# OPTIMIZING THE CLINICAL FUNCTIONING INFORMATION TOOL (ClinFIT) IN ROUTINE CLINICAL PRACTICE: DEVELOPMENT OF FUNCTIONAL STAGING CUTOFF SCORES FOR REHABILITATION PROVISION AND INTENSITY

## TL;DR

This study developed cutoff scores for the ClinFIT tool to help determine the intensity of rehabilitation needed for patients based on their functional impairment.

## Contribution

The study introduces data-driven cutoff scores for the ClinFIT tool to stratify rehabilitation intensity in clinical practice.

## Key findings

- Two ClinFIT cutoff scores (135 and 192) were identified to distinguish between light, moderate, and high rehabilitation intensity.
- The cutoff scores showed acceptable discriminatory performance (AUCs: 0.720 and 0.748).
- The staging system was robust across different demographic and diagnostic groups.

## Abstract

To develop data-driven functional staging cutoff scores for the Clinical Functioning Information Tool (ClinFIT) total raw score to stratify patients according to rehabilitation provision and intensity.

This observational study included adult inpatients (n = 270) admitted to a tertiary rehabilitation unit. ClinFIT total scores at admission were analysed alongside the Therapy Disciplines domain of the Rehabilitation Complexity Scale to represent rehabilitation intensity. Receiver Operating Characteristic analysis was used to identify optimal cutoff points distinguishing between levels of rehabilitation intensity. Subgroup analyses were conducted by age, sex, and diagnosis.

Participants were predominantly male (54.1%), with a mean age of 62.9 ± 14.3 years. ClinFIT total raw scores improved significantly across all health conditions at discharge compared with admission (p < 0.001), reflecting substantial functional recovery during inpatient rehabilitation. Two ClinFIT total score cutoffs were identified: 135 (light vs moderate) and 192 (moderate vs high intensity), with acceptable discriminatory performance (AUCs: 0.720, 0.748, respectively). Subgroup analyses supported the robustness of this 3-level staging system across demographic and diagnostic groups.

This study provides evidence-based cutoff scores for ClinFIT, supporting its clinical use for stratifying rehabilitation provision and intensity. These findings may enhance clinical decision-making, optimize resource allocation, and promote wider adoption of the ClinFIT. Further validation in external and diverse populations is warranted.

Clinical Functioning Information Tool (ClinFIT) is an instrument for clinicians to assess how health conditions affect a person’s ability to function in daily life. It provides a total raw score of 0–300, higher scores indicate greater functional impairment. This study developed cutoff scores for the ClinFIT to guide the level of rehabilitation support required for a patient in everyday rehabilitation practice. ClinFIT data from 270 adults in a rehabilitation unit were analysed at admission and discharge. Two key cutoff scores (135 and 192) were identified, dividing patients into light, moderate, and high rehabilitation intensity groups. These categories reflected differences in therapy needs and progress. This can guide clinical decision-making, help plan therapy intensity, and improve use of rehabilitation resources. This functional staging system can support more consistent and equitable rehabilitation care across different patient groups and settings.