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Comparing the reliability of five participation instruments in persons with spinal conditions
OBJECTIVE: To compare the score distribution and reliability of 5 participation instruments developed using the International Classification of Functioning, Disability and Health.
METHODS: Individuals treated for spinal conditions at an acute hospital were followed-up and 545 participated. Subjects completed 5 participation instruments (Impact on Participation and Autonomy (IPA), Keele Assessment of Participation (KAP), Participation Measure-Post Acute Care (PM-PAC), Participation Objective Participation Subjective (POPS) and World Health Organization Disability Assessment Schedule II (WHODAS II)). Test-retest reliability was assessed in 139 subjects. The score distribution, internal consistency and test-retest reliability were assessed.
RESULTS: All the instruments demonstrated considerable ceiling effects, except for the POPS. Internal consistency (Cronbach’s alpha) was ≥ 0.70 for all domains. The IPA and WHODAS II had the highest test-retest values, with intraclass correlation coefficients ≥ 0.70. The minimal detectable change as a percentage of the absolute scale score range was primarily between 20% and 30%.
CONCLUSION: The IPA, PM-PAC and WHODAS II have similar measurement properties. The KAP was designed for population-based studies and the POPS includes objective and subjective information, which may explain some of the differences observed. Researchers and clinicians should select an instrument that will fulfil their measurement objectives and future studies should assess minimal important change.
Vanessa K. Noonan, Jacek Kopec, Luc Noreau, Joel Singer, Louise C. Mâsse, Marcel F. Dvorak
- World Health Organization. International Classification of Functioning, Disability and Health. Geneva (Switzerland): World Health Organization; 2001.
- Noonan VK, Kopec JA, Noreau L, Singer J, Dvorak MF. A review of participation instruments based on the International Classification of Functioning, Disability and Health. Disabil Rehabil 2009; 31: 1883–1901.
- Dekker J, Dallmeijer AJ, Lankhorst GJ. Clinimetrics in rehabilitation medicine: current issues in developing and applying measurement instruments. J Rehabil Med 2005; 37: 193–201.
- Fitzpatrick R, Davey C, Buxton MJ, Jones DR. Evaluating patient-based outcome measures for use in clinical trials. Health Technol Assess 1998; 2: 1–74.
- Scientific Advisory Committee of the Medical Outcomes Trust. Assessing health status and quality-of-life instruments: attributes and review criteria. Qual Life Res 2002; 11: 193–205.
- Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, Dekker J, et al. Quality criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007; 60: 34–42.
- Posl M. Evaluation of the World Health Organization Disability Assessment Schedule II (WHODAS II) – German Version [dissertation]. Ludwig Maximilian University: Munich (Germany); 2004.
- Wilkie R, Peat G, Thomas E, Hooper H, Croft PR. The Keele Assessment of Participation: a new instrument to measure participation restriction in population studies. Combined qualitative and quantitative examination of its psychometric properties. Qual Life Res 2005; 14: 1889–1899.
- Beckerman H, Roebroeck ME, Lankhorst GJ, Becher JG, Bezemer PD, Verbeek AL. Smallest real difference, a link between reproducibility and responsiveness. Qual Life Res 2001; 10: 571–578.
- de Vet HC, Terwee CB, Knol DL, Bouter LM. When to use agreement versus reliability measures. J Clin Epidemiol 2006; 59: 1033–1039.
- Cassidy JD, Cote P, Carroll LJ, Kristman V. Incidence and course of low back pain episodes in the general population. Spine 2005; 30: 2817–2823.
- Katz JN. Lumbar disc disorders and low-back pain: socioeconomic factors and consequences. J Bone Joint Surg Am 2006; 88 Suppl 2: 21–24.
- Lund ML, Nordlund A, Nygard L, Lexell J, Bernspang B. Perceptions of participation and predictors of perceived problems with participation in persons with spinal cord injury. J Rehabil Med 2005; 37: 3–8.
- Kannus P, Niemi S, Palvanen M, Parkkari J. Continuously increasing number and incidence of fall-induced, fracture-associated, spinal cord injuries in elderly persons. Arch Intern Med 2000; 160: 2145–2149.
- Tinetti ME, Baker DI, McAvay G, Claus EB, Garrett P, Gottschalk M, et al. A multifactorial intervention to reduce the risk of falling among elderly people living in the community. N Engl J Med 1994; 331: 821–827.
- Cardol M, de Haan RJ, de Jong BA, van den Bos GA, de Groot IJ. Psychometric properties of the Impact on Participation and Autonomy Questionnaire. Arch Phys Med Rehabil 2001; 82: 210–216.
- Gandek B, Sinclair SJ, Jette AM, Ware JE, Jr. Development and initial psychometric evaluation of the Participation Measure for Post-Acute Care (PM-PAC). Am J Phys Med Rehabil 2006; 86: 57–71.
