Predictive Validity of Rappaport's Disability Rating Scale in Subjects with Acute Brain Dysfunction

Abstract

We implemented a correlational study to evaluate the effectiveness of Rappaport's Disability Rating Scale in predicting length of hospital stay and discharge status. We evaluated 128 patients who had had cerebrovascular accidents or head injuries using Rappaport's Disability Rating Scale and documented their lengths of stay and discharge dispositions. Significant correlations were obtained between initial Disability Rating scores and lengths of hospital stay (r = .50, p less than .01), discharge Disability Rating scores (r = .66, p less than .01), and discharge status (r = .40, p less than .01). Higher initial ratings of disability were associated with higher discharge ratings and longer terms of hospitalization. Higher ratings of disability were also associated with discharge to another treatment facility rather than home. Despite this evidence supporting the predictive validity of Rappaport's Disability Rating Scale, accurate prediction of length of hospitalization remains difficult because of extreme sample variability. Areas of further investigation are considered.

Factors Predicting Functional and Cognitive Recovery Following Severe Traumatic, Anoxic, and Cerebrovascular Brain Damage

“…23 Studies have confirmed the prognostic value of the DRS score. 16,40,41,46 To our knowledge, no previous studies have calculated the probability of return home on the basis of specific scores on clinical scales and features in individuals with severe ABI of traumatic, cerebrovascular, or anoxic etiology. The data obtained by the tree regression demonstrated that even patients with severe disability (DRS score <19.5 at admission) have a high probability of returning home (86%).…”

“…27,29 About the prognostic factors, the most commonly studied are age, 10,12,17,18,20,35,36 coma duration, 10,21 posttraumatic amnesia, 10,16 early rehabilitation, 22,[36][37][38] and functional and cognitive levels at admission. 12,[16][17][18]22,[39][40][41] Unfortunately, the results are sometimes contradictory 42,43 and thus only partially clear and congruent conclusions can be drawn and applied to clinical practice in the management of patients with severe ABI of different etiologies.…”

The Predictive Validity of the Newcastle Independence Assessment Form Research (NIAF-R): Further Development of an Alternative Measure

“…In the development ot the NIAF-R, the authors believed it was important to establish the predictive of the tul)l. Outcome mcasures that have been shown to have cB'idence of predictive validity are few. Research has shown that discharge Disability Rating Scalc (DRS) (9) scores have been predicted by injury variables ( 10) and also by illitiol DRS scores ( 11 ). One-)'ear follow-up DRS scores are predicted by initial DRS scores (10), hut no other variables were accounted for in these methods.…”

The Importance of Outcome Data in Brain Injury Rehabilitation

“…In searching for a follow-up tool, the clinical team at ReMed reviewed literature that critiqued several outcome rating scales, specifically the Disability Rating Scale (DRS), the Functional Independence Measure (FIM), and the Functional Assessment Measure (FAM) (Bowers & Kofroth, 1989;Eliason & Topp, 1984;Keith, 1984). It was determined that to ensure reliable data by using these scales would require more staff training time and detailed assessment of client functioning than was feasible.…”