Effects of using consumer and expert ratings of an activities of daily living scale on predicting functional outcomes of postacute care

To test the effects of using preference weights for activities of daily liv ing (ADL) outcome measures derived from different sources, data from a larg e study of the outcomes of postacute care (PAC study) were analyzed using t wo different weightings for the ADL measures. Both were developed using the same magnitude estimation technique; one from a panel of long-term care ex perts (the expert rating system); the other from a group of elderly Medicar e beneficiaries (the consumer rating system). Neither group was directly in volved in the PAC study. Although ADL scores generated by both rating syste ms were highly correlated prior to hospitalization and at hospital discharg e, the consumer and expert rating systems generated significantly different functional outcomes measured by the change of ADL scores with a few except ions. Compared to the consumer rating system, the expert rating system gene rated a greater change in functional outcomes at each of three follow-up ti me points after hospital discharge. This study suggests that the choice of weights for ADL items is important. (C) 2001 Elsevier Science Inc. All righ ts reserved.