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Improved Tracking of Mobility Across Care Settings: A Crosswalk Between AM-PAC Mobility "6-Clicks" and GG Items
Daniel L Young1, Leah Ling2, Chong Zhang3
1Department of Physical Therapy, University of Nevada Las Vegas, Las Vegas, NV.
Objective:
To create a crosswalk linking Activity Measure for Postacute Care (AM-PAC) Inpatient Basic Mobility ‟6-Clicks" Short Form with a sum score from 15 mobility-related section GG standardized data elements (GG Items), aiding longitudinal measurement of physical function.
Design:
Correlational analyses of paired standardized AM-PAC and GG Items scores, recorded within 48 hours of each other, were analyzed. The equipercentile method established bidirectional concordance links. Performance evaluated using R2, intraclass correlation coefficient (2,1), and bootstrapped standard errors.
Setting:
An acute rehabilitation hospital.
Participants:
There were 923 patients (N=923). Their mean age was 58 years, and 90% had neurologic diagnoses.
Interventions:
Not applicable.
Main Outcome Measures:
The primary outcome was the bidirectional concordance (crosswalk) between AM-PAC and GG Items.
Results:
The mean AM-PAC T score was 48 (SD=7.1), and the mean GG Items score was 72 (SD=16). Pearson correlation between the measures was 0.84. Linking accuracy was good; R2 was 0.70 for GG Items (derived from AM-PAC) and 0.74 for AM-PAC T score (derived from GG Items). Respective intraclass correlation coefficients between linked and observed scores were 0.87 and 0.85. SEs were low. Case examples demonstrated consistent crosswalked scores between hospital discharge (AM-PAC) and inpatient rehabilitation admission (GG Items).
Conclusions:
A reliable crosswalk between AM-PAC and GG Items scores was successfully developed, enabling score conversion. This tool offers clinicians and researchers an improved ability to longitudinally track patient function across different care settings, potentially enhancing care continuity, supporting research, and informing resource allocation. Future validation in other populations is recommended.
