Construct validity, responsiveness, and interpretability of the Utrecht Scale for Evaluation of Rehabilitation (USER) in patients admitted to inpatient geriatric rehabilitation.
Margot W M de Waal, Michael Jansen, Loes M Bakker and 4 others
PMID 37743801WHAT IT FOUND
The Utrecht Scale for Evaluation of Rehabilitation (USER) is a valid observational tool for older adults in inpatient geriatric care.
It detects meaningful physical improvement at 14.5 points and screens cognitive function without burdening patients with interviews.
Key findings
01The USER physical function scale demonstrated adequate construct validity and responsiveness, detecting change over time in geriatric rehabilitation patients.
02A change of 14.5 points on the USER physical function scale represents the minimal important change, distinguishing patients who improved from those who did not.
03The USER cognitive function scale showed adequate construct validity and can be used to screen for cognitive impairment at admission, triggering further diagnostics if scores are below maximum.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
Read the rest of this summary
You get three full summaries a month, free, and we do not ask for a card. Search, the TL;DRs and your library stay unlimited either way.
What it does not show
The study population had a lower percentage of trauma patients and a higher percentage of amputees compared to typical Dutch geriatric rehabilitation data, which may limit generalizability. Data were not collected for patients who had not yet been discharged by the end of the study period, so a loss-to-follow-up analysis was not possible. The USER cognitive function scale showed a significant ceiling effect (42% maximum scores at admission), which reduces its sensitivity for detecting mild cognitive issues in high-functioning patients. Responsiveness was only tested for the physical function scale, not the cognitive scale, as the cognitive scale was viewed primarily as a screening tool.
Declared interests
The authors declared no potential conflicts of interest. The study was funded by Verenso, the Dutch Association of Elderly Care Physicians.
The easy way to misread this
Do not assume the USER cognitive function scale is equally responsive to change as the physical scale. The study only validated the physical scale's responsiveness and minimal important change. The cognitive scale showed a high ceiling effect, meaning it is best used for screening dysfunction at admission rather than tracking cognitive improvement over time.