{"doi":"10.1001/jamanetworkopen.2020.4702","title":"Validation of Medicare Rehabilitation Functional Assessments in Routine Care","abstract":"Importance: Assessment of functional outcomes is currently limited by a lack of large data sets. Functional assessments are included in Medicare rehabilitation assessment files, yet the validity of these measures in routine care is unknown. Objective: To evaluate the validity of individual-level routine care functional assessments in Medicare rehabilitation settings compared with criterion-standard National Health and Aging Trends Study (NHATS) research assessments obtained no more than 90 days later. Design, Setting, and Participants: This cross-sectional study of individuals aged 65 years and older used the 2011 to 2015 NHATS linked with Medicare assessment files. Individuals with a discharge assessment from inpatient rehabilitation facilities, skilled nursing facilities, or home health agencies and a criterion-standard NHATS assessment were included. Data analysis was performed June 2019 to November 2019. Main Outcomes and Measures: Summary functional assessment based on independence with eating, toilet hygiene, bathing, dressing, transfers, and mobility or walking. Linear regression was used to assess agreement between the 2 scales, adjusting for time between assessments and rehabilitation setting. Results: A total of 1036 adults aged 65 years and older (671 [64.8%] aged ≥80 years; 670 [64.7%] women; 685 [66.1%] white participants) met the study criteria. The correlation of the assessments was 0.63 (95% CI, 0.59 to 0.66; mean [SD] rehabilitation score, 27.5 [7.2]; mean [SD] NHATS score, 30.5 [10.1]). The correlation increased to 0.66 (95% CI, 0.60 to 0.71) for assessments no more than 30 days apart. The linear regression model adjusting for rehabilitation setting and days between evaluations found the assessments were strongly correlated (β = 1.00 [95% CI, 0.93 to 1.08]; intercept, 0.72 [95% CI, -1.79 to 3.24]; R2 = 0.42). Differences in scores were generally small (mean [SD] of NHATS - rehabilitation score, 2.96 [7.91]), and only 59 assessments (5.7%) differed by more than 2 SDs of the mean difference. Rehabilitation service scores were typically higher than NHATS scores in individuals with lower mean scores; however, the population with lower mean scores was small (156 [15.1%]). Conclusions and Relevance: In this large sample of older US adults, routine care rehabilitation facility functional assessments had overall moderate correlation with criterion-standard research assessments.","journal":"JAMA Network Open","year":2020,"id":85674,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.882,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":265987,"name":"Lesli E. Skolarus","orcid":"0000-0002-3088-9838","position":1,"is_corresponding":false},{"id":437862,"name":"Chunyang Feng","orcid":"0000-0002-8260-7206","position":2,"is_corresponding":false},{"id":335344,"name":"James Burke","orcid":"0000-0002-2296-1588","position":3,"is_corresponding":false},{"id":384645,"name":"Kevin A. Kerber","orcid":"0000-0002-4722-8307","position":0,"is_corresponding":true}],"reference_count":16,"raw_metadata":null,"created_at":"2026-07-18T21:58:16.217017Z","pmid":"32401316","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}