title: Methodology for the development and calibration of the SCI-QOL item banks.
abstract: OBJECTIVE
  To develop a comprehensive, psychometrically sound, and conceptually grounded patient reported outcomes (PRO) measurement system for individuals with spinal cord injury (SCI).
  
  
  METHODS
  Individual interviews (n=44) and focus groups (n=65 individuals with SCI and n=42 SCI clinicians) were used to select key domains for inclusion and to develop PRO items. Verbatim items from other cutting-edge measurement systems (i.e. PROMIS, Neuro-QOL) were included to facilitate linkage and cross-population comparison. Items were field tested in a large sample of individuals with traumatic SCI (n=877). Dimensionality was assessed with confirmatory factor analysis. Local item dependence and differential item functioning were assessed, and items were calibrated using the item response theory (IRT) graded response model. Finally, computer adaptive tests (CATs) and short forms were administered in a new sample (n=245) to assess test-retest reliability and stability.
  
  
  METHODS
  A calibration sample of 877 individuals with traumatic SCI across five SCI Model Systems sites and one Department of Veterans Affairs medical center completed SCI-QOL items in interview format.
  
  
  RESULTS
  We developed 14 unidimensional calibrated item banks and 3 calibrated scales across physical, emotional, and social health domains. When combined with the five Spinal Cord Injury--Functional Index physical function banks, the final SCI-QOL system consists of 22 IRT-calibrated item banks/scales. Item banks may be administered as CATs or short forms. Scales may be administered in a fixed-length format only.
  
  
  CONCLUSIONS
  The SCI-QOL measurement system provides SCI researchers and clinicians with a comprehensive, relevant and psychometrically robust system for measurement of physical-medical, physical-functional, emotional, and social outcomes. All SCI-QOL instruments are freely available on Assessment CenterSM.
authors.forename: David S
authors.initials: DS
authors.lastname: Tulsky
authors.forename: Pamela A
authors.initials: PA
authors.lastname: Kisala
authors.forename: David
authors.initials: D
authors.lastname: Victorson
authors.forename: Seung W
authors.initials: SW
authors.lastname: Choi
authors.forename: Richard
authors.initials: R
authors.lastname: Gershon
authors.forename: Allen W
authors.initials: AW
authors.lastname: Heinemann
authors.forename: David
authors.initials: D
authors.lastname: Cella
mesh_terms: D002138:Calibration; D006801:Humans; D011788:Quality of Life; D013119:Spinal Cord Injuries / Q000145:classification* / Q000534:rehabilitation; D011795:Surveys and Questionnaires / Q000592:standards*; D015599:Trauma Severity Indices
keywords: Computer Adaptive Testing; Health-Related Quality of Life; Item Response Theory; Patient Reported Outcomes; Spinal Cord Injury