Developing a contemporary functional outcome measure for spinal cord injury research

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Study design: This study used qualitative analysis of focus group discussions. Objective: The primary objective was to select functional activities to include in an item pool, which is the first step in developing a spinal cord injury computer adaptive test (SCI-CAT).
Setting: This multisite study was conducted at six US National Spinal Cord Injury Model Systems Programs. Methods: Focus group discussions, which included persons with tetraplegia and paraplegia and clinicians, were conducted. Transcripts were analyzed using grounded theory approach. Functional activities were identified, binnedl winnowed, written as functional items, and cognitively tested. Results:' Focus group discussion analysis identified 326 functional activity items that fit into categories
outlined in the International Classification of Functioning, Disability and Health (ICF) framework: Mobility (1 93 items), including assessment of functioning in a manual (44 items) and power wheelchair (1 9 items); self-care (1 09 items); and communication (1 9 items). Items related to sexual function were also identified (5 items). Conclusion: The SCI-CAT item pool includes items that assess functional activities important to persons with SCI. Items cover a wide range of functional ability and reflect most ICF categories. The Spinal Cord (201 0) 48, 262-267; doi:1 0.1 038/sc.2009.1 3 1 ; p.blished online 20 October 2009 Keywords: spinal cord injury; outcome measure; functional assessment; item response theory; computer adaptive testing SCI-CAT pool is currently being field tested to develop a calibrated item bank. Further development will yield a CAT of functional activities appropriate for SCI research.

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