Linking AM-PAC Mobility and Daily Activity to the PROMIS Physical Function Metric

Abstract

Objective The purpose of this study was to link Activity Measure for Post-Acute Care (AM-PAC) Mobility and Daily Activity scales to the PROMIS Physical Function (PF) allowing for a common metric across scales. Methods Cross-sectional study of patients 18 years and older presenting to one of eight outpatient rehabilitation clinics in southwestern Pennsylvania. Patients completed one survey with questions from the AM-PAC Daily Activity and Mobility short forms, and the PROMIS PF item bank. Using item response theory, we performed two rounds of fixed-parameter calibration. In the first, we calibrated the AM-PAC Daily Activity and Mobility items with 27 fixed item parameters from the PROMIS PF. Second, we calibrated the AM-PAC Daily Activity items with 11 PROMIS Upper Extremity fixed item parameters. This process uses the construct of physical function and equates AM-PAC items on the same underlying measurement scale for the PROMIS PF. Results Both scales measured a wide range of functioning and demonstrated good calibration. Data were appropriate for a fixed-parameter item response theory-based crosswalk. AM-PAC Daily Activity and Mobility raw scores were mapped onto the PROMIS PF metric. AM-PAC Daily Activity scores were also mapped onto the PROMIS PF Upper Extremity metric. Conclusion Question items from the AM-PAC Daily Activity, AM-PAC Mobility, and PROMIS PF similarly measure the construct of physical function. This consistency allows for a crosswalk of AM-PAC scores onto the PROMIS PF metric. Impact Crosswalk tables developed in this study allow for converting scores from the AM-PAC Daily Activity and Mobility scales to the PROMIS PF metric. This will facilitate monitoring of longitudinal change in function over time and across settings.

Activity Measure for Post-Acute Care “6-Clicks” Basic Mobility Scores Predict Discharge Destination After Acute Care Hospitalization in Select Patient Groups: A Retrospective, Observational Study

“… 8 , 9 Recent research confirmed that the “6-Clicks” tools may play an important role in predicting discharge destination in acute care 6 , 10 , 11 , 12 , 13 , 14 , 15 , 16 and other inpatient 17 , 18 , 19 and outpatient settings. 20 , 21 , 22 , 23 Clinicians may use Basic Mobility and/or the Daily Activities “6-Clicks” scores along with factors such as patients’ personal circumstances in deciding whether discharge to home, with or without services, or an institution (skilled nursing facility [SNF] or inpatient rehabilitation facility [IRF]) best meets patients’ needs. Selecting the appropriate discharge destination helps to ensure the appropriate continuum of care while working toward rehabilitation goals, thus optimizing overall health care costs.…”