Affiliation:
1. From the Institute of Cardiovascular and Medical Sciences, University of Glasgow, United Kingdom (R.L.M., M.A., M.T.-R., K.R.L., T.J.Q.); and Stroke Research Group Institute for Neuroscience and Institute for Ageing, Newcastle University, United Kingdom (H.R.).
Abstract
Background and Purpose—
There may be a potential to reduce the number of items assessed in the Barthel Index (BI), and shortened versions of the BI have been described. We sought to collate all existing short-form BI (SF-BI) and perform a comparative validation using clinical trial data.
Methods—
We performed a systematic review across multidisciplinary electronic databases to find all published SF-BI. Our validation used the VISTA (Virtual International Stroke Trials Archive) resource. We describe concurrent validity (agreement of each SF-BI with BI), convergent and divergent validity (agreement of each SF-BI with other outcome measures available in the data set), predictive validity (association of prognostic factors with SF-BI outcomes), and content validity (item correlation and exploratory factor analyses).
Results—
From 3546 titles, we found 8 articles describing 6 differing SF-BI. Using acute trial data (n=8852), internal reliability suggested redundancy in BI (Cronbach α, 0.96). Each SF-BI demonstrated a strong correlation with BI, modified Rankin Scale, National Institutes of Health Stroke Scale (all ρ≥0.83;
P
<0.001). Using rehabilitation trial data (n=332), SF-BI demonstrated modest correlation with quality of life measures Stroke Impact Scale and 5 domain EuroQOL (ρ≥0.50,
P
<0.001). Prespecified prognostic factors were associated with SF-BI outcomes (all
P
<0.001). Our factor analysis described a 3 factor structure, and item reduction suggested an optimal 3-item SF-BI comprising bladder control, transfer, and mobility items in keeping with 1 of the 3-item SF-BI previously described in the literature.
Conclusions—
There is redundancy in the original BI; we have demonstrated internal and external validity of a 3-item SF-BI that should be simple to use.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Advanced and Specialised Nursing,Cardiology and Cardiovascular Medicine,Clinical Neurology
Reference33 articles.
1. Functional evaluation: the BARTHEL Index.;Mahoney FI;Md State Med J,1965
2. Functional Outcome Measures in Contemporary Stroke Trials
3. Functional assessment in older people
4. The Barthel ADL Index: A standard measure of physical disability?
5. Stroke rehabilitation: analysis of repeated Barthel index measures.;Granger CV;Arch Phys Med Rehabil,1979
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