Ottenbacher K J, Hsu Y, Granger C V, Fiedler R C
University of Texas Medical Branch at Galveston, USA.
Arch Phys Med Rehabil. 1996 Dec;77(12):1226-32. doi: 10.1016/s0003-9993(96)90184-7.
The reliability of the Functional Independence Measure (FIMSM) for adults was examined using procedures of meta-analysis.
Eleven published studies reporting estimates of reliability for the FIM were located using computer searches of Index Medicus, Psychological Abstracts, the Functional Assessment Information Service, and citation tracking.
Studies were identified and coded based on type of reliability (interrater, test-retest, or equivalence), method of data analysis, size of sample, and training or experience of raters.
Information from the articles was coded by two independent raters. Interrater reliability for coding all elements included in the analysis ranged from .89 to 1.00.
The 11 investigations included a total of 1,568 patients and produced 221 reliability coefficients. The majority of the reliability values (81%) were from interrater reliability studies, and the intraclass correlation coefficient (ICC) was the most commonly used statistical procedure to compute reliability. The reported reliability values were converted to a common correlation metric and aggregated across the 11 studies. The results revealed a median interrater reliability for the total FIM of .95 and median test-retest and equivalence reliability values of .95 and .92, respectively. The median reliability values for the six FIM subscales ranged from .95 for Self-Care to .78 for Social Cognition. For the individual FIM items, median reliability values varied from .90 for Toilet Transfer to .61 for Comprehension. Median and mean reliability coefficients for FIM motor items were generally higher than for items in the cognitive or communication subscales.
Based on the 11 studies examined in this review the FIM demonstrated acceptable reliability across a wide variety of settings, raters, and patients.
采用荟萃分析程序检验成人功能独立性测量量表（FIMSM）的可靠性。
通过检索医学索引、心理学文摘、功能评估信息服务以及引文追踪，找到了11项已发表的报告FIM可靠性估计值的研究。
根据可靠性类型（评定者间、重测或等效性）、数据分析方法、样本量以及评定者的培训或经验对研究进行识别和编码。
文章中的信息由两名独立评定者进行编码。对分析中包含的所有元素进行编码的评定者间信度在0.89至1.00之间。
11项调查共纳入1568例患者，得出221个可靠性系数。大多数可靠性值（81%）来自评定者间可靠性研究，组内相关系数（ICC）是计算可靠性最常用的统计方法。将报告的可靠性值转换为通用相关度量，并在11项研究中进行汇总。结果显示，FIM总分的评定者间可靠性中位数为0.95，重测和等效性可靠性中位数分别为0.95和0.92。FIM六个分量表的可靠性中位数从自我照顾的0.95到社会认知的0.78不等。对于FIM的各个项目，可靠性中位数从如厕转移的0.90到理解的0.61不等。FIM运动项目的可靠性中位数和均值通常高于认知或沟通分量表中的项目。
基于本综述中所考察的11项研究，FIM在各种环境、评定者和患者中均显示出可接受的可靠性。
