Journal-based CME articleSpinal Cord Injury-Functional Index: Item Banks to Measure Physical Functioning in Individuals With Spinal Cord Injury
Section snippets
Article 1: Spinal Cord Injury-Functional Index: Item Banks to Measure Physical Functioning of Individuals With Spinal Cord Injury
David S. Tulsky, PhD; Alan M. Jette, PT, PhD; Pamela A. Kisala, MA; Claire Kalpakjian, PhD; Marcel P. Dijkers, PhD; Gale Whiteneck, PhD; Pengsheng Ni, MD, MPH; Steven Kirshblum, MD; Susan Charlifue, PhD; Allen W. Heinemann, PhD; Martin Forchheimer, MPP; Mary D. Slavin, PT, PhD; Bethlyn Houlihan, MSW, MPH; Denise G. Tate, PhD; Trevor Dyson-Hudson, MD; Denise Fyffe, PhD; Steve Williams, MD; Jeanne Zanca, MPT, PhD
Article 2: Development and Initial Evaluation of the Spinal Cord Injury-Functional Index
Alan M. Jette, PT, PhD; David S. Tulsky, PhD; Pengsheng Ni, MD, MPH; Pamela A. Kisala, MA; Mary D. Slavin, PT, PhD; Marcel P. Dijkers, PhD; Allen W. Heinemann, PhD; Denise G. Tate, PhD; Gale Whiteneck, PhD; Susan Charlifue, PhD; Bethlyn Houlihan, MSW, MPH; Steve Williams, MD; Steven Kirshblum, MD; Trevor Dyson-Hudson, MD; Jeanne Zanca, MPT, PhD; Denise Fyffe, PhD
Statement of Need
A major treatment goal in the rehabilitation of persons with spinal cord injury (SCI) is to maximize the restoration of physical functioning. Documenting the extent of recovery is imperative for: 1) assessing treatment efficacy; 2) evaluating the cost-effectiveness of treatment interventions; 3) examining the impact of policy changes on patient outcomes; 4) evaluating the quality of care being provided; and 5) providing appropriate, long-term prognostic information to patients and their
Accreditation Statement
This journal-based activity has been planned and developed in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the sponsorship of Professional Education Services Group (PESG).
PESG is accredited by the ACCME to provide continuing medical education (CME) for physicians.
Credit Designation Statement
PESG designates this Journal-based CME activity for a maximum of 2.0 AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
All other health care professionals completing continuing education credit for this activity will be issued a certificate of participation.
Educational Objectives
To support the attainment of knowledge, competence, and performance, the learner should be able to achieve the following objectives:
- 1
Describe the current outcomes measurement tools being used with persons with SCI.
- 2
Discuss the limitations of the current outcomes measurement tools being used with persons with SCI.
- 3
Describe the development of a new outcome measurement tool with the item content and structure being designed specifically for persons with SCI.
- 4
Explain how the Spinal Cord
Planning Committee
Susan Charlifue, PhD; Marcel P. Dijkers, PhD; Trevor Dyson-Hudson, MD; Martin Forchheimer, MPP; Denise Fyffe, PhD; Allen W. Heinemann, PhD; Bethlyn Houlihan, MSW, MPH; Alan M. Jette, PT, PhD; Claire Kalpakjian, PhD; Steven Kirshblum, MD; Pamela A. Kisala, MA; Pengsheng Ni, MD, MPH; Mary D. Slavin, PT, PhD; Denise G. Tate, PhD; David S. Tulsky, PhD; Gale Whiteneck, PhD; Steve Williams, MD, Jeanne Zanca, MPT, PhD; PESG staff.
Faculty Profiles & Disclosure Information
As a sponsor accredited by the ACCME, it is the policy of PESG to require the disclosure of anyone who is in a position to control the content of an educational activity. All relevant financial relationships with any commercial interests and/or manufacturers must be disclosed to participants at the beginning of each activity. The faculty of this educational activity disclose the following:
Susan Charlifue, PhD
Craig Hospital, Englewood, CO
No financial conflicts to disclose.
Marcel P. Dijkers, PhD
Mt. Sinai School of Medicine, New York, NY
No financial conflicts to disclose.
Trevor Dyson-Hudson, MD
University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Department of Physical Medicine and Rehabilitation, Newark, NJ
No financial conflicts to disclose.
