Weeks Douglas L, Ambrose Sara B, Tindall Angelique G
Clinical Research Department, St. Luke's Rehabilitation Institute , Spokane, WA, USA.
Elson S. Floyd College of Medicine, Washington State University , Spokane, WA, USA.
Brain Inj. 2020 Jun 6;34(7):881-888. doi: 10.1080/02699052.2020.1761564. Epub 2020 May 12.
The Modified Mini-Mental State Examination (3MS) could provide useful information about cognitive status in traumatic brain injury (TBI), yet has not been validated in this population. We studied the reliability, construct validity, clinical responsiveness, and cognitive impairment classification-ability of the 3MS compared to the Mini-Mental State Examination (MMSE).
Adult participants receiving inpatient rehabilitation services for TBI were administered the 3MS and MMSE at admission and discharge (n = 72). Construct validity and classification agreement were assessed through relationships of each measure with cognitive items of the Functional Independence Measure (FIM) and rehabilitation length of stay (LOS).
3MS reliability at admission and discharge (Cronbach's alphas = .871 and .839, respectively) exceeded that for the MMSE (Cronbach's alpha = .748 and .653, respectively). 3MS construct validity was marginally better than for the MMSE as assessed through correlations with FIM cognitive scores and LOS. Standard error of measurement as a percentage of the total scale was lower for the 3MS; responsiveness of the 3MS was superior as assessed by the 95% confidence interval for minimal detectable change. Cognitive impairment classification-ability was superior for the 3MS.
While both instruments had reasonable psychometric properties, the 3MS had a superior psychometric profile in the acute phase of TBI.
改良简易精神状态检查表（3MS）可为创伤性脑损伤（TBI）的认知状态提供有用信息，但尚未在该人群中得到验证。我们研究了3MS与简易精神状态检查表（MMSE）相比的信度、结构效度、临床反应性和认知障碍分类能力。
对接受TBI住院康复服务的成年参与者在入院时和出院时进行3MS和MMSE测试（n = 72）。通过每项测量与功能独立性测量（FIM）的认知项目和康复住院时间（LOS）之间的关系来评估结构效度和分类一致性。
3MS在入院时和出院时的信度（克朗巴赫系数分别为0.871和0.839）超过了MMSE（克朗巴赫系数分别为0.748和0.653）。通过与FIM认知评分和LOS的相关性评估，3MS的结构效度略优于MMSE。3MS测量标准误占总分的百分比更低；通过最小可检测变化的95%置信区间评估，3MS的反应性更好。3MS的认知障碍分类能力更强。
虽然两种工具都具有合理的心理测量特性，但在TBI急性期，3MS具有更优的心理测量特征。
