Kings College London, School of Medicine, Department of Palliative Care, Policy and Rehabilitation Regional Rehabilitation Unit, Northwick Park Hospital, London, UK.
Clin Rehabil. 2010 Dec;24(12):1121-6. doi: 10.1177/0269215510375904. Epub 2010 Aug 16.
to examine the extent of agreement between Barthel Index scores derived from Northwick Park Dependency Scores (NPDS) and the Functional Independence Measure (FIM) ratings, in an inpatient setting.
previously described conversion criteria were applied in a secondary analysis of a large existing dataset, gathered in a tertiary specialist inpatient neurorehabilitation unit.
patients with neurological disabilities (N = 1347), mainly following acquired brain injury.
comparison of Barthel scores derived from the NPDS (rated by nursing staff) and from parallel FIM scores (rated by the therapy team).
very strong intraclass correlations were observed between the total scores (0.93, P<0.001); 95% limits of agreement ranged from -3.53 to 4.90. Item-by-item agreement (linear-weighted Cohen's kappa coefficients) ranged from 0.41 to 0.77, which represents 'moderate' to 'substantial' agreement. A significant bias towards lower NPDS-derived scores (median 10 (interquartile range (IQR) 6-16) compared with median 11 (IQR 7-16) for the FIM-derived score; Wilcoxon z 11.60, P<0.001) was considered most likely to reflect actual differences in patient performance observed by therapy and nursing staff.
this study demonstrates good overall agreement between the Barthel Index ratings derived from NPDS and FIM scores. However, scores may be affected by differential performance with nursing and therapy staff, and should not automatically be regarded as equivalent.
在住院环境中，检查诺威治公园依赖评分（NPDS）衍生的巴氏量表评分与功能独立性测量（FIM）评分之间的一致性程度。
在一个大型现有数据集的二次分析中应用了先前描述的转换标准，该数据集是在三级专科住院神经康复病房中收集的。
患有神经功能障碍的患者（N=1347），主要是后天性脑损伤。
比较 NPDS（由护理人员评定）和平行 FIM 评分（由治疗团队评定）得出的巴氏量表评分。
观察到总分之间存在很强的组内相关性（0.93，P<0.001）；95%一致性界限范围为-3.53 至 4.90。逐项一致性（线性加权 Cohen's kappa 系数）范围为 0.41 至 0.77，代表“中度”至“高度”一致。NPDS 衍生评分（中位数 10（四分位距（IQR）6-16））明显偏向于较低的评分，而 FIM 衍生评分（中位数 11（IQR 7-16）；Wilcoxon z 11.60，P<0.001），这最有可能反映治疗和护理人员观察到的患者表现的实际差异。
本研究表明，NPDS 和 FIM 评分衍生的巴氏量表评分之间总体上具有良好的一致性。然而，评分可能受到与护理和治疗人员的不同表现的影响，不应自动视为等效。
