Inter-rater reliability of the early functional abilities scale.

Area of Science:

• Rehabilitation Medicine
• Neuroscience
• Clinical Assessment Tools

Background:

• Accurate functional assessment is crucial for patients with traumatic brain injury (TBI).
• The Early Functional Abilities (EFA) scale is used in early rehabilitation settings.
• Understanding the reliability of assessment tools among different healthcare professionals is vital for consistent patient care.

Purpose of the Study:

• To evaluate the inter-rater reliability of the Early Functional Abilities (EFA) scale.
• To determine the consistency of EFA scoring among different members of the rehabilitation team.

Main Methods:

• An observational study design was employed.
• Twenty-four patients with TBI in an intensive care unit's early rehabilitation phase were assessed.
• The EFA scale was administered by four rehabilitation professionals; inter-rater reliability was analyzed using linear weighted kappa statistics.

Main Results:

• Overall weighted kappa values for EFA items ranged from 0.27 to 0.60.
• Sensorimotor functional items demonstrated the highest agreement (mean kappa 0.68–0.76).
• Vegetative ability, position tolerance, and wakefulness items showed lower agreement (kappa 0.49, 0.33, 0.49). Occupational therapists and physiotherapists had better agreement than physicians and nurses.

Conclusions:

• The EFA scale demonstrates good inter-rater reliability for most items among the rehabilitation team.
• The EFA scale can be utilized by all interdisciplinary team members following appropriate training.
• A revision to reduce items within the vegetative functional domain is recommended to improve reliability.