Construct validation of the Language Independent Functional Evaluation versus the Barthel Index in a Mongolian...

Differences in language and literacy impede our understanding of the impact of disability around the world. Since function is primarily action, the computer-animated Language Independent Functional Evaluation (L.I.F.E.) might bypass the use of written or verbal scales. This study validates L.I.F.E. in a developing world population.

Families were randomly chosen from the city centre, suburban 'ger' districts and countryside of Arvaikheer, Mongolia. The L.I.F.E. and cross-translated Mongolian Barthel Index were administered in random order. Demographics including subjective observation of disability were gathered. L.I.F.E. scores were converted to Barthel equivalents.

One hundred forty-four persons completed the test, 24 answered for other persons. Persons with observed disability had lower L.I.F.E. scores (64.55 vs. 94.53, p < 0.001). L.I.F.E. and Barthel scores related well. (Spearman's rho = 0.757, p < 0.001; for persons with observed disability Pearson r = 0.820, p < 0.001). Individual functions all had high interclass correlations (>0.75), except bowel and bladder, which had moderate correlations. Qualitative inquiry found the L.I.F.E. was preferred over the Barthel.

Using L.I.F.E., function can be measured without language or literacy. L.I.F.E. expands our ability to measure and compare the prevalence of disability and the impact of rehabilitation across regions perhaps leading to more rational allocation of resources.