- Brown M, Dijkers MP, Gordon WA, Ashman T, Charatz H, Cheng Z. Participation objective, Participation subjective: a measure of participation combining outsider and insider perspectives. J Head Trauma Rehabil 2004; 19: 459–481.
- World Health Organization. Geneva: WHODAS II [updated 2001, November 27; cited 2006 March 10]. Available from: http://www.who.int/icidh/whodas.
- Streiner DL, Norman GR. Health measurement scales: a practical guide to their development and use. 2nd edn. Oxford: Oxford University Press; 1995.
- Marino RJ, Barros T, Biering-Sorensen F, Burns SP, Donovan WH, Graves DE, et al. International standards for neurological classification of spinal cord injury. J Spinal Cord Med 2003; 26 Suppl 1: S50–S56.
- Sangha O, Stucki G, Liang MH, Fossel AH, Katz JN. The Self-Administered Comorbidity Questionnaire: a new method to assess comorbidity for clinical and health services research. Arthritis Rheum 2003; 49: 156–163.
- Dijkers M. Comments on van Brakel et al.’s Participation Scale. Disabil Rehabil 2006; 28: 1360–1362.
- Gray DB, Hollingsworth HH, Stark SL, Morgan KA. Participation Survey/Mobility: psychometric properties of a measure of participation for people with mobility impairments and limitations. Arch Phys Med Rehabil 2006; 87: 189–197.
- van Brakel WH, Anderson AM, Mutatkar RK, Bakirtzief Z, Nicholls PG, Raju MS, et al. The Participation Scale: measuring a key concept in public health. Disabil Rehabil 2006; 28: 193–203.
- Ostir GV, Granger CV, Black T, Roberts P, Burgos L, Martinkewiz P, et al. Preliminary results for the PAR-PRO: a measure of home and community participation. Arch Phys Med Rehabil 2006; 87: 1043–1051.
- Haley SM, Gandek B, Siebens H, Black-Schaffer RM, Sinclair SJ, Tao W, et al. Computerized adaptive testing for follow-up after discharge from inpatient rehabilitation: II. Participation outcomes. Arch Phys Med Rehabil 2008; 89: 275–283.
- Sandstrom M, Lundin-Olsson L. Development and evaluation of a new questionnaire for rating perceived participation. Clin Rehabil 2007; 21: 833–845.
- Pallant JF, Misajon R, Bennett E, Manderson L. Measuring the impact and distress of health problems from the individual’s perspective: development of the Perceived Impact of Problem Profile (PIPP). Health Qual Life Outcomes 2006; 4: 36.
- Fayers PM, Machin D. Quality of life: assessment, analysis and interpretation. Chichester: John Wiley and Sons; 2000.
- Bland JM, Altman DG. Measuring agreement in method comparison studies. Stat Methods Med Res 1999; 8: 135–160.
- Franchignoni F, Ferriero G, Giordano A, Guglielmi V, Picco D. Rasch psychometric validation of the Impact on Participation and Autonomy questionnaire in people with Parkinson’s disease. Eura Medicophys 2007; 43: 451–461.
- Lund ML, Fisher AG, Lexell J, Bernspang B. Impact on Participation and Autonomy questionnaire: internal scale validity of the Swedish version for use in people with spinal cord injury. J Rehabil Med 2007; 39: 156–162.
- Middelkamp W, Moulaert VR, Verbunt JA, van Heugten CM, Bakx WG, Wade DT. Life after survival: long-term daily life functioning and quality of life of patients with hypoxic brain injury as a result of a cardiac arrest. Clin Rehabil 2007; 21: 425–431.
- Sibley A, Kersten P, Ward CD, White B, Mehta R, George S. Measuring autonomy in disabled people: Validation of a new scale in a UK population. Clin Rehabil 2006; 20: 793–803.
- van Genderen FR, van Meeteren NL, Heijnen L, van den Berg HM, Helders PJ. The use of a disability model in haemophilia research. Haemophilia 2005; 11: 472–480.
- Dijkers MP, Whiteneck G, El Jaroudi R. Measures of social outcomes in disability research. Arch Phys Med Rehabil 2000; 81: S63–S80.
- Chisolm TH, Abrams HB, McArdle R, Wilson RH, Doyle PJ. The WHO-DAS II: psychometric properties in the measurement of functional health status in adults with acquired hearing loss. Trends Amplif 2005; 9: 111–126.
- McKibbin C, Patterson TL, Jeste DV. Assessing disability in older patients with schizophrenia: results from the WHODAS-II. J Nerv Ment Dis 2004; 192: 405–413.
- de Boer MR, de Vet HC, Terwee CB, Moll AC, Volker-Dieben HJ, van Rens GH. Changes to the subscales of two vision-related quality of life questionnaires are proposed. J Clin Epidemiol 2005; 58: 1260–1268.
- de Vet HC, Bouter LM, Bezemer PD, Beurskens AJ. Reproducibility and responsiveness of evaluative outcome measures. Theoretical considerations illustrated by an empirical example. Int J Technol Assess Health Care 2001; 17: 479–487.
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