Whyte, JohnGiacino, Joseph T.Heinemann, Allen W.Bodien, YelenaHart, TessaSherer, MarkWhiteneck, Gale G.Mellick, DavidHammond, Flora M.Semik, PatrickRosenbaum, AmyNakase Richardson, Risa2021-03-312021-03-312021-01Whyte, J., Giacino, J. T., Heinemann, A. W., Bodien, Y., Hart, T., Sherer, M., Whiteneck, G. G., Mellick, D., Hammond, F. M., Semik, P., Rosenbaum, A., & Richardson, R. N. (2021). Brain Injury Functional Outcome Measure (BI-FOM): A Single Instrument Capturing the Range of Recovery in Moderate-Severe Traumatic Brain Injury. Archives of Physical Medicine and Rehabilitation, 102(1), 87–96. https://doi.org/10.1016/j.apmr.2020.09.377https://hdl.handle.net/1805/25513Objective To develop a measure of global functioning after moderate-severe TBI with similar measurement precision but a longer measurement range than the FIM. Design Phase 1: retrospective analysis of 5 data sets containing FIM, Disability Rating Scale, and other assessment items to identify candidate items for extending the measurement range of the FIM; Phase 2: prospective administration of 49 candidate items from phase 1, with Rasch analysis to identify a unidimensional scale with an extended range. Setting Six TBI Model System rehabilitation hospitals. Participants Individuals (N=184) with moderate-severe injury recruited during inpatient rehabilitation or at 1-year telephone follow-up. Interventions Participants were administered the 49 assessment items in person or via telephone. Main Outcome Measures Item response theory parameters: item monotonicity, infit/outfit statistics, and Factor 1 variance. Results After collapsing misordered rating categories and removing misfitting items, we derived the Brain Injury Functional Outcome Measure (BI-FOM), a 31-item assessment instrument with high reliability, greatly extended measurement range, and improved unidimensionality compared with the FIM. Conclusions The BI-FOM improves global measurement of function after moderate-severe brain injury. Its high precision, relative lack of floor and ceiling effects, and feasibility for telephone follow-up, if replicated in an independent sample, are substantial advantages.enPublisher Policyassessmentbrain injuriesoutcome measurementArticle