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Physical disability construct convergence across instruments: towards a universal metric

W P Fisher1

  • 1Louisiana State University Medical Center, New Orleans 70112, USA.

Journal of Outcome Measurement
|January 1, 1997
PubMed
Summary

Physical disability measures show high stability across different instruments and samples, suggesting a universal metric for functional independence is achievable. This research supports evidence-based health management.

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Area of Science:

  • Health outcomes research
  • Psychometrics
  • Disability studies

Background:

  • Healthcare is shifting towards evidence-based and individualized management.
  • There is a need for general, scale-free measures of functional independence.
  • Existing physical disability instruments may not be directly comparable.

Purpose of the Study:

  • To examine the stability of the physical disability construct across different instruments and samples.
  • To assess the feasibility of creating a universal metric for functional independence.
  • To determine if different physical functioning scales can be equated.

Main Methods:

  • A novel method, pseudo-common item equating, was employed.
  • Similar, non-identical items from different physical functioning instruments were compared.

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  • Data from over 30 articles using Rasch analysis of physical functioning scales were reviewed, utilizing eleven calibrations from four instruments.

    • Main Results:

    • An overall average correlation of .93 (disattenuated for error) was found between measures.
    • An average of 7 pseudo-common items were used in the comparisons.
    • The results indicate that measures from different calibrations are likely linearly transformable versions of the same metric (average p-value = .01).

    Conclusions:

    • The quantitative stability of physical functional independence across instruments and samples is high.
    • The development and implementation of a universal metric for physical disability is a realistic objective.
    • This stability supports the move towards more standardized and comparable health outcome measures.