Determination of the Minimal Clinically Important Difference in the FIM Instrument in Patients With Stroke
| Autor: | Marianne Beninato, Kathleen M Gill-Body, Joel Stein, Randie M. Black-Schaffer, Sara S. Salles, Paul Stark |
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| Rok vydání: | 2006 |
| Předmět: |
Adult
Male medicine.medical_specialty Activities of daily living medicine.medical_treatment Physical Therapy Sports Therapy and Rehabilitation Motor Activity Sensitivity and Specificity Severity of Illness Index Statistics Nonparametric Cohort Studies Disability Evaluation Cognition Sex Factors Risk Factors Acute care Activities of Daily Living Outcome Assessment Health Care Severity of illness medicine Health Status Indicators Humans Prospective Studies Prospective cohort study Stroke Physical Therapy Modalities Aged Probability Aged 80 and over Rehabilitation Receiver operating characteristic business.industry Minimal clinically important difference Age Factors Stroke Rehabilitation Recovery of Function Middle Aged Prognosis medicine.disease humanities Treatment Outcome Physical therapy Female sense organs business human activities |
| Zdroj: | Archives of Physical Medicine and Rehabilitation. 87:32-39 |
| ISSN: | 0003-9993 |
| Popis: | Beninato M, Gill-Body KM, Salles S, Stark PC, Black-Schaffer RM, Stein J. Determination of the minimal clinically important difference in the FIM instrument in patients with stroke. Objective To define the minimal clinically important difference (MCID) for the FIM instrument in patients poststroke. Design Prospective case series discharged over a 9-month period. Setting Long-term acute care hospital. Participants Patients with stroke (N=113). Interventions Not applicable. Main Outcome Measures Admission, discharge, and change scores were calculated for the total FIM, motor FIM, and cognitive FIM. Assessments of clinical change were rated at discharge on a 15-point (−7 to +7) Likert scale by attending physicians, with MCID defined at a cutoff score of 3. The FIM change scores associated with MCID were identified from receiver operating characteristic curves. Bayesian analysis was used to determine the probability of individual patients achieving MCID. Results FIM change scores associated with MCID were 22, 17, and 3 for the total FIM, motor FIM, and cognitive FIM, respectively. The accuracy of the MCID was greater when subjects were categorized based on admission FIM scores than when considering the sample as a whole. Larger FIM change scores were related to MCID in subjects with lower admission FIM scores. Conclusions These findings will assist in the interpretation of FIM change scores relative to physicians' assessments of important clinical change. |
| Databáze: | OpenAIRE |
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