Martin Forchheimer, MPP
University of Michigan Medical School, Department of Physical Medicine and Rehabilitation, Ann Arbor, MI
No financial conflicts to disclose.
Denise Fyffe, PhD
University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Department of Physical Medicine and Rehabilitation, Newark, NJ
No financial conflicts to disclose.
Allen W. Heinemann, PhD
Northwestern University and Rehabilitation Institute of Chicago, Department of Physical Medicine and Rehabilitation, Chicago, IL
No financial conflicts to disclose.
Bethlyn Houlihan, MSW, MPH
Boston University School of Public Health, Health and Disability Research Institute, Boston, MA
No financial conflicts to disclose.
Alan M. Jette, PT, PhD
Boston University School of Public Health, Health and Disability Research Institute, Boston, MA
No financial conflicts to disclose.
Claire Kalpakjian, PhD
University of Michigan Medical School, Department of Physical Medicine and Rehabilitation, Ann Arbor, MI
No financial conflicts to disclose.
Steven Kirshblum, MD
Kessler Institute for Rehabilitation, West Orange, NJ
No financial conflicts to disclose.
Pamela A. Kisala, MA
University of Michigan Medical School, Department of Physical Medicine and Rehabilitation, Ann Arbor, MI
No financial conflicts to disclose.
Pengsheng Ni, MD, MPH
Boston University School of Public Health, Health and Disability Research Institute, Boston, MA
No financial conflicts to disclose.
Mary D. Slavin, PT, PhD
Boston University School of Public Health, Health and Disability Research Institute, Boston, MA
No financial conflicts to disclose.
Denise G. Tate, PhD
University of Michigan Medical School, Department of Physical Medicine and Rehabilitation, Ann Arbor, MI
No financial conflicts to disclose.
David S. Tulsky, PhD
University of Michigan Medical School, Department of Physical Medicine and Rehabilitation, Ann Arbor, MI
No financial conflicts to disclose.
Gale Whiteneck, PhD
Craig Hospital, Englewood, CO
No financial conflicts to disclose.
Steve Williams, MD
Boston Medical Center, New England Regional Spinal Cord Injury Center, Boston, MA
No financial conflicts to disclose.
Jeanne Zanca, MPT, PhD
Mt. Sinai School of Medicine, New York, NY
No financial conflicts to disclose.
PESG Staff
No financial conflicts to disclose.
Resolution of Conflict of Interest
PESG has implemented a process to resolve conflict of interest for each CME activity. In order to help ensure content objectivity, independence, and fair balance, and to ensure that the content is aligned with the interest of the public, PESG has resolved the conflict by external content review.
Unapproved/Off-Label Use Disclosure
PESG requires CME faculty to disclose to the participants:
- 1
When products or procedures being discussed are off-label, unlabeled, experimental, and/or investigational (not US Food and Drug Administration [FDA] approved); and
- 2
Any limitations on the information presented, such as data that are preliminary or that represent ongoing research, interim analyses, and/or unsupported opinion. Faculty may discuss information about pharmaceutical agents that is outside of FDA-approved labeling. This
Intended Audience
This program is intended for physicians and healthcare professionals responsible for the comprehensive care for individuals with chronic illness and disabilities.
Method of Participation
In order to claim credit, participants must complete the following:
- 1
Pre-activity self-assessment questions
- 2
Read the 2 articles included in this activity.
- 3
Complete the CME Test and Evaluation. Participants must achieve a score of 70% on the CME Test.
Participants can complete the pre-activity self-assessment and CME Test and Evaluation online by logging on to http://acrm.cds.pesgce.com. Upon successful completion of the online tests and evaluation form, you can instantly download and print your
CME Inquiries
For all CME certificate inquiries, please contact us at [email protected].
This continuing education activity is active starting October 1, 2012 and will expire September 30, 2013.
Estimated Time to Complete This Activity: 2.0 hours
Development of the SCI-FI Item Pools
SCI-FI development (fig 1) began with a thorough literature review, input from focus groups conducted with individuals with SCI and SCI clinicians, and feedback from experts in SCI rehabilitation. As reported by Slavin et al,15 12 focus groups with individuals who had SCI and 6 focus groups with SCI clinicians were held at 6 Spinal Cord Injury Model System (SCIMS) centers, and a rigorous qualitative analysis was conducted to extract potential activities, skills, and tasks to be included in the
Results
As shown in table 2, the SCI-FI item pool for field testing comprised 328 items, including 204 new, SCI-specific physical functioning items, 37 Neuro-QOL physical health items, 25 AM-PAC items, 33 PROMIS physical functioning items, 57 Shriners Pediatric SCI-CAT items, and 6 PROMIS assistive technology items.
