NSW Brain Injury Rehabilitation Forum May 2011

 

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Making sense of MPAI-4 outcome results:
what are the benefits of using keyform charts?
JENNIE BRENTNALL, The University of Sydney

 

Title: Making sense of MPAI-4 outcome results: what are the benefits of using keyform charts?

Authors: Jennie Brentnall & Helen Badge

Background and Aims: The Mayo-Portland Adaptability Inventory (MPAI-4) is a psychometrically sound measure of outcome following acquired brain injury. It is available in eight languages and is used internationally in clinical practice and research. Keyforms, which are based on the Rasch measurement model, provide a mechanism to score and illustrate individual outcomes on established measures. This paper aims to demonstrate the utility of using a keyform for illustrating outcomes on the MPAI-4.

Methods: A mixed methods approach is applied to test and illustrate the strengths and limitations of the keyform scoring method in clinical practice. Data from two state-wide outcomes projects are used to examine the reliability and validity of the MPAI-4 keyform. The relevance of keyform charts to support interpretation of clinical outcomes using MPAI-4 results is demonstrated using quantitative and qualitative data provided by the keyform with group data and single case examples.

Results:The keyform can be used to derive valid and reliable total and subscale scores for the MPAI-4 and to facilitate qualitative interpretation of data. Statistically, the keyform provides an accessible method to derive scores on this established outcome measure that retain many of the benefits of Rasch analysis. These features enable the measurement of individual and group level change and are relatively robust in dealing with missing and unexpected data. The keyform chart can improve the clinical utility of the MPAI-4 providing a visual representation of the pattern of a person's scores and how these change over time, which demonstrates the person's current status, clinical needs and outcome.

Discussion and Conclusions: The keyform provides an accessible method of generating robust scores and interpreting score profiles. The keyform affords advantages for both clinical and research applications of this brain injury outcome measure