Brain Injury Functional Outcome Measure (BI-FOM): A Single Instrument Capturing the Range of Recovery in Moderate-Severe Traumatic Brain Injury

John Whyte; Joseph T. Giacino; Allen W. Heinemann; Yelena Bodien; Tessa Hart; Mark Sherer; Gale G. Whiteneck; David Mellick; Flora M. Hammond; Patrick Semik; Amy Rosenbaum; Risa Nakase Richardson

doi:10.1016/j.apmr.2020.09.377

Brain Injury Functional Outcome Measure (BI-FOM): A Single Instrument Capturing the Range of Recovery in Moderate-Severe Traumatic Brain Injury

John Whyte^*, Joseph T. Giacino, Allen W. Heinemann, Yelena Bodien, Tessa Hart, Mark Sherer, Gale G. Whiteneck, David Mellick, Flora M. Hammond, Patrick Semik, Amy Rosenbaum, Risa Nakase Richardson

^*Corresponding author for this work

Physical Medicine and Rehabilitation

Research output: Contribution to journal › Article › peer-review

10 Scopus citations

Abstract

Objective: To develop a measure of global functioning after moderate-severe TBI with similar measurement precision but a longer measurement range than the FIM. Design: Phase 1: retrospective analysis of 5 data sets containing FIM, Disability Rating Scale, and other assessment items to identify candidate items for extending the measurement range of the FIM; Phase 2: prospective administration of 49 candidate items from phase 1, with Rasch analysis to identify a unidimensional scale with an extended range. Setting: Six TBI Model System rehabilitation hospitals. Participants: Individuals (N=184) with moderate-severe injury recruited during inpatient rehabilitation or at 1-year telephone follow-up. Interventions: Participants were administered the 49 assessment items in person or via telephone. Main Outcome Measures: Item response theory parameters: item monotonicity, infit/outfit statistics, and Factor 1 variance. Results: After collapsing misordered rating categories and removing misfitting items, we derived the Brain Injury Functional Outcome Measure (BI-FOM), a 31-item assessment instrument with high reliability, greatly extended measurement range, and improved unidimensionality compared with the FIM. Conclusions: The BI-FOM improves global measurement of function after moderate-severe brain injury. Its high precision, relative lack of floor and ceiling effects, and feasibility for telephone follow-up, if replicated in an independent sample, are substantial advantages.

Original language	English (US)
Pages (from-to)	87-96
Number of pages	10
Journal	Archives of physical medicine and rehabilitation
Volume	102
Issue number	1
DOIs	https://doi.org/10.1016/j.apmr.2020.09.377
State	Published - Jan 2021

Funding

Supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR; grant nos. 90DP0037 , 90DPTB0004 , 90DP0039 , 90DP0036 , 90DRTB0002 , 90DP0034 , 90DP0013 , and 90DP0028 ). Additional funding was provided by Moss Rehabilitation Research Institute. NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government. Supported by the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR; grant nos. 90DP0037, 90DPTB0004, 90DP0039, 90DP0036, 90DRTB0002, 90DP0034, 90DP0013, and 90DP0028). Additional funding was provided by Moss Rehabilitation Research Institute. NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this publication do not necessarily represent the policy of NIDILRR, ACL, or HHS, and you should not assume endorsement by the Federal Government.

Keywords

Assessment
Brain injuries
Outcome Measurement
Patient outcome
Rehabilitation

ASJC Scopus subject areas

Physical Therapy, Sports Therapy and Rehabilitation
Rehabilitation

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10.1016/j.apmr.2020.09.377

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Whyte, J., Giacino, J. T., Heinemann, A. W., Bodien, Y., Hart, T., Sherer, M., Whiteneck, G. G., Mellick, D., Hammond, F. M., Semik, P., Rosenbaum, A., & Richardson, R. N. (2021). Brain Injury Functional Outcome Measure (BI-FOM): A Single Instrument Capturing the Range of Recovery in Moderate-Severe Traumatic Brain Injury. Archives of physical medicine and rehabilitation, 102(1), 87-96. https://doi.org/10.1016/j.apmr.2020.09.377

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title = "Brain Injury Functional Outcome Measure (BI-FOM): A Single Instrument Capturing the Range of Recovery in Moderate-Severe Traumatic Brain Injury",

abstract = "Objective: To develop a measure of global functioning after moderate-severe TBI with similar measurement precision but a longer measurement range than the FIM. Design: Phase 1: retrospective analysis of 5 data sets containing FIM, Disability Rating Scale, and other assessment items to identify candidate items for extending the measurement range of the FIM; Phase 2: prospective administration of 49 candidate items from phase 1, with Rasch analysis to identify a unidimensional scale with an extended range. Setting: Six TBI Model System rehabilitation hospitals. Participants: Individuals (N=184) with moderate-severe injury recruited during inpatient rehabilitation or at 1-year telephone follow-up. Interventions: Participants were administered the 49 assessment items in person or via telephone. Main Outcome Measures: Item response theory parameters: item monotonicity, infit/outfit statistics, and Factor 1 variance. Results: After collapsing misordered rating categories and removing misfitting items, we derived the Brain Injury Functional Outcome Measure (BI-FOM), a 31-item assessment instrument with high reliability, greatly extended measurement range, and improved unidimensionality compared with the FIM. Conclusions: The BI-FOM improves global measurement of function after moderate-severe brain injury. Its high precision, relative lack of floor and ceiling effects, and feasibility for telephone follow-up, if replicated in an independent sample, are substantial advantages.",