Demographic data for the calibration study participants are shown in table 3. Approximately 46% of the individuals were diagnosed with paraplegia and 54% with tetraplegia; 46% of the sample
Discussion
The SCI-FI marks a significant advance in measuring physical functioning in individuals with SCI. Its content is based on direct feedback from individuals with SCI as well as SCI clinicians, and psychometric analyses24 provide evidence of the content validity of the SCI-FI. We followed the PROMIS standards for scale development throughout the qualitative and quantitative phases of this study. No other measure of physical functioning is as comprehensive and uniquely tailored to the needs of
Conclusions
The SCI-FI represents an ambitious attempt to develop a patient-reported measure of physical functioning in the SCI population. A rigorous item development process occurred that involved literature reviews, integration with previously existing items and scales, expert opinion, and feedback from consumers. After these procedures, a large multisite field test was conducted in which 855 individuals with traumatic SCI participated. The results of this study support a 5-factor solution breaking down
References (41)
- et al.
Research from the model spinal cord injury systems: findings from the current 5-year grant cycle
Arch Phys Med Rehab
(2004) - et al.
The PROMIS Initiative: involvement of rehabilitation stakeholders in development and examples of applications in rehabilitation research
Arch Phys Med Rehabil
(2011) - et al.
Incorporating the patient's perspective into drug development and communication: an ad hoc task force report of the patient-reported outcomes (PRO) harmonization group meeting at the Food and Drug Administration, February 16, 2001
Value Health
(2003) - et al.
The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008
J Clin Epidemiol
(2010) - et al.
The Neurology Quality-of-Life Measurement Initiative
Arch Phys Med Rehabil
(2011) - et al.
Evaluation of a preliminary physical function item bank supported the expected advantages of the Patient-Reported Outcomes Measurement Information System (PROMIS)
J Clin Epidemiol
(2008) - et al.
Development and initial evaluation of the Spinal Cord Injury-Functional Index
Arch Phys Med Rehabil
(2012) - et al.
Linking the activity measure for post acute care and the quality of life outcomes in neurological disorders
Arch Phys Med Rehabil
(2011) Outcome measures: evolution in clinical trials of neurological/functional recovery in spinal cord injury
Spinal Cord
(2010)Review of treatment trials in human spinal cord injury: issues, difficulties, and recommendations
Neurosurgery
(2006)
Clinical Guide for the Uniform Data Set for Medical Rehabilitation (including the FIM™ instrument)
The Functional Independence Measure: a new tool for rehabilitation
Adv Clin Rehabil
The Catz-Itzkovich SCIM: a revised version of the Spinal Cord Independence Measure
Disabil Rehabil
Outcome measures in spinal cord injury: recent assessments and recommendations for future directions
Spinal Cord
A multicenter international study on the Spinal Cord Independence Measure, version III: Rasch psychometric validation
Spinal Cord
Walking Index for Spinal Cord injury (WISCI II): scale revision
Spinal Cord
The reproducibility and convergent validity of the Walking Index for Spinal Cord Injury (WISCI) in chronic spinal cord injury
Neurorehabil Neural Repair
Functional evaluation: the Barthel Index
Md Med State J
Outcome of comprehensive medical rehabilitation: measurement by PULSES profile and the Barthel Index
Arch Phys Med Rehabil
The Quadriplegia Index of Function (QIF)–sensivitiy and reliability demonstrated in a study of 30 quadriplegic patients
Paraplegia
Cited by (0)
Supported by the U.S. Department of Education, National Institute of Disability and Rehabilitation Research (grant nos. H133N060022, H133N060024, H133N060014, H133N060005, H133N060027, and H133N060032) and by the National Institutes of Health, National Institute of Child Health & Human Development, National Center for Medical Rehabilitation Research, and National Institute of Neurological Disorders and Stroke (grant no. 5R01HD054659).
No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the authors or on any organization with which the authors are associated.
In-press corrected proof published online on Jul 30, 2012, at www.archives-pmr.org.