Objective

To develop a system to guide interpretation of scores generated from the newly developed item response theory (IRT)-based, multi-dimensional computer adaptive test (FAMCAT) which assesses three important domains of function: mobility, daily activities, and applied cognition.

Design

Cross-sectional data used to inform a modified-Delphi approach to establish FAMCAT cut points delineating various functional ability levels.

Setting

Large Midwestern academic teaching hospital

Participants

2049 patients hospitalized to an inpatient medical service

Intervention

Not applicable.

Main Outcome Measures

FAMCAT Basic Mobility, Daily Activity, and Applied Cognition scores

Results

IRT-based score estimation data was successfully integrated with expert clinical feedback using a modified-Delphi process to arrive at consensus yielding 4 functional level strata (ranging from bed-based mobility to independent mobility) for both the FAMCAT Mobility and Daily Activity scales; 1 cut-point was supported to delineate two functional strata for Applied Cognition.

Conclusions

Meaningful cut-points were established for each FAMCAT domain using a data-informed, modified-Delphi process for achieving consensus. The resulting FAMCAT interpretation guide may be used to develop an ability-matched mobility preservation program and identify patients who may require a higher level of supervision based on the resulting FAMCAT scores.

中文翻译：

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确定临床相关的功能层以在因疾病住院的患者中直接保持活动能力

客观的

开发一个系统来指导对新开发的基于项目反应理论 (IRT) 的多维计算机自适应测试 (FAMCAT) 生成的分数的解释，该测试评估三个重要的功能领域：流动性、日常活动和应用认知。

设计

横截面数据用于通知改进的 Delphi 方法，以建立描绘各种功能能力水平的 FAMCAT 切点。

环境

大型中西部学术教学医院

参加者

2049 名住院患者接受住院医疗服务

干涉

不适用。

主要观察指标

FAMCAT 基本活动能力、日常活动和应用认知分数

结果

基于 IRT 的评分估计数据成功地与专家临床反馈相结合，使用改进的 Delphi 过程达成共识，为 FAMCAT 移动和日常活动量表产生 4 个功能水平层次（从基于床的移动到独立移动）；支持 1 个切点来描绘应用认知的两个功能层。

结论

有意义的切点是为每个 FAMCAT 域建立的，使用数据通知、改进的 Delphi 过程来达成共识。由此产生的 FAMCAT 解释指南可用于制定能力匹配的活动性保护计划，并根据由此产生的 FAMCAT 评分确定可能需要更高级别监督的患者。