Linking Existing Instruments to Develop an Activity of Daily Living Item Bank

Chih Ying Li, Sergio Romero, Heather S. Bonilha, Kit N. Simpson, Annie N. Simpson, Ickpyo Hong, Craig A. Velozo

Research output: Contribution to journalArticlepeer-review

19 Scopus citations


This study examined dimensionality and item-level psychometric properties of an item bank measuring activities of daily living (ADL) across inpatient rehabilitation facilities and community living centers. Common person equating method was used in the retrospective veterans data set. This study examined dimensionality, model fit, local independence, and monotonicity using factor analyses and fit statistics, principal component analysis (PCA), and differential item functioning (DIF) using Rasch analysis. Following the elimination of invalid data, 371 veterans who completed both the Functional Independence Measure (FIM) and minimum data set (MDS) within 6 days were retained. The FIM-MDS item bank demonstrated good internal consistency (Cronbach’s α =.98) and met three rating scale diagnostic criteria and three of the four model fit statistics (comparative fit index/Tucker–Lewis index = 0.98, root mean square error of approximation = 0.14, and standardized root mean residual = 0.07). PCA of Rasch residuals showed the item bank explained 94.2% variance. The item bank covered the range of θ from −1.50 to 1.26 (item), −3.57 to 4.21 (person) with person strata of 6.3. The findings indicated the ADL physical function item bank constructed from FIM and MDS measured a single latent trait with overall acceptable item-level psychometric properties, suggesting that it is an appropriate source for developing efficient test forms such as short forms and computerized adaptive tests.

Original languageEnglish (US)
Pages (from-to)25-43
Number of pages19
JournalEvaluation and the Health Professions
Issue number1
StatePublished - Mar 1 2018
Externally publishedYes


  • activities of daily living
  • continuity of patient care
  • outcome assessment (health care)
  • psychometrics
  • veterans

ASJC Scopus subject areas

  • Health Policy


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