Malec, James F.Kean, JacobMonahan, Patrick O.2019-05-152019-05-152017-07Malec, J. F., Kean, J., & Monahan, P. O. (2017). The Minimal Clinically Important Difference for the Mayo-Portland Adaptability Inventory. The Journal of head trauma rehabilitation, 32(4), E47–E54. doi:10.1097/HTR.0000000000000268https://hdl.handle.net/1805/19296OBJECTIVES: To determine the Minimal Clinically Important Difference (MCID) and Robust Clinically Important Difference (RCID) of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) as measures of response to intervention. METHODS: Retrospective analysis of existing data. Both distribution- and anchor-based methods were used to triangulate on the MCID and to identify a moderate, that is, more robust, level of change (RCID) for the MPAI-4. These were further evaluated with respect to clinical provider ratings. PARTICIPANTS: Data for individuals with acquired brain injury in rehabilitation programs throughout the United States in the OutcomeInfo Database (n = 3087) with 2 MPAI-4 ratings. MAIN MEASURES: MPAI-4, Supervision Rating Scale, Clinician Rating of Global Clinical Improvement. RESULTS: Initial analyses suggested 5 T-score points (5T) as the MCID and 9T as the RCID. Eighty-one percent to 87% of clinical raters considered a 5T change and 99% considered a 9T change to indicate meaningful improvement. CONCLUSIONS: 5T represents the MCID for the MPAI-4 and 9T, the RCID. Both values are notably less than the Reliable Change Index (RCI). While the RCI indicates change with a high level of statistical confidence, it may be insensitive to change that is considered meaningful by providers and participants as indicated by the MCID.en-USPublisher PolicyAdaptation, PsychologicalAdultAgedBrain Injuries, TraumaticMiddle AgedMinimal Clinically Important DifferencePsychometricsRecovery of FunctionReproducibility of ResultsRetrospective StudiesArticle