Abstract
Background The interrater reliability of 2 new inpatient functional short-form measures, Activity Measure for Post-Acute Care (AM-PAC) “6-Clicks” basic mobility and daily activity scores, has yet to be established.
Objective The purpose of this study was to examine the interrater reliability of AM-PAC “6-Clicks” measures.
Design A prospective observational study was conducted.
Methods Four pairs of physical therapists rated basic mobility and 4 pairs of occupational therapists rated daily activity of patients in 1 of 4 hospital services. One therapist in a pair was the primary therapist directing the assessment while the other therapist observed. Each therapist was unaware of the other's AM-PAC “6-Clicks” scores. Reliability was assessed with intraclass correlation coefficients (ICCs), Bland-Altman plots, and weighted kappa.
Results The ICCs for the overall reliability of basic mobility and daily activity were .849 (95% confidence interval [CI]=.784, .895) and .783 (95% CI=.696, .847), respectively. The ICCs for the reliability of each pair of raters ranged from .581 (95% CI=.260, .789) to .960 (95% CI=.897, .983) for basic mobility and .316 (95% CI=−.061, .611) to .907 (95% CI=.801, .958) for daily activity. The weighted kappa values for item agreement ranged from .492 (95% CI=.382, .601) to .712 (95% CI=.607, .816) for basic mobility and .251 (95% CI=.057, .445) to .751 (95% CI=.653, .848) for daily activity. Mean differences between raters' scores were near zero.
Limitations Raters were from one health system. Each pair of raters assessed different patients in different services.
Conclusions The ICCs for AM-PAC “6-Clicks” total scores were very high. Levels of agreement varied across pairs of raters, from large to nearly perfect for physical therapists and from moderate to nearly perfect for occupational therapists. Levels of agreement for individual item scores ranged from small to very large.
Footnotes
All authors provided concept/idea/research design. Dr D.U. Jette, Mr Ranganathan, and Dr Frost provided writing and data analysis. Dr Stilphen, Mr Ranganathan, Dr Passek, and Dr Frost provided data collection and project management. Mr Ranganathan provided fund procurement. Dr Stilphen and Dr Frost provided participants and facilities/equipment. Dr Stilphen, Mr Ranganathan, and Dr Frost provided institutional liaisons. Dr Frost provided administrative support. Dr Stilphen, Dr Passek, Dr Frost, and Dr A.M. Jette provided consultation (including review of manuscript before submission).
The authors' appreciation goes to Nancy White, PT, DPT, OCS, for her enthusiasm and support in bringing this project to fruition and to the 16 clinician colleagues who participated in data collection.
The institutional review boards at Cleveland Clinic and University of Vermont approved the study.
Funding from the American Physical Therapy Association supported the data collection efforts.
- Received May 1, 2014.
- Accepted November 25, 2014.
- © 2015 American Physical Therapy Association
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