The minimal clinically important difference for the mayo-portland adaptability inventory

James F. Malec, Jacob Kean, Patrick O. Monahan

Research output: Contribution to journalArticle

3 Scopus citations


Objectives: 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.

Original languageEnglish (US)
Pages (from-to)E47-E54
JournalJournal of Head Trauma Rehabilitation
Issue number4
StatePublished - Jan 1 2017


  • Brain injury
  • Outcome assessment
  • Rehabilitation

ASJC Scopus subject areas

  • Physical Therapy, Sports Therapy and Rehabilitation
  • Rehabilitation
  • Clinical Neurology

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