The Extended Barthel Index (EBI) can Be Reported as a Unidimensional Interval-Scaled Metric – A Psychometric Study

Abstract

Background The Extended Barthel Index (EBI), consisting of the original Barthel Index plus 6 cognitive items, provides a tool to monitor patients’ outcomes in rehabilitation. Whether the EBI provides a unidimensional metric, thus can be reported as a valid sum-score, remains to be examined.

Objective To examine whether the EBI can be reported as unidimensional interval-scaled metric for neurological and musculoskeletal rehabilitation.

Methods Rasch analysis of a calibration sample of 800 cases from neurological or musculoskeletal rehabilitation in 2016 in Switzerland.

Results In the baseline analysis no fit to the Rasch Model was achieved. When accommodating local dependencies with a testlet approach satisfactory fit to the Rasch Model was achieved, and an interval scale transformation table was created.

Conclusion The results support the reporting of adapted EBI total scores for both rehabilitation groups by applying the interval scaled transformation table presented in this study.

Zusammenfassung

Hintergrund Der Erweiterte Barthel Index (EBI), der den Barthel Index um 6 kognitive Items ergänzt, ist ein Assessmentinstrument für die Rehabilitation. Ob der EBI eine eindimensionale Metrik liefert und somit als valider Gesamtscore berichtet werden kann, ist unklar.

Ziel Untersuchung ob der EBI für die neurologische und muskuloskelettale Rehabilitation als eindimensionale intervallskalierte Metrik berichtet werden kann.

Methode Rasch-Analyse einer Stichprobe von 800 neurologischen und muskuloskelettalen Rehapatienten aus der Schweiz.

Ergebnisse In der Basisanalyse wurde keine Übereinstimmung mit den Annahmen des Rasch-Modells erreicht. Nachdem lokale Item-Abhängigkeiten mit 2 Testlets angepasst wurden, wurde die Übereinstimmung erreicht und eine intervallskalierte Transformationstabelle erstellt.

Konklusion Die Ergebnisse unterstützen die Verwendung eines angepassten EBI Gesamtscores für beide Rehabilitationsgruppen unter Anwendung der intervallskalierten Transformationstabelle.

Key words

activities of daily living - assessment instruments - outcome assessment - rehabilitation - Rasch model - quality management

Schlüsselwörter

Alltagsaktivität - Ergebnismessung - Qualitätsmanagement - Rehabilitation - Rasch Modell - Assessmentinstrumente

^* NRP74 StARS clinics: cereneo Schweiz – Robinson Kundert; Hôpital du Valais Spital Wallis, Centre Martigny, Sierre, Brig & Saint-Amé – Els De Waele; Klinik Schönberg – Philipp Banz; Kliniken Valens, Rehazentrum Valens, Rehazentrum Walenstadtberg & Rheinburg-Klinik – Stefan Bachmann, Luzerner Höhenklinik Montana – Jean-Marie Schnyder, Reha Rheinfelden – Thierry Ettlin

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