The Center for Functional Assessment Research (CFAR)
The Center for Functional Assessment Research (CFAR) was established in 1979 at Erie County Medical
Center by Glen Gresham, M.D., and Maria Labi, M.D., of the Department of Rehabilitation Medicine,
with an emphasis on the use of functional assessment to study the clinical epidemiology of stroke
and arthritis. In 1983, Carl V. Granger, M.D., was recruited from Brown University to become the
Director of CFAR and Chair of Rehabilitation Medicine at Buffalo General Hospital. Byron Hamilton,
M.D., Ph.D., joined Dr. Granger soon thereafter. A national task force was established in 1983 to gauge
the need for a uniform data set for medical rehabilitation that could be used to document the outcomes
and costs of inpatient medical rehabilitation. As a result of the needs identified by the task force,
The Research Foundation of the State University of New York sought and received a grant from the U.S.
Department of Education's National Institute on Disability and Rehabilitation Research (NIDRR). The
work done pursuant to the grant resulted in the development of the FIM™ instrument. Demographic,
diagnostic, and other variables were added to form the Uniform Data Set for Medical Rehabilitation.
The FIM™ instrument is an easy-to-use assessment tool that allows trained personnel to assign a numerical
value, the FIM™ rating, to a patient's level of function in 18 physical and mental tasks that represent
basic activities of daily life.
In 1984, Dr. Gresham and Dr. Granger published the first definitive work on functional assessment,
"Functional Assessment in Rehabilitation Medicine." Uniform Data System for Medical Rehabilitation
(UDSMR) was founded in 1987 as a data-processing and reporting service for facilities that provide comprehensive
medical rehabilitation services for adults. Among the 25 initial subscribers were rehabilitation facilities
that used the FIM™ instrument to track patient functional status and rehabilitation outcomes. Today, over 1,400
facilities in the United States, Canada, Hong Kong, Finland, Sweden, Australia, and Italy have agreements with
UDSMR, whose databases include more than 13 million patient assessments, making it the largest repository of
medical rehabilitation treatment outcomes in the world. UDSMR, a division of UUB Foundation Activities
, Inc. has over 60 employees and occupies over 15,000 square feet of office space in Amherst, New York,
a short distance away from the University at Buffalo, the State University of New York.
CFAR is the foundation for, and academic research entity within, UDSMR.
The vision statements that govern CFAR include:
UDSMR and CFAR have collaborative research projects with UB's Department of Rehabilitation Sciences, the Center for Assistive
Technology, the Center for Inclusive Design and Environmental Access (IDEA), the Department of Neurology-Jacobs Neurological
Institute (New York State MS Consortium), and the Center of Excellence for Document Analysis and Recognition (CEDAR).
Non-university research collaborators in the WNY region include the Pain Clinic at Buffalo General Hospital, Erie County
Senior Services, Catholic Charities Adult Day program, the Weinberg Campus, St. Columban's Adult Home, and D'Youville College.
National collaborators include the 16-member New York State Multiple Sclerosis Consortium, the University of Pennsylvania, the
Rehabilitation Institute of Chicago, Northwestern University, Cedars-Sinai Hospital, the University of Texas Medical Branch
(Galveston), and the Grace Center for Adult Day Services (Portland, Oregon).
- To establish, maintain, and disseminate uniformity of instruments that document levels of disability and outcomes of medical rehabilitation for persons with disability and/or chronic health conditions, using state-of-the-art technologies.
- To establish the LIFEwaresm System as the measurement tool of the national and international medical rehabilitation communities to track outpatients.
- To establish and maintain the world's leading outcomes database for all phases of medical rehabilitation and chronic disease.
- To establish and maintain the leading system for functional assessment research related to severity, disability, and the measurement of outcomes for persons with disability and/or chronic health conditions.
- To continue commitment to credible and progressive development of tools for clinical applications.
CFAR's focus, under the leadership of Dr. Granger and in conjunction with his research staff, is to strengthen current research
collaborations and to identify new partnerships consistent with the overall mission and focus of the organization.
CFAR - either as a solo applicant or with multiple partners - has submitted grant applications to DHHS, NIDRR, NYSDOH, the
CDC, and NSF. Ongoing efforts to attract external funding will center on research projects in development of an electronic
health record for rehabilitation medicine professionals, outcome measurement in adult day programs, well aging, living well
with disability, and racial and ethnic disparities in healthcare.