Abstract
Objective To determine the level of agreement between patient self-report and therapist-assessed performance of mobility using the de Morton Mobility Index (DEMMI). Design Interrater agreement study. Setting Outpatient hospital clinic. Participants Consecutive sample of patients (N=128) undergoing preoperative assessment for elective lower limb (LL) arthroplasty. Interventions Participants completed a therapist-directed assessment of the DEMMI followed by self-report of performance. A random subsample (n=62, 48%) also completed a self-report of anticipated performance before the therapist-directed assessment. Both raters (participant and therapist) were blinded to the scores obtained from the other rater. Main Outcome Measures Interrater agreement between patient self-report and therapist-directed assessment of the total DEMMI scores was assessed using the intraclass correlation coefficient model 2,1 (ICC2,1) with a 95% confidence interval. The Bland-Altman plots were also used to illustrate the agreement between the 2 raters. Results The intraclass correlation coefficient (ICC) between patient self-report after performance and therapist-directed assessment of the total DEMMI score was.967 (95% confidence interval,.952–.977). The ICC between patient self-report of anticipated performance and therapist-directed assessment of the total DEMMI score was.830 (95% confidence interval,.730–.894). The Bland-Altman plots depicted higher levels of agreement among participants with impaired levels of mobility (≤74 out of 100) than did those with near-maximum DEMMI scores. Conclusions Patient self-report of anticipated performance is an acceptable proxy for DEMMI scores derived from the therapist rating of performance. Caution should be exercised when interpreting self-report scores of patients with near-maximum levels of mobility. Further research is required to establish whether these results can be generalized across a range of patient populations and to clinicians with differing backgrounds and expertise.
| Original language | English |
|---|---|
| Pages (from-to) | 2157-2165 |
| Number of pages | 9 |
| Journal | Archives of Physical Medicine and Rehabilitation |
| Volume | 97 |
| Issue number | 12 |
| DOIs | |
| Publication status | Published - 1 Dec 2016 |
Keywords
- Mobility limitation
- Rehabilitation
- Self report
- Task performance and analysis
Cite this
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Patient and Therapist Agreement on Performance-Rated Ability Using the de Morton Mobility Index. / Haas, Romi; Bowles, Kelly Ann; O'Brien, Lisa; Haines, Terry.
In: Archives of Physical Medicine and Rehabilitation, Vol. 97, No. 12, 01.12.2016, p. 2157-2165.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Patient and Therapist Agreement on Performance-Rated Ability Using the de Morton Mobility Index
AU - Haas, Romi
AU - Bowles, Kelly Ann
AU - O'Brien, Lisa
AU - Haines, Terry
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Objective To determine the level of agreement between patient self-report and therapist-assessed performance of mobility using the de Morton Mobility Index (DEMMI). Design Interrater agreement study. Setting Outpatient hospital clinic. Participants Consecutive sample of patients (N=128) undergoing preoperative assessment for elective lower limb (LL) arthroplasty. Interventions Participants completed a therapist-directed assessment of the DEMMI followed by self-report of performance. A random subsample (n=62, 48%) also completed a self-report of anticipated performance before the therapist-directed assessment. Both raters (participant and therapist) were blinded to the scores obtained from the other rater. Main Outcome Measures Interrater agreement between patient self-report and therapist-directed assessment of the total DEMMI scores was assessed using the intraclass correlation coefficient model 2,1 (ICC2,1) with a 95% confidence interval. The Bland-Altman plots were also used to illustrate the agreement between the 2 raters. Results The intraclass correlation coefficient (ICC) between patient self-report after performance and therapist-directed assessment of the total DEMMI score was.967 (95% confidence interval,.952–.977). The ICC between patient self-report of anticipated performance and therapist-directed assessment of the total DEMMI score was.830 (95% confidence interval,.730–.894). The Bland-Altman plots depicted higher levels of agreement among participants with impaired levels of mobility (≤74 out of 100) than did those with near-maximum DEMMI scores. Conclusions Patient self-report of anticipated performance is an acceptable proxy for DEMMI scores derived from the therapist rating of performance. Caution should be exercised when interpreting self-report scores of patients with near-maximum levels of mobility. Further research is required to establish whether these results can be generalized across a range of patient populations and to clinicians with differing backgrounds and expertise.
AB - Objective To determine the level of agreement between patient self-report and therapist-assessed performance of mobility using the de Morton Mobility Index (DEMMI). Design Interrater agreement study. Setting Outpatient hospital clinic. Participants Consecutive sample of patients (N=128) undergoing preoperative assessment for elective lower limb (LL) arthroplasty. Interventions Participants completed a therapist-directed assessment of the DEMMI followed by self-report of performance. A random subsample (n=62, 48%) also completed a self-report of anticipated performance before the therapist-directed assessment. Both raters (participant and therapist) were blinded to the scores obtained from the other rater. Main Outcome Measures Interrater agreement between patient self-report and therapist-directed assessment of the total DEMMI scores was assessed using the intraclass correlation coefficient model 2,1 (ICC2,1) with a 95% confidence interval. The Bland-Altman plots were also used to illustrate the agreement between the 2 raters. Results The intraclass correlation coefficient (ICC) between patient self-report after performance and therapist-directed assessment of the total DEMMI score was.967 (95% confidence interval,.952–.977). The ICC between patient self-report of anticipated performance and therapist-directed assessment of the total DEMMI score was.830 (95% confidence interval,.730–.894). The Bland-Altman plots depicted higher levels of agreement among participants with impaired levels of mobility (≤74 out of 100) than did those with near-maximum DEMMI scores. Conclusions Patient self-report of anticipated performance is an acceptable proxy for DEMMI scores derived from the therapist rating of performance. Caution should be exercised when interpreting self-report scores of patients with near-maximum levels of mobility. Further research is required to establish whether these results can be generalized across a range of patient populations and to clinicians with differing backgrounds and expertise.
KW - Mobility limitation
KW - Rehabilitation
KW - Self report
KW - Task performance and analysis
UR - http://www.scopus.com/inward/record.url?scp=84994525018&partnerID=8YFLogxK
U2 - 10.1016/j.apmr.2016.07.008
DO - 10.1016/j.apmr.2016.07.008
M3 - Article
VL - 97
SP - 2157
EP - 2165
JO - Archives of Physical Medicine and Rehabilitation
JF - Archives of Physical Medicine and Rehabilitation
SN - 0003-9993
IS - 12
ER -