title: Exploring rating scale responsiveness: does the total score reflect the sum of its parts?
abstract: Evaluating rehabilitation requires rating scales that detect change. The authors examined Barthel Index (BI) data from 1,495 patients at a neurorehabilitation unit to determine whether total scale responsiveness accurately reflects item responsiveness. Total score effect sizes were moderate to large (0.47 to 1.09). Item-level effect sizes (0.13 to 1.16) reveal floor (3.5 to 82.3%) and ceiling (9.7 to 95.4%) effects. Results suggest BI total score effect sizes may hide item-level weaknesses and may underestimate the impact of rehabilitation.
authors.affiliation: Neurological Outcome Measures Unit, Institute of Neurology, University College London, UK.
authors.forename: Rory J
authors.initials: RJ
authors.lastname: O'Connor
authors.forename: Stefan J
authors.initials: SJ
authors.lastname: Cano
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Thompson
authors.forename: Jeremy C
authors.initials: JC
authors.lastname: Hobart
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002493:Central Nervous System Diseases / Q000534:rehabilitation*; D015986:Confounding Factors, Epidemiologic; D019317:Evidence-Based Medicine; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009103:Multiple Sclerosis / Q000534:rehabilitation; D015203:Reproducibility of Results; D012720:Severity of Illness Index; D013119:Spinal Cord Injuries / Q000534:rehabilitation; D000071939:Stroke Rehabilitation