Document Detail


Determination of the minimal clinically important difference in the FIM instrument in patients with stroke.
MedLine Citation:
PMID:  16401435     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To define the minimal clinically important difference (MCID) for the FIM instrument in patients poststroke. DESIGN: Prospective case series discharged over a 9-month period. SETTING: Long-term acute care hospital. PARTICIPANTS: Patients with stroke (N=113). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Admission, discharge, and change scores were calculated for the total FIM, motor FIM, and cognitive FIM. Assessments of clinical change were rated at discharge on a 15-point (-7 to +7) Likert scale by attending physicians, with MCID defined at a cutoff score of 3. The FIM change scores associated with MCID were identified from receiver operating characteristic curves. Bayesian analysis was used to determine the probability of individual patients achieving MCID. RESULTS: FIM change scores associated with MCID were 22, 17, and 3 for the total FIM, motor FIM, and cognitive FIM, respectively. The accuracy of the MCID was greater when subjects were categorized based on admission FIM scores than when considering the sample as a whole. Larger FIM change scores were related to MCID in subjects with lower admission FIM scores. CONCLUSIONS: These findings will assist in the interpretation of FIM change scores relative to physicians' assessments of important clinical change.
Authors:
Marianne Beninato; Kathleen M Gill-Body; Sara Salles; Paul C Stark; Randie M Black-Schaffer; Joel Stein
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of physical medicine and rehabilitation     Volume:  87     ISSN:  0003-9993     ISO Abbreviation:  Arch Phys Med Rehabil     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-10     Completed Date:  2006-02-22     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  2985158R     Medline TA:  Arch Phys Med Rehabil     Country:  United States    
Other Details:
Languages:  eng     Pagination:  32-9     Citation Subset:  AIM; IM    
Affiliation:
Graduate Programs in Physical Therapy, MGH Institute of Health Professions, Boston, MA 02129, USA. mbeninato@mghihp.edu
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MeSH Terms
Descriptor/Qualifier:
Activities of Daily Living / classification*
Adult
Age Factors
Aged
Aged, 80 and over
Cognition / physiology
Cohort Studies
Disability Evaluation*
Female
Health Status Indicators*
Humans
Male
Middle Aged
Motor Activity / physiology
Outcome Assessment (Health Care) / methods*
Physical Therapy Modalities
Probability
Prognosis
Prospective Studies
Recovery of Function
Risk Factors
Sensitivity and Specificity
Severity of Illness Index
Sex Factors
Statistics, Nonparametric
Stroke / diagnosis*,  rehabilitation*
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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