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Title: Evaluation of internal construct validity and unidimensionality of the brachial assessment tool, a patient-reported outcome measure for brachial plexus injury.
Epworth Authors: Olver, John
Hill, Bridget
Other Authors: Bialocerkowski, Andrea
Ferris, Scott
Williams, Gavin
Pallant, Julie
Keywords: Brachial Assessment Tool
Brachial Plexus Injury
Outcome Measures
Outcome Assessment
Premorbid Limb Dominance
Construct Validity
Assessment Tools
Epworth Monash Rehabilitation Medicine Unit, Epworth HealthCare, Melbourne, VIC, Australia.
Issue Date: Dec-2016
Publisher: Elsevier
Citation: Arch Phys Med Rehabil. 2016 Dec;97(12):2146-2156
Abstract: OBJECTIVE: To evaluate the internal construct validity and dimensionality of a new patient-reported outcome measure for people with traumatic brachial plexus injury (BPI) based on the International Classification of Functioning, Disability and Health definition of activity. DESIGN: Cross-sectional study. SETTING: Outpatient clinics. PARTICIPANTS: Adults (age range, 18-82y) with a traumatic BPI (N=106). INTERVENTIONS: There were 106 people with BPI who completed a 51-item 5-response questionnaire. Responses were analyzed in 4 phases (missing responses, item correlations, exploratory factor analysis, and Rasch analysis) to evaluate the properties of fit to the Rasch model, threshold response, local dependency, dimensionality, differential item functioning, and targeting. MAIN OUTCOME MEASURES: Not applicable, as this study addresses the development of an outcome measure. RESULTS: Six items were deleted for missing responses, and 10 were deleted for high interitem correlations >.81. The remaining 35 items, while demonstrating fit to the Rasch model, showed evidence of local dependency and multidimensionality. Items were divided into 3 subscales: dressing and grooming (8 items), arm and hand (17 items), and no hand (6 items). All 3 subscales demonstrated fit to the model with no local dependency, minimal disordered thresholds, no unidimensionality or differential item functioning for age, time postinjury, or self-selected dominance. Subscales were combined into 3 subtests and demonstrated fit to the model, no misfit, and unidimensionality, allowing calculation of a summary score. CONCLUSIONS: This preliminary analysis supports the internal construct validity of the Brachial Assessment Tool, a unidimensional targeted 4-response patient-reported outcome measure designed to solely assess activity after traumatic BPI regardless of level of injury, age at recruitment, premorbid limb dominance, and time postinjury. Further examination is required to determine test-retest reliability and responsiveness.
DOI: 10.1016/j.apmr.2016.06.021
PubMed URL:
ISSN: 0003-9993
Journal Title: Archives of Physical Medicine and Rehabilitation
Type: Journal Article
Affiliated Organisations: Menzies Health Institute, Queensland, Griffith University, QLD, Australia.
University of Melbourne, Melbourne, VIC, Australia.
The Alfred, Melbourne, VIC, Australia.
Type of Clinical Study or Trial: Cross-Sectional Study
Appears in Collections:Head & Neck

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