{
    "abstract": "The Johns Hopkins Highest Level of Mobility (JH-HLM) scale is used to document the observed mobility of hospitalized patients, including those patients in the intensive care unit (ICU) setting.\nTo evaluate the inter-rater reliability of the JH-HLM, completed by physical therapists, across medical, surgical, and neurological adult ICUs at a single large academic hospital.\nThe JH-HLM is an ordinal scale for documenting a patient's highest observed level of activity, ranging from lying in bed (score\u202f=\u202f1) to ambulating >250\u202ffeet (score\u202f=\u202f8). Eighty-one rehabilitation sessions were conducted by eight physical therapists, with 1 of 2 reference physical therapist rater simultaneously observing the session and independently scoring the JH-HLM. The intraclass correlation coefficient was used to determine the inter-rater reliability.\nA total of 77 (95%) of 81 assessments had perfect agreement. The overall intraclass correlation coefficient for inter-rater reliability was 0.98 (95% confidence interval: 0.96, 0.99), with similar scores in the medical, surgical, and neurological ICUs. A Bland-Altman plot revealed a mean difference in JH-HLM scoring of 0 (limits of agreement: -0.54 to 0.61).\nThe JH-HLM has excellent inter-rater reliability as part of routine physical therapy practice, across different types of adult ICUs.",
    "authors": [
        {
            "affiliation": "Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA.",
            "firstname": "Stephanie",
            "initials": "S",
            "lastname": "Hiser"
        },
        {
            "affiliation": "Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Departments of Medicine and Critical Care Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Gangnam-gu, Seoul, Republic of Korea; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.",
            "firstname": "Chi Ryang",
            "initials": "CR",
            "lastname": "Chung"
        },
        {
            "affiliation": "Concordia University, St. Paul, MN, USA.",
            "firstname": "Amy",
            "initials": "A",
            "lastname": "Toonstra"
        },
        {
            "affiliation": "Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.",
            "firstname": "Lisa Aronson",
            "initials": "LA",
            "lastname": "Friedman"
        },
        {
            "affiliation": "Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA.",
            "firstname": "Elizabeth",
            "initials": "E",
            "lastname": "Colantuoni"
        },
        {
            "affiliation": "Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.",
            "firstname": "Erik",
            "initials": "E",
            "lastname": "Hoyer"
        },
        {
            "affiliation": "Department of Physical Medicine and Rehabilitation, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Outcomes After Critical Illness and Surgery (OACIS) Group, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA. Electronic address: dale.needham@jhmi.edu.",
            "firstname": "Dale M",
            "initials": "DM",
            "lastname": "Needham"
        }
    ],
    "conclusions": "The JH-HLM has excellent inter-rater reliability as part of routine physical therapy practice, across different types of adult ICUs.",
    "copyrights": "Copyright \u00a9 2020 Associa\u00e7\u00e3o Brasileira de Pesquisa e P\u00f3s-Gradua\u00e7\u00e3o em Fisioterapia. Publicado por Elsevier Espa\u00f1a, S.L.U. All rights reserved.",
    "doi": "10.1016/j.bjpt.2020.07.010\n10.1097/CCM.0000000000000040\n10.1186/s13054-017-1827-6\n10.1016/j.jcrc.2014.09.018\n10.1097/CCM.0b013e3182376e6d\n10.1016/j.hrtlng.2013.11.003\n10.1002/jhm.2546\n10.1097/JAT.0000000000000086\n10.1016/j.jclinepi.2010.03.002\n10.1016/S0140-6736(16)31637-3\n10.1016/j.jcrc.2015.08.007",
    "journal": "Brazilian journal of physical therapy",
    "keywords": [
        "Critical illness",
        "Intensive care unit",
        "Mobility limitations",
        "Physical function",
        "Rehabilitation"
    ],
    "methods": null,
    "publication_date": "2020-08-20",
    "pubmed_id": "32811787\n24247473\n28978333\n25316527\n22067629\n24373338\n26849277\n29106679\n21130355\n18839484\n27707496\n26346813",
    "results": "A total of 77 (95%) of 81 assessments had perfect agreement. The overall intraclass correlation coefficient for inter-rater reliability was 0.98 (95% confidence interval: 0.96, 0.99), with similar scores in the medical, surgical, and neurological ICUs. A Bland-Altman plot revealed a mean difference in JH-HLM scoring of 0 (limits of agreement: -0.54 to 0.61).",
    "title": "Inter-rater reliability of the Johns Hopkins Highest Level of Mobility Scale (JH-HLM) in the intensive care unit.",
    "xml": "<Element 'PubmedArticle' at 0x7885060bd170>"
}