Dr. Eric Armbrecht is an Assistant Professor at the Saint Louis University Center for Outcomes Research, holding dual appointments in the School of Medicine and School of Public Health. He has led numerous efforts for developing, evaluating, and communicating health improvement strategies within government, non-profit and corporate settings. His research and consulting work is focused the development and implementation of new ideas that facilitate chronic disease prevention and management throughout the health care system.
Abstract: The Sickness Impact Profile (SIP) is one of the most widely recognized generic health status instruments, but its length has often left it out of consideration for outcomes research. We assess a short alternative, the Sickness Impact Profile 68 (SIP68), for retest and proxy reliability, validity, and scaling properties, in a population of adults with disability (PWD). For convergent validity, the SIP68 was compared to the instrumental activities of daily living (IADLs), activities of daily living (ADLs) and the short-form 36 (SF-36). We completed 398 interviews with PWD, 131 index-proxy sets, and 40 retests. Retest intraclass correlations were above 0.75 for all scales and dimensions except the physical dimension (0.61). Proxy reliability ranged from 0.26 (psychological autonomy and communication) to 0.85 (somatic autonomy). Correlation between the SIP68 and SIP was 0.94 overall; between the SIP68 and similar scales of the SF-36 correlations was moderate, and highest for physical health scales. We repeated the SIP68 development factor analysis and reproduced a structure of the full SIP that included 65 of SIP68 items. However, 36 additional items were retained that are not part of the SIP68. Overall, the SIP68 shows promise for use as a disability outcomes tool.
Abstract: Functional limitation has received considerable attention in gerontology and geriatrics. Much of this work has focused on single-wave transitions devoid of context rather than on the pattern of transitions over time that constitute trajectories. This Forum article suggests that it is time for a different way of looking at functional limitation pathways. It focuses on trajectories. Responses to three Rosow and Breslau (1966) and two Nagi (1976) items, asked of 12,998 older adults who participated in up to seven waves of data collection as part of the Established Populations for the Epidemiologic Study of the Elderly, are used to illustrate this approach, emphasizing both its conceptual and pragmatic advantages. The results provide greater clarity in terms of those who become functionally limited, take on more functional limitations, or recover as well as those who are likely to be lost to follow-up and in terms of the outcomes associated with those individuals over time.
