Applying a Bookmarking Approach to Setting Clinically Relevant Interpretive Standards for the Spinal Cord Injury - Functional Index/Capacity (SCI-FI/C) Basic Mobility and Self Care Item Bank Scores.

Objective To develop clinically relevant interpretive standards for the Spinal Cord Injury – Functional Index/Capacity (SCI-FI/C) Basic Mobility and Self-Care item bank scores. Design Modified “bookmarking” standard-setting methodology, including two stakeholder consensus meetings with individuals with SCI and SCI clinicians, respectively, and a final, combined (consumers and clinicians) “convergence” meeting. Setting Two Spinal Cord Injury Model System centers in the U.S. Participants Adults with traumatic SCI and clinicians who work with individuals with SCI. Main Outcome Measures Placement of bookmarks between vignettes based on SCI-FI Basic Mobility and Self-Care T-scores. Bookmarks were placed between vignettes representing “No Problems,” “Mild Problems,” “Moderate Problems,” and “Severe Problems” for each item bank. Results Each consensus group resulted in a single set of scoring cut points for the SCI-FI/C Basic Mobility and Self-Care item banks. The cut points were similar but not identical between the consumer and clinician groups, necessitating a final convergence meeting. For SCI-FI/C Basic Mobility, the convergence group agreed on cut scores of 61.25 (no problems/mild problems), 51.25 (mild problems/moderate problems), and 41.25 (moderate problems/severe problems). For SCI-FI/C Self Care, the convergence group agreed on cut scores of 56.25 (no/mild), 51.25 (mild/moderate), and 38.75 (moderate/severe). Conclusions The results of this study provide straightforward interpretive guidelines for SCI researchers and clinicians using the SCI-FI/C Basic Mobility and Self-Care instruments. These results are appropriate for the full bank, computer adaptive test, and short form versions of the SCI-FI/C Basic Mobility and Self-Care item banks.