keywords = "Assessment, Brain injuries, Outcome Measurement, Patient outcome, Rehabilitation",

author = "John Whyte and Giacino, {Joseph T.} and Heinemann, {Allen W.} and Yelena Bodien and Tessa Hart and Mark Sherer and Whiteneck, {Gale G.} and David Mellick and Hammond, {Flora M.} and Patrick Semik and Amy Rosenbaum and Richardson, {Risa Nakase}",

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year = "2021",

month = jan,

doi = "10.1016/j.apmr.2020.09.377",

language = "English (US)",

volume = "102",

pages = "87--96",

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Whyte, J, Giacino, JT, Heinemann, AW, Bodien, Y, Hart, T, Sherer, M, Whiteneck, GG, Mellick, D, Hammond, FM, Semik, P, Rosenbaum, A & Richardson, RN 2021, 'Brain Injury Functional Outcome Measure (BI-FOM): A Single Instrument Capturing the Range of Recovery in Moderate-Severe Traumatic Brain Injury', Archives of physical medicine and rehabilitation, vol. 102, no. 1, pp. 87-96. https://doi.org/10.1016/j.apmr.2020.09.377

TY - JOUR

T1 - Brain Injury Functional Outcome Measure (BI-FOM)

T2 - A Single Instrument Capturing the Range of Recovery in Moderate-Severe Traumatic Brain Injury

AU - Whyte, John

AU - Giacino, Joseph T.

AU - Heinemann, Allen W.

AU - Bodien, Yelena

AU - Hart, Tessa

AU - Sherer, Mark

AU - Whiteneck, Gale G.

AU - Mellick, David

AU - Hammond, Flora M.

AU - Semik, Patrick

AU - Rosenbaum, Amy

AU - Richardson, Risa Nakase

PY - 2021/1

Y1 - 2021/1

N2 - Objective: To develop a measure of global functioning after moderate-severe TBI with similar measurement precision but a longer measurement range than the FIM. Design: Phase 1: retrospective analysis of 5 data sets containing FIM, Disability Rating Scale, and other assessment items to identify candidate items for extending the measurement range of the FIM; Phase 2: prospective administration of 49 candidate items from phase 1, with Rasch analysis to identify a unidimensional scale with an extended range. Setting: Six TBI Model System rehabilitation hospitals. Participants: Individuals (N=184) with moderate-severe injury recruited during inpatient rehabilitation or at 1-year telephone follow-up. Interventions: Participants were administered the 49 assessment items in person or via telephone. Main Outcome Measures: Item response theory parameters: item monotonicity, infit/outfit statistics, and Factor 1 variance. Results: After collapsing misordered rating categories and removing misfitting items, we derived the Brain Injury Functional Outcome Measure (BI-FOM), a 31-item assessment instrument with high reliability, greatly extended measurement range, and improved unidimensionality compared with the FIM. Conclusions: The BI-FOM improves global measurement of function after moderate-severe brain injury. Its high precision, relative lack of floor and ceiling effects, and feasibility for telephone follow-up, if replicated in an independent sample, are substantial advantages.

AB - Objective: To develop a measure of global functioning after moderate-severe TBI with similar measurement precision but a longer measurement range than the FIM. Design: Phase 1: retrospective analysis of 5 data sets containing FIM, Disability Rating Scale, and other assessment items to identify candidate items for extending the measurement range of the FIM; Phase 2: prospective administration of 49 candidate items from phase 1, with Rasch analysis to identify a unidimensional scale with an extended range. Setting: Six TBI Model System rehabilitation hospitals. Participants: Individuals (N=184) with moderate-severe injury recruited during inpatient rehabilitation or at 1-year telephone follow-up. Interventions: Participants were administered the 49 assessment items in person or via telephone. Main Outcome Measures: Item response theory parameters: item monotonicity, infit/outfit statistics, and Factor 1 variance. Results: After collapsing misordered rating categories and removing misfitting items, we derived the Brain Injury Functional Outcome Measure (BI-FOM), a 31-item assessment instrument with high reliability, greatly extended measurement range, and improved unidimensionality compared with the FIM. Conclusions: The BI-FOM improves global measurement of function after moderate-severe brain injury. Its high precision, relative lack of floor and ceiling effects, and feasibility for telephone follow-up, if replicated in an independent sample, are substantial advantages.

KW - Assessment

KW - Brain injuries

KW - Outcome Measurement

KW - Patient outcome

KW - Rehabilitation

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ER -

Brain Injury Functional Outcome Measure (BI-FOM): A Single Instrument Capturing the Range of Recovery in Moderate-Severe Traumatic Brain Injury

Abstract

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Keywords

ASJC Scopus subject areas

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