Interpreting physical and behavioral health scores from new work disability instruments.

OBJECTIVE To develop a system to guide interpretation of scores generated from 2 new instruments measuring work-related physical and behavioral health functioning (Work Disability - Physical Function (WD-PF) and WD - Behavioral Function (WD-BH)). DESIGN Cross-sectional, secondary data from 3 independent samples to develop and validate the functional levels for physical and behavioral health functioning. SUBJECTS Physical group: 999 general adult subjects, 1,017 disability applicants and 497 work-disabled subjects. Behavioral health group: 1,000 general adult subjects, 1,015 disability applicants and 476 work-disabled subjects. METHODS Three-phase analytic approach including item mapping, a modified-Delphi technique, and known-groups validation analysis were used to develop and validate cut-points for functional levels within each of the WD-PF and WD-BH instrument's scales. RESULTS Four and 5 functional levels were developed for each of the scales in the WD-PF and WD-BH instruments. Distribution of the comparative samples was in the expected direction: the general adult samples consistently demonstrated scores at higher functional levels compared with the claimant and work-disabled samples. CONCLUSION Using an item-response theory-based methodology paired with a qualitative process appears to be a feasible and valid approach for translating the WD-BH and WD-PF scores into meaningful levels useful for interpreting a person's work-related physical and behavioral health functioning.