Preliminary psychometric evaluation of the Brachial Assessment Tool Part 2: Construct validity and Responsiveness

Publication date: Available online 14 December 2017
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Bridget Hill, Gavin Williams, John Olver, Scott Ferris, Andrea Bialocerkowski
ObjectiveTo evaluate construct validity and responsiveness of the Brachial Assessment Tool (BrAT), a new patient-reported outcome measure for people with traumatic Brachial Plexus Injury (BPI) and to compare it to the Disability of the Arm, Shoulder and Hand (DASH) and the Upper Extremity Functional Index (UEFI)DesignCross sectional studySettingOutpatient clinicsParticipantsAdults with confirmed traumatic BPIIntervention29 people (aged 20 – 69 years) with BPI completed the BrAT three times over an 18-month period together with sixteen DASH activity items and the UEFI. Evaluations were undertaken of construct validity, known groups validity, one-way repeated ANOVA and effect size.Main outcome measuresThe BrAT, DASH, UEFIResultsThe BrAT demonstrated a moderate to low correlation with the DASH activity items (< 0.7) and a large correlation with the UEFI (> 0.7). According to known groups validity only the BrAT was able to discriminate between people who stated they could use their hand versus those who were unable to use their hand to perform activities. All measures indicated a significant effect for time with the exception of BrAT subscale 1. The effect size was highest for the BrAT but lower than expected (BrAT 0.52 – 0.40. DASH 0.15. UEFI 0.36).ConclusionThese preliminary findings support the BrAT as a valid and responsive patient-reported outcome measure for adults with traumatic BPI. The BrAT activity items appear to be more targeted than the DASH or UEFI particularly for people with more severe BPI. The BrAT also appears to be measuring a different activity construct to the DASH and the UEFI. Further work is required to confirm these results with larger sample sizes.



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