Development and Validation of Crosswalks Between FIM® and SCIM III for Voluntary Musculoskeletal Movement Functions.
Linda A T Jones, Chih-Ying Li, David Weitzenkamp and 3 others
PMID 34330180WHAT IT FOUND
The conversion methods met the main validation standard for FIM and SCIM III voluntary movement scores in spinal cord injury.
The Rasch and equipercentile methods performed better on additional checks than the expert panel method.
Key findings
01The crosswalk was built from 662 subjects with both FIM and SCIM III scores and tested in 119 US and 133 Canadian data pairs.
02Correlations between observed and converted scores were .897 to .972, above the .866 threshold.
03The equipercentile and Rasch methods met additional criteria more often than the expert panel method.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
The study had no demographic data for the Swiss sample and considerable missing injury data in the US sample, with 51% missing injury level and 41% missing severity, so subgroup comparisons were limited. FIM and SCIM III scores could be up to 7 days apart, and US discharge assessments averaged 1.90 days apart compared with .41 days in Canada, so real functional change between tests may have affected the US validation. The crosswalk covers only voluntary musculoskeletal items, not the full FIM or SCIM III, and requires item-level scores. Two items did not fit the single movement construct well but were kept to make the crosswalk easier to use. SCIM III data were collected by observation, not interview, so interview-based use may need further checking. The US dataset met additional criteria less often than the Swiss or Canadian datasets.
Declared interests
The authors declared no potential conflicts of interest.
The easy way to misread this
Do not assume FIM and SCIM III total scores can be swapped for all function. The crosswalk covers only voluntary musculoskeletal items and needs item-level scores; bowel, bladder, respiration, and cognitive items were excluded.