An Internet-Based Evaluation System for Postacute Acquired Brain Injury

描述（由申请人提供）：本项目的总体目标是开发一个基于网络的国家数据库系统，用于获得性脑损伤（ABI）的评估和结果测量（梅奥-波特兰适应性量表; MPAI-4）。拟议的数据库将提供人口统计学的全国样本;社会和治疗环境;诊断/损伤描述符;最重要的是，ABI患者急性后康复过程和结果的变化。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，说明其康复服务相对于为类似个人提供服务并使用类似方法的其他提供者的康复服务的有效性。虽然这种类型的程序评估系统对于住院康复是完善的（即，功能损害测量;目前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）要求方案评估方法，导致大量心理测量质量有限的“本土”措施。相比之下，MPAI-4的心理测量特性和可用性在过去15年中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。原型MPAI-4数据库是由Inventive Software Solutions（ISS）与宾夕法尼亚州的一个小型用户组开发的。拟议项目将使用最先进的数据库技术（即，安全的基于网络的在线数据收集）。除了该项目评估产品的商业化和传播的直接目标外，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患者的医疗、康复、职业、独立生活和其他服务需求。 在项目的第一阶段，我们建立了一个新的基于Web的原型。在成功地进行了可用性测试、联合顾问和行政审查小组进行了审查之后，在费城、凤凰城和印第安纳波利斯举行的焦点小组会议上介绍了新系统。评估表由焦点小组参与者填写，结果由联盟顾问分析。然后，来自不同背景的30名试点测试人员对该系统进行了检查。同样，评估表由试点测试人员填写，结果由联合体顾问进行分析。 在拟议的第二阶段项目中，将进一步完善该产品，使其适合于广大的国家用户群体使用。成功的市场营销，以开发一个大的用户群是必要的（a）确保一个更有代表性的慢性损伤和活动水平和ABI的人参与抽样，和（B）提供一个经济基础，通过订阅费，从参与康复计划的长期维护这个项目。在第二阶段项目中，我们还建议最终确定系统、政策和程序，以支持项目的持续财务可行性、科学数据和测量完整性、道德实践以及用户教育和培训。 公共卫生相关性：康复设施认证委员会（CARF）要求采用方案评估方法。MPAI-4是一种测量工具，可以满足国家数据库系统的严重需求，用于从康复提供者那里收集信息，用于评估获得性脑损伤（ABI）患者的康复服务。除了该项目评估产品的商业化和传播的直接目标外，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患者的医疗、康复、职业、独立生活和其他服务需求。

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.