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NEUROLOGY 2006;67:2056-2059
© 2006 American Academy of Neurology
Brief Communications

Exploring disability rating scale responsiveness II: Do more response options help?

S. J. Cano, PhD, R. J. O’Connor, MD, A. J. Thompson, MD and J. C. Hobart, PhD

From the Neurological Outcomes Measures Unit, Institute of Neurology, University College London, United Kingdom (S.J.C., R.J.O., A.J.T., J.C.H.); and Department of Clinical Neuroscience, Peninsula Medical School, Derriford Hospital, Plymouth, United Kingdom (J.C.H.).

Address correspondence and reprint requests to Dr Jeremy Hobart, Senior Lecturer and Honorary Consultant Neurologist, Peninsula Medical School, Room N16, ITTC Building, Tamar Science Park, Davy Road, Plymouth, PL6 8BX Devon UK; e-mail: jeremy.hobart{at}pms.ac.uk

The Barthel Index (BI) may underestimate disability change because its items have few response options. We examined whether a similar scale with more response options (Functional Independence Measure, FIM) was more responsive (n = 1,396). The FIM had greater potential for responsiveness and identified more people who changed. However, its actual responsiveness, measured by effect sizes, equaled that of the BI. This counterintuitive finding suggests that effect sizes may be limited indicators of responsiveness.

Disclosure: Rory O’Connor was supported by UCLH Trustees grants. Jeremy Hobart was supported in part by the NHS Health Technology Assessment Programme; however, the views and opinions expressed are not necessarily those of the executive. The Neurological Outcomes Measure Unit is supported by the De Laszlo Foundation and the Peninsula Medical School. The authors report no conflicts of interest.

Received May 4, 2006. Accepted in final form August 23, 2006.






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