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Development and validation of interpretability cutoffs for the short forms of the Brain Injury Rehabilitation Trust
Benedetta Basagni1, Leonardo Pellicciari2, Antonio DE Tanti3
1Clinica di Riabilitazione Toscana (CRT), Montevarchi, Arezzo, Italy.
Background:
Previous analyses demonstrated that Italian versions of the five short forms of the Brain Injury Rehabilitation Trust Personality Questionnaires (SF-BIRT-PQs) showed strong psychometric properties. However, evidence on their interpretability lacks.
Aim:
To calculate cutoffs for each of the SF-BIRT-PQ to discriminate between the subject's behavior that deviates significantly (D+) or not (D-) from the average of healthy individuals.
Design:
Multicenter prospective study.
Population:
One hundred and fifty-four subjects with acquired brain injury, their 154 caregivers, and 120 healthy subjects.
Methods:
SF-BIRT-PQs and disability measures were administered to the included subjects. Moreover, subjects scored the Satisfaction Profile (SAT-P) and disability measures, while the Caregiver Burden Inventory (CBI) and Frontal Behavioral Inventory (FBI) were administered to caregivers. Cutoffs between scores indicating D- or D+ patients were calculated with Z-scores, and Mann-Whitney Tests were used to assess the scores of the comparator instruments across the two groups (i.e., D+ and D-) generated by the cutoff for each SF-BIRT-PQs separately for the patient (using SAT-P, DRS, LCF) and caregiver samples (using CBI, FBI, DRS, LCF).
Results:
Cutoffs to discriminate between D+ and D- were identified (SF-BMQ ≥25 points, SF-BREQ ≥19 points, SF-BSCQ ≥14 points, SF-BDQ ≥15 points, SF-BIQ ≥18 points indicated D+). Generally, for the patients' sample, between-group comparisons showed significant differences between all SF-BIRT-PQs (except BDQ and BIQ) and the SAT-P subscales (P<0.05) but not with disability measures (P>0.05). In contrast, for the caregivers' sample, between-group comparisons showed significant differences between all SF-BIRT-PQs and the CBI and FBI subscales (P<0.05) but not with disability measures (P>0.05). A digital ruler was devised to convert raw scores into interval measures.
Conclusions:
We provided evidence in support of the construct validity of the proposed cutoffs for each SF-BIRT-PQ.
Clinical Rehabilitation Impact:
These cutoffs make the short forms of the BIRT-PQs interpretable by quantifying the amount of the patient's behavior divergence from that of the average healthy individual. The electronic rulers for each BIRT-PQ provide several functions that greatly facilitate the SF-BIRT-PQ administration and interpretation.
