Utility of the Mayo-Portland adaptability inventory-4 for self-reported outcomes in a military sample with traumatic brain injury.
OBJECTIVE
To investigate the psychometric properties of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) obtained by self-report in a large sample of active duty military personnel with traumatic brain injury (TBI).


DESIGN
Consecutive cohort who completed the MPAI-4 as a part of a larger battery of clinical outcome measures at the time of intake to an outpatient brain injury clinic.


SETTING
Medical center.


PARTICIPANTS
Consecutively referred sample of active duty military personnel (N=404) who suffered predominantly mild (n=355), but also moderate (n=37) and severe (n=12), TBI.


INTERVENTIONS
Not applicable.


MAIN OUTCOME MEASURE
MPAI-4 RESULTS: Initial factor analysis suggested 2 salient dimensions. In subsequent analysis, the ratio of the first and second eigenvalues (6.84:1) and parallel analysis indicated sufficient unidimensionality in 26 retained items. Iterative Rasch analysis resulted in the rescaling of the measure and the removal of 5 additional items for poor fit. The items of the final 21-item Mayo-Portland Adaptability Inventory-military were locally independent, demonstrated monotonically increasing responses, adequately fit the item response model, and permitted the identification of nearly 5 statistically distinct levels of disability in the study population. Slight mistargeting of the population resulted in the global outcome, as measured by the Mayo-Portland Adaptability Inventory-military, tending to be less reflective of very mild levels of disability.


CONCLUSIONS
These data collected in a relatively large sample of active duty service members with TBI provide insight into the ability of patients to self-report functional impairment and the distinct effects of military deployment on outcome, providing important guidance for the meaningful measurement of outcome in this population.
['Kean|Jacob|J|', 'Malec|James F|JF|', 'Cooper|Douglas B|DB|', 'Bowles|Amy O|AO|']
D000328:Adult D001930:Brain Injuries D004185:Disability Evaluation D005163:Factor Analysis, Statistical D005260:Female D006801:Humans D008297:Male D008889:Military Personnel D025341:Principal Component Analysis D011594:Psychometrics D015203:Reproducibility of Results D057566:Self Report
Mayo-Portland Adaptability Inventory-4 traumatic brain injury Brain injuries Psychometrics MPAI-4 Military personnel TBI Mayo-Portland Adaptability Inventory-military MPAI-m MRFA MTBI Outcome and process assessment (health care) Outcome assessment (health care) Rehabilitation VHS mild traumatic brain injury minimum rank factor analysis veteran health care systems