title: Towards the development of clinical measures for spinal cord injury based on the International Classification of Functioning, Disability and Health with Rasch analyses.
abstract: OBJECTIVE
  To determine whether the International Classification of Functioning, Disability and Health (ICF) categories relevant to spinal cord injury (SCI) can be integrated in clinical measures and to obtain insights to guide their future operationalization. Specific aims are to find out whether the ICF categories relevant to SCI fit a Rasch model taking into consideration the dimensionality found in previous investigations, local item dependencies, or differential item functioning.
  
  
  METHODS
  All second-level ICF categories collected in the Development of ICF Core Sets for SCI project in specialized centers within 15 countries from 2006 through 2008.
  
  
  METHODS
  Secondary data analysis.
  
  
  METHODS
  Adults (N=1048) with SCI from the early postacute and long-term living context.
  
  
  METHODS
  Not applicable.
  
  
  METHODS
  Two unidimensional Rasch analyses: one for the ICF categories from body functions and body structures components and another for the ICF categories from the activities and participation component.
  
  
  RESULTS
  Results support good reliability and targeting of the ICF categories in both dimensions. In each dimension, few ICF categories were subject to misfit. Local item dependency was observed between ICF categories of the same chapters. Group effects for age and sex were observed only to a small extent.
  
  
  CONCLUSIONS
  The validity of ICF categories to develop measures of functioning in SCI for clinical practice and research is to some extent supported. Model adjustments were suggested to further improve their operationalization and psychometrics.
authors.affiliation: Swiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland; ICF Research Branch in cooperation with the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland.
authors.forename: Carolina S
authors.initials: CS
authors.lastname: Ballert
authors.affiliation: Swiss Paraplegic Research, Nottwil, Switzerland; Department of Health Sciences and Health Policy, University of Lucerne, Lucerne, Switzerland; ICF Research Branch in cooperation with the WHO Collaborating Centre for the Family of International Classifications in Germany (at DIMDI), Nottwil, Switzerland.
authors.forename: Gerold
authors.initials: G
authors.lastname: Stucki
authors.affiliation: Department for Spinal Cord Injuries, Glostrup Hospital, University of Copenhagen, Copenhagen, Denmark.
authors.forename: Fin
authors.initials: F
authors.lastname: Biering-Sørensen
authors.affiliation: Swiss Paraplegic Research, Nottwil, Switzerland; Faculty of Social and Human Sciences, School of Psychology, University of Southampton, Southampton, UK; Department of Medical Informatics, Biometry and Epidemiology, Pettenkofer School of Public Health, Research Unit for Biopsychosocial Health, Ludwig-Maximilians-University of Munich, Munich, Germany. Electronic address: A.Cieza@soton.ac.uk.
authors.forename: Alarcos
authors.initials: A
authors.lastname: Cieza
mesh_terms: D000203:Activities of Daily Living / Q000145:classification*; D000328:Adult; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D064702:International Classification of Functioning, Disability and Health; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D017063:Outcome Assessment, Health Care / Q000379:methods; D011594:Psychometrics; D020127:Recovery of Function; D015203:Reproducibility of Results; D013119:Spinal Cord Injuries / Q000145:classification* / Q000503:physiopathology* / Q000534:rehabilitation
keywords: International Classification of Functioning, Disability and Health; Paraplegia; Psychometrics; Rehabilitation; Spinal cord injuries