Combining Items from Three Federally-Mandated Assessments Using Rasch Measurement to Reliably Measure Cognition Across Post-Acute Care Settings.

Abstract Objective To combine items from the Functional Independence MeasureTM (FIMTM), Minimum Data Set 2.0 (MDS), and the Outcome and Assessment Information Set-B (OASIS) to reliably measure cognition across post-acute care settings and facilitate future studies of patient cognitive recovery. Design Rasch analysis of data from a prospective, observational cohort study. Setting Post-acute care inclusive of inpatient rehabilitation facilities, skilled nursing facilities, and home health agencies. Participants 147 patients receiving rehabilitation services. Interventions Not applicable. Main Outcome Measure(s) FIMTM, MDS 2.0, and the OASIS-B. Results Six cognition items (CogMeas) demonstrated good construct validity with no misfitting items, unidimensionality, good precision (person separation reliability .95), and an item hierarchy that reflected a clinically meaningful continuum of cognitive challenge. Conclusions This is the first attempt to combine the cognition items from the three historically, federally mandated assessments to create a common metric for cognition. These 6 items could be adopted as standardized patient assessment data elements to improve cognitive assessment across post-acute care settings.