Objective

The Modified Mini-Mental State Examination (3MS) could provide useful information about cognitive status in traumatic brain injury (TBI), yet has not been validated in this population. We studied the reliability, construct validity, clinical responsiveness, and cognitive impairment classification-ability of the 3MS compared to the Mini-Mental State Examination (MMSE).

Methods

Adult participants receiving inpatient rehabilitation services for TBI were administered the 3MS and MMSE at admission and discharge (n = 72). Construct validity and classification agreement were assessed through relationships of each measure with cognitive items of the Functional Independence Measure^TM (FIM) and rehabilitation length of stay (LOS).

Results

3MS reliability at admission and discharge (Cronbach’s alphas = .871 and .839, respectively) exceeded that for the MMSE (Cronbach’s alpha = .748 and .653, respectively). 3MS construct validity was marginally better than for the MMSE as assessed through correlations with FIM cognitive scores and LOS. Standard error of measurement as a percentage of the total scale was lower for the 3MS; responsiveness of the 3MS was superior as assessed by the 95% confidence interval for minimal detectable change. Cognitive impairment classification-ability was superior for the 3MS.

Conclusions

While both instruments had reasonable psychometric properties, the 3MS had a superior psychometric profile in the acute phase of TBI.

中文翻译：

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改良的迷你精神状态检查在颅脑外伤住院康复中的实用性：初步发现。

目的

改良的迷你精神状态检查（3MS）可以提供有关颅脑损伤（TBI）认知状态的有用信息，但尚未在该人群中得到验证。我们研究了3MS与迷你精神状态检查（MMSE）相比的可靠性，结构效度，临床响应能力和认知障碍分类能力。

方法

接受TBI住院康复服务的成年参与者在入院和出院时接受3MS和MMSE的治疗（n = 72）。通过每项措施与功能独立性措施^TM（FIM）和康复住院时间（LOS）的认知项目之间的关系，评估构建的有效性和分类一致性。

结果

3MS的入场和出场可靠性（Cronbach的α分别为0.871和.839）超过了MMSE的可靠性（Cronbach的alpha分别为.748和.653）。通过与FIM认知评分和LOS的相关性评估，3MS的结构效度略好于MMSE。3MS的标准测量误差（以总比例的百分比表示）较低；3MS的响应性优于95％的置信区间，可检测到最小的变化。3MS的认知障碍分类能力更好。

结论

尽管两种仪器都具有合理的心理测量特性，但3T在TBI急性期的心理测量特性却优越。