and resources of the country.Design A multidimensional between-item response Rasch model was used. The choice of the dimensions was conceptually driven using the ICF components from the functioning chapters and splits of the activity and participation component described in the ICF.Setting Secondary analysis of data from an international, cross-sectional, multicentric study for the Development of ICF Core Sets for Spinal Cord Injury.Participantsg Persons with SCI (N=1048) from the early postacute and long-term living context from 14 middle/low- and high-resource countries.Interventions Not applicable. Main Outcome Measure Ratings of categories of the ICF relevant for SCI were analyzed.Results Five models were tested on the complete sample and 5 subgroups. The overall reliability of all models and reliability within dimensions of the unidimensional and 2-dimensional models were good to excellent. The ICF categories spread well along the disability scale. The model fit improvement from the unidimensional to the 2-dimensional and from the 2-dimensional to the 3-dimensional model was significant in all groups (P<.0001). The improvement, however, from a unidimensional to a 2-dimensional structure was markedly better than from a 2-dimensional to a 3-dimensional one.Conclusions We propose that a 2-dimensional structure separating body functions and body structures from the activity and participation categories should serve as a basis for developing clinical measures in SCI in the future.

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KW - Australia

KW - Brazil

KW - Canada

KW - Cross-Sectional Studies

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KW - Health Status

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KW - Israel

KW - Male

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KW - New Zealand

KW - Paraplegia

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KW - Quadriplegia

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KW - United States

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