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Abstract
Purpose. The UK Functional Assessment Measure (UK FIM+FAM) is a widely used outcome measure in brain injury rehabilitation. An Extended Activities of Daily Living (EADL) module was included in its original development, but has never been formally evaluated. This study evaluated its scoring accuracy and reliability using vignettes (short clinical scenarios).
Method. A set of vignettes was developed and tested by a panel of experienced UK FIM+FAM trainers to derive ‘gold standard’ scores. To evaluate scoring accuracy, these were subsequently compared with scores made by 12 rehabilitation professionals; first individually, and then together in four multi-disciplinary (MD) teams to reflect clinical practice. Scoring was repeated after 1 month. Inter-rater and intra-rater reliability were evaluated for both individual and MD team scores using weighted Cohen's kappa statistics.
Results. Agreement with ‘gold standard scores' was excellent, ranging from kw = 0.88–0.97 (individuals) and kw = 0.93–1.00 (MD teams). Inter-rater agreement was good to excellent, ranging from k = 0.68–0.92 (individuals) and k = 0.74–1.00 (MD teams). Test–retest agreement was excellent, ranging from kw = 0.92–1.00 (individuals) and kw = 0.89–0.99 (MD teams).
Conclusion. This vignette-based study demonstrated high levels of scoring accuracy and reliability for the EADL items of the UK FIM+FAM. Further testing in real-life situations is now warranted.
Notes
Notes
1. FIM™ is a trademark of the Uniform Data System for Medical Rehabilitation, a division of UB Foundation Activities, Inc.
2. Copies of the EADL items may be obtained with the UK FIM+FAM on application to authors. Scoring manuals and copies of vignettes are available to individuals who register as trainers within the UK FIM+FAM training centre.