Haley Stephen M, Andres Patricia L, Coster Wendy J, Kosinski Mark, Ni Pengsheng, Jette Alan M
Research and Training Center on Measuring Rehabilitation Outcomes, Center for Rehabilitation Effectiveness, Sargent College of Health and Rehabilitation Sciences, Boston University, Boston, MA, USA.
Arch Phys Med Rehabil. 2004 Apr;85(4):649-60. doi: 10.1016/j.apmr.2003.08.098.
To develop a comprehensive set of short forms using item response theory (IRT) and item pooling procedures for the purpose of monitoring postacute care functional recovery.
Prospective study.
Six postacute health care networks in the greater Boston area, including inpatient acute rehabilitation, transitional care units, home care, and outpatient services.
A convenience sample of 485 adult volunteers who were currently receiving skilled rehabilitation services.
Not applicable.
We developed a set of 6 short forms across 3 activity domains from new items and items from existing postacute care instruments.
Inpatient- and community-based short forms were developed for each of 3 activity domains: physical & movement, applied cognition, and personal care & instrumental. Items were selected for inclusion on the short forms to maximize content coverage and information value of items across the range of content and to minimize ceiling and floor effects. We were able to match the distribution of sample scores with very good item precision for 1 of the constructs (physical & movement); the other 2 domains (personal care & instrumental, applied cognition) were more challenging because of the variability in patient recovery and ceiling effects.
ITR methods and item pooling procedures were valuable in developing paired sets of short-form instruments for inpatient and community rehabilitation that provided estimates of functioning along a common metric for use across postacute care settings.
运用项目反应理论（IRT）和项目合并程序开发一套全面的简表，用于监测急性后期护理中的功能恢复情况。
前瞻性研究。
大波士顿地区的六个急性后期医疗保健网络，包括住院急性康复、过渡护理单元、家庭护理和门诊服务。
485名正在接受专业康复服务的成年志愿者的便利样本。
不适用。
我们从新项目和现有急性后期护理工具中的项目开发了一套涵盖3个活动领域的6种简表。
针对3个活动领域（身体与运动、应用认知、个人护理与工具使用）中的每个领域，分别开发了基于住院和社区的简表。选择纳入简表的项目，以最大限度地扩大内容覆盖范围和项目在整个内容范围内的信息价值，并尽量减少天花板效应和地板效应。对于其中一个结构（身体与运动），我们能够以非常好的项目精度匹配样本分数的分布；由于患者恢复情况的变异性和天花板效应，另外两个领域（个人护理与工具使用、应用认知）更具挑战性。
项目反应理论（ITR）方法和项目合并程序在开发用于住院和社区康复的成对简表工具方面很有价值，这些简表工具可沿着通用指标提供功能估计，以便在急性后期护理环境中使用。
