Derivation and validation of a short form Nottingham extended activities of daily living (SF-NEADL) scale

Purpose: The Nottingham Extended Activities of Daily Living (NEADL) assessment is commonly used in research and clinical contexts.However, there are concerns surrounding psychometric properties, and with 22-items, NEADL may be too long for clinical use at scale.We aimed to derive a psychometrically robust short form NEADL. Methods: Data were from the Virtual International Stroke Trials Archive, including individual participant data from 3,6,12 months.Six-month data were used to evaluate NEADL reliability and validity.Corrected item-total correlations identified items for inclusion in the short form (SF-NEADL).The resulting SF-NEADL was then assessed at all time-points for reliability, structural and construct validity, including confirmatory factor analysis (CFA).Results: NEADL had high internal consistency, and five items with corrected item-total correlations over 0.7 were selected to create a SF-NEADL.The NEADL and SF-NEADL at 6 months had excellent reliability, and construct validity.SF-NEADL reliability and validity were stable at 3 and 12 months.CFA did not suggest unidimensionality of NEADL or SF-NEADL, but SF-NEADL achieved good fit with a two-item structure.Conclusion: Reliability and validity of our SF-NEADL suggest it is a robust alternative to standard eADL assessments.Its use of fewer and more relevant items makes it suitable for use in busy healthcare settings. h IMPLICATIONS FOR REHABILITATION• Assessment of ability in extended activities of daily living (eADL) is a fundamental part of research and clinical practice.• We derived a short form of the Nottingham eADL scale, containing 5 questions about mobility and kitchen tasks, that captures functional independence in daily life as robustly as the original scale.• With 5 items rather than the original 22, the SF-NEADL is easier to administer and less likely to induce participant fatigue and incomplete response, making it suitable for inclusion in a battery of tests as part of a research or clinical protocol.