title: Interrater Reliability of AM-PAC "6-Clicks" Basic Mobility and Daily Activity Short Forms.
abstract: BACKGROUND
  The interrater reliability of 2 new inpatient functional short-form measures, Activity Measure for Post-Acute Care (AM-PAC) "6-Clicks" basic mobility and daily activity scores, has yet to be established.
  
  
  OBJECTIVE
  The purpose of this study was to examine the interrater reliability of AM-PAC "6-Clicks" measures.
  
  
  METHODS
  A prospective observational study was conducted.
  
  
  METHODS
  Four pairs of physical therapists rated basic mobility and 4 pairs of occupational therapists rated daily activity of patients in 1 of 4 hospital services. One therapist in a pair was the primary therapist directing the assessment while the other therapist observed. Each therapist was unaware of the other's AM-PAC "6-Clicks" scores. Reliability was assessed with intraclass correlation coefficients (ICCs), Bland-Altman plots, and weighted kappa.
  
  
  RESULTS
  The ICCs for the overall reliability of basic mobility and daily activity were .849 (95% confidence interval [CI]=.784, .895) and .783 (95% CI=.696, .847), respectively. The ICCs for the reliability of each pair of raters ranged from .581 (95% CI=.260, .789) to .960 (95% CI=.897, .983) for basic mobility and .316 (95% CI=-.061, .611) to .907 (95% CI=.801, .958) for daily activity. The weighted kappa values for item agreement ranged from .492 (95% CI=.382, .601) to .712 (95% CI=.607, .816) for basic mobility and .251 (95% CI=.057, .445) to .751 (95% CI=.653, .848) for daily activity. Mean differences between raters' scores were near zero.
  
  
  CONCLUSIONS
  Raters were from one health system. Each pair of raters assessed different patients in different services.
  
  
  CONCLUSIONS
  The ICCs for AM-PAC "6-Clicks" total scores were very high. Levels of agreement varied across pairs of raters, from large to nearly perfect for physical therapists and from moderate to nearly perfect for occupational therapists. Levels of agreement for individual item scores ranged from small to very large.
authors.affiliation: D.U. Jette, PT, DSc, FAPTA, Physical Therapy Program, MGH Institute of Health Professions, 36 First Ave, Charlestown Navy Yard, Boston, MA 02129 (USA), and Rehabilitation and Movement Science, University of Vermont, Burlington, Vermont. djette@mghihp.edu.
authors.forename: Diane U
authors.initials: DU
authors.lastname: Jette
authors.affiliation: M. Stilphen, PT, DPT, Rehabilitation and Sports Therapy Department, Cleveland Clinic, Cleveland, Ohio.
authors.forename: Mary
authors.initials: M
authors.lastname: Stilphen
authors.affiliation: V.K. Ranganathan, MS, MBA, Physical Medicine and Rehabilitation Department, Cleveland Clinic.
authors.forename: Vinoth K
authors.initials: VK
authors.lastname: Ranganathan
authors.affiliation: S. Passek, PT, DPT, Physical Medicine and Rehabilitation Department, Cleveland Clinic.
authors.forename: Sandra
authors.initials: S
authors.lastname: Passek
authors.affiliation: F.S. Frost, MD, Physical Medicine and Rehabilitation Department, Cleveland Clinic.
authors.forename: Frederick S
authors.initials: FS
authors.lastname: Frost
authors.affiliation: A.M. Jette, PT, PhD, FAPTA, School of Public Health, Health and Disability Research Institute, Boston University Medical Campus, Boston, Massachusetts.
authors.forename: Alan M
authors.initials: AM
authors.lastname: Jette
mesh_terms: D000203:Activities of Daily Living; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D051346:Mobility Limitation; D059825:Physical Therapists; D011446:Prospective Studies; D015203:Reproducibility of Results