School of Physical and Occupational Therapy, McGill University, Montréal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada.
School of Physical and Occupational Therapy, McGill University, Montréal, Canada; Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada; Institute of Health Sciences Education, McGill University, Montréal, Canada.
Arch Phys Med Rehabil. 2023 Aug;104(8):1300-1313. doi: 10.1016/j.apmr.2022.12.196. Epub 2023 Jan 26.
OBJECTIVE: To assess the Mayo-Portland Adaptability Inventory-version 4 (MPAI-4) and related measures' measurement properties and the quality of evidence supporting these results; and identify the interpretability and feasibility of the MPAI-4 and related measures. DATA SOURCES: We conducted a systematic review according to COnsensus-based Standards for the selection of health Measurement Instruments (COSMIN) guidelines. We searched 9 electronic databases and registries, and hand searched reference lists of included articles. STUDY SELECTION: Two independent reviewers screened and selected all articles. From 605 retrieved articles, 48 were included. DATA EXTRACTION: Two independent reviewers appraised the evidence quality and rated the extracted classical test theory and Rasch results from each study. DATA SYNTHESIS: We used meta-analysis and COSMIN's approach to synthesize measurement properties evidence (insufficient, sufficient), and the modified Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach to synthesize evidence quality (very low, low, moderate, high) by diagnosis (traumatic brain injury [TBI], stroke), and setting (inpatient, outpatient). The MPAI-4 and its subscales are sufficiently comprehensible (GRADE: very low), but there is currently no other content validity evidence (relevance, comprehensiveness). The MPAI-4 and its participation index (M2PI) have sufficient interrater reliability for stroke and TBI outpatients (GRADE: moderate), whereas interrater reliability between TBI inpatients and clinicians is currently insufficient (GRADE: moderate). There is no evidence for measurement error. For stroke and TBI outpatients, the MPAI-4 and M2PI have sufficient construct validity (GRADE: high) and responsiveness (GRADE: moderate-high). For TBI inpatients, the MPAI-4 and M2PI have mixed indeterminant/sufficient construct validity and responsiveness evidence (GRADE: moderate-high). There is 1 study with mixed insufficient/sufficient evidence for each MPAI-4 adaptation (21- and 22-item MPAI, 9-item M2PI) (GRADE: low-high). CONCLUSION: Users can be most confident in using the MPAI-4 and M2PI in TBI and stroke outpatient settings. Future research is needed on reliability, measurement error, predictive validity, and content validity of the MPAI-4 and its related measures across populations and settings.
目的：评估 Mayo-Portland 适应能力量表第四版（MPAI-4）及相关测量工具的测量特性，以及支持这些结果的证据质量；并确定 MPAI-4 及相关测量工具的可解释性和可行性。
资料来源：我们根据共识基础的健康测量仪器选择标准（COSMIN）指南进行了系统评价。我们检索了 9 个电子数据库和登记处，并对纳入文章的参考文献进行了手工检索。
研究选择：两名独立的审查员筛选并选择了所有文章。从 605 篇检索文章中，有 48 篇被纳入。
数据提取：两名独立的审查员评估了证据质量，并对每项研究中提取的经典测试理论和 Rasch 结果进行了评分。
数据分析：我们使用荟萃分析和 COSMIN 的方法综合测量特性证据（不充分、充分），并使用改良的推荐评估、制定和评价（GRADE）方法综合证据质量（极低、低、中、高），按诊断（创伤性脑损伤[TBI]、中风）和设置（门诊、住院）进行分类。MPAI-4 及其分量表具有足够的可理解性（GRADE：极低），但目前没有其他内容效度证据（相关性、全面性）。MPAI-4 及其参与指数（M2PI）对于中风和 TBI 门诊患者具有足够的评分者间信度（GRADE：中），而 TBI 住院患者与临床医生之间的评分者间信度目前不足（GRADE：中）。没有测量误差的证据。对于中风和 TBI 门诊患者，MPAI-4 和 M2PI 具有足够的结构效度（GRADE：高）和反应度（GRADE：中-高）。对于 TBI 住院患者，MPAI-4 和 M2PI 的结构效度和反应度证据存在混合不确定/充分（GRADE：中-高）。有 1 项研究对 MPAI-4 的每种适应性（21 项和 22 项 MPAI、9 项 M2PI）具有混合不充分/充分的证据（GRADE：低-高）。
结论：在 TBI 和中风门诊环境中，用户最有信心使用 MPAI-4 和 M2PI。未来需要在人群和环境中进行关于 MPAI-4 及其相关测量工具的可靠性、测量误差、预测效度和内容效度的研究。
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