The Early Functional Abilities-revised may bridge the gap between the disorder of consciousness and the functional independence scales: evidence from Rasch analysis.
Serena Caselli, Svend Kreiner, Aladar B Ianes and 2 others
PMID 36169932WHAT IT FOUND
A revised 12-item version of the Early Functional Abilities scale measures early recovery in disorders of consciousness on a single reliable scale.
It correlates strongly with both consciousness and functional independence measures, filling the gap between them.
Key findings
01The revised 12-item Early Functional Abilities scale demonstrated adequate internal construct validity and sufficient reliability for individual patient measurement.
02The revised scale estimates correlated very strongly with both the Coma Recovery Scale-Revised and the Modified Functional Independence Measure.
03The correlation between the consciousness scale and the functional independence scale was lower than either scale's correlation with the revised Early Functional Abilities scale.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study used a single sample for both refining the scale and validating it, meaning the results need replication in a separate group to confirm they are not due to chance. The study did not test whether the revised scale can predict future outcomes or functional recovery. The sample included patients at various stages of recovery and in different settings, which may affect how the scale performs in specific clinical contexts. The study was conducted in Italy, and the scale's performance in other languages or healthcare systems is unknown.
Declared interests
The authors declare no conflicts of interest. The study used routine clinical data collected by healthcare providers, and legal representatives provided consent for research use.
The easy way to misread this
Do not assume the revised 12-item scale is ready for clinical use without further validation. The study used the same patients to refine the scale and test its accuracy, so the results need confirmation in a new, independent group.