An Internet-Based Evaluation System for Postacute Acquired Brain Injury

描述（由申请人提供）：该项目的总体目标是开发一个基于网络的国家数据库系统，用于评估和结果测量（梅奥-波特兰适应性量表；MPAI-4）获得性脑损伤（ABI）。拟议的数据库将提供全国人口统计样本；社会和治疗环境；诊断/损伤描述符;最重要的是，改变急性康复过程和ABI患者的预后。该数据库将用于每半年向参与的康复服务提供者提供反馈，说明他们的康复服务相对于其他服务类似个人和使用类似方法的提供者的康复服务的有效性。虽然这种类型的项目评估体系（即功能损伤测量；FIM）在住院康复中已经建立，但目前还没有这样的系统可用于急性后康复。康复设施认证委员会（CARF）要求项目评估方法，导致大量“本土”测量有限的心理测量质量。相比之下，在过去的15年里，MPAI-4的心理测量特性和可用性已经使用最先进的测量技术（例如，Rasch分析）以及传统的心理测量评估程序进行了改进。发明软件解决方案（ISS）在宾夕法尼亚州与一个小用户组开发了一个原型MPAI-4数据库。拟议的项目将使用最先进的数据库技术（即安全的网络联机数据收集）。除了商业化和传播这一方案评估产品的直接目标外，最终获得的数据可能有助于宣传、政策制定、残疾确定以及确定ABI患者对医疗、康复、职业、独立生活和其他服务的需求。在项目的第一阶段，我们构建了一个新的基于web的原型。在成功的可用性测试、财团顾问和执行审查小组的审查之后，新系统在费城、凤凰城和印第安纳波利斯举行的焦点小组会议上展示。评价表由焦点小组参与者填写，评价表由联合体顾问进行分析。该系统随后由30名不同背景的试点测试人员进行了测试。同样，评价表由试点测试人员完成，结果由联合体顾问进行分析。在拟议的第二期项目中，该产品将进一步改进，以适合大型国家用户群体使用。成功的市场营销以发展一个庞大的用户群体是必要的(a)确保对慢性损伤和ABI患者的活动和参与水平进行更具代表性的抽样，以及(b)通过参与康复计划的订阅费为该项目的长期维持提供经济基础。在这个二期项目中，我们还建议最终确定系统、政策和程序，以支持项目正在进行的财务可行性、科学数据和测量的完整性、道德实践以及用户教育和培训。

DESCRIPTION (provided by applicant): The overall objective of this project is to develop a Web-based national data base system for an assessment and outcome measure (Mayo-Portland Adaptability Inventory; MPAI-4) for acquired brain injury (ABI). The proposed database will provide a national sample of demographics; social and treatment environments; diagnosis/injury descriptors; and most importantly, change over the course of post-acute rehabilitation and outcomes for people with ABI. This database will be used to provide semi-annual feedback to participating rehabilitation providers about the effectiveness of their rehabilitation services relative to those of other providers serving similar individuals and using similar methods. Although a program evaluation system of this type is well-established for inpatient rehabilitation (i.e., Functional Impairment Measure; FIM), no such system is currently available for post-acute rehabilitation. Methods for program evaluation are required by the Committee on the Accreditation of Rehabilitation Facilities (CARF) resulting in a large number of "home-grown" measures of limited psychometric quality. In contrast, the psychometric properties and usability of the MPAI-4 have been refined over the last 15 years using state-of-the-art measurement technology (e.g., Rasch analysis) as well as traditional psychometric evaluation procedures. A prototype MPAI-4 database was developed with a small user group in Pennsylvania by Inventive Software Solutions (ISS). The proposed project will use state-of-the-art database technologies (i.e., secure web-based, on-line data collection). In addition to the immediate goal of commercialization and dissemination of this program evaluation product, ultimately data obtained may be useful for advocacy, policy development, disability determination, and determination of needs for medical, rehabilitation, vocational, independent living and other services of people with ABI. In Phase I of the project we built a new Web-based prototype. Upon successful usability testing, reviews by consortium consultants and the executive review panel, the new system was presented at focus groups held in Philadelphia, Phoenix and in Indianapolis. Evaluation forms were completed by the focus group attendees and the results were analyzed by the consortium consultants. The system was then examined by 30 pilot testers from varying backgrounds. Again, evaluation forms were completed by the pilot testers and the results were analyzed by the consortium consultants. In the proposed Phase II project the product will be further refined to be suitable for use by a large national user group. Successful marketing to develop a large user group is necessary to (a) assure a more representative sampling of chronic impairment and levels of activity and participation of people with ABI, and (b) provide an economic basis for long-term maintenance of this project through subscriber fees from participating rehabilitation programs. In this Phase II project we also propose to finalize systems, policies, and procedures in order to support the project's ongoing financial viability, scientific data and measurement integrity, ethical practices, and user education and training. PUBLIC HEALTH RELEVANCE: Methods for program evaluation are required by the Committee on the Accreditation of Rehabilitation Facilities (CARF). The MPAI-4 is a measurement tool that can meet the critically unmet need for a national database system for gathering information from rehabilitation providers to be used for the evaluation of rehabilitative services for people with acquired brain injury (ABI). In addition to the immediate goal of commercialization and dissemination of this program evaluation product, ultimately data obtained may be useful for advocacy, policy development, disability determination, and determination of needs for medical, rehabilitation, vocational, independent living and other services of people with ABI.