Rasch analysis of the orientation log and reconsideration of the latent construct during inpatient rehabilitation.
OBJECTIVE
To investigate the measurement properties of the Orientation Log (O-Log) and a hybrid scale using Rasch analysis techniques and to explore the relations between the items of the 2 scales and the latent linear construct modeled in the Rasch analysis.


METHODS
Calibration of data collected weekly during inpatient rehabilitation.


METHODS
Ninety patients admitted for rehabilitation after traumatic brain injury.


RESULTS
Measure reliability/construct validity of the O-Log was too low to justify restructuring of disordered rating scales, but the broader set of items in the hybrid scale demonstrated good measure reliability/construct validity prior to and following rating scale restructuring. Both O-Log and hybrid measures demonstrated statistical fit with the linear latent construct, suggesting that orientation and memory are only a subset of symptoms in a broader syndrome.


CONCLUSIONS
Posttraumatic amnesia is by definition a proxy measure of a broader syndrome during early recovery and not a measure of the syndrome itself. The results suggest that the O-Log cannot reliably measure progress during early recovery. Furthermore, the analysis suggests that the construct of posttraumatic amnesia is too narrow and should be revisited to improve monitoring of recovery and prognostic estimation after brain injury.
Kean
Jacob
J
Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, Indianapolis, IN 46202, USA. jakean@indiana.edu
Abell
Malene
M
Malec
James F
JF
Trzepacz
Paula T
PT
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000647:Amnesia / Q000175:diagnosis*; D001930:Brain Injuries / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D008875:Middle Aged; D009949:Orientation; D011569:Psychiatric Status Rating Scales; D015203:Reproducibility of Results; D013577:Syndrome; D055815:Young Adult