“How to use fancy statistics to make a good vocational brain injury measurement tool even better!”

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Clinicians and rehab counselors feel their real-world feedback on what to measure and how to measure it is not always accounted for in research efforts. This is especially true when it comes to tools intended for daily use in resource-constrained clinical environments & vocational programs. If the end user doesn’t have confidence in the clinical utility of a measurement tool, they will be less likely to use it. Our mission in this paper was to describe not only the statistical process behind a measure redesign effort (Rasch analysis), but also to emphasize how expert clinical feedback can inform and even 'override the numbers' regarding item inclusion or adjustment. The tool we selected for redesign measures basic employment characteristics of safety, productivity, and interpersonal relations after brain injury. The measure that resulted from this process, the Employment Feasibility Checklist (EFC), is not only statistically validated but also is up to 43% more efficient for clinicians to use than the original measure. The authors also ‘put their money where their statistics are’, in that we use the tool in our own clinics!

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