Establishing the Test-Retest Reliability and Minimal Detectable Change of the Multiple Sclerosis Resiliency Scale

Elizabeth S Gromisch; Aaron P Turner; Lindsay O Neto; Jennifer A Ruiz; Albert C Lo; Thomas Agresta; Frederick W Foley

doi:10.7224/1537-2073.2021-126

Establishing the Test-Retest Reliability and Minimal Detectable Change of the Multiple Sclerosis Resiliency Scale

Int J MS Care. 2023 Jan-Feb;25(1):15-19. doi: 10.7224/1537-2073.2021-126. Epub 2022 Sep 7.

Authors

Elizabeth S Gromisch^{1

2

3

4}, Aaron P Turner^{5

6

7

8}, Lindsay O Neto^{1

2}, Jennifer A Ruiz^{1

2

3}, Albert C Lo¹, Thomas Agresta⁸, Frederick W Foley^{9

10}

Affiliations

¹ Mandell Center for Multiple Sclerosis, Mount Sinai Rehabilitation Hospital, Trinity Health Of New England, Hartford, CT, USA (ESG, LON, JAR, ACL).
² Department of Rehabilitative Medicine (ESG, LON, JAR), Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA.
³ Department of Medical Sciences (ESG, JAR), Frank H. Netter MD School of Medicine at Quinnipiac University, North Haven, CT, USA.
⁴ Department of Neurology, University of Connecticut School of Medicine, Farmington, CT, USA (ESG).
⁵ Multiple Sclerosis Center of Excellence West, Veterans Affairs, Seattle, WA, USA (APT).
⁶ Rehabilitation Care Service, VA Puget Sound Health Care System, Seattle, WA, USA (APT).
⁷ Department of Rehabilitation Medicine, University of Washington, Seattle, WA, USA (APT).
⁸ Department of Family Medicine and the Center for Quantitative Medicine, University of Connecticut Health Center, Farmington, CT, USA (TA).
⁹ Ferkauf Graduate School of Psychology, Yeshiva University, Bronx, NY, USA (FWF).
¹⁰ Holy Name Medical Center Multiple Sclerosis Center, Teaneck, NJ, USA (FWF).

Abstract

Background: The Multiple Sclerosis Resiliency Scale (MSRS) was designed to assess factors connected to resilience when facing MS-related challenges. Although the MSRS has demonstrated good internal consistency and construct validity, its test-retest reliability has yet to be established. Identifying the minimal detectable change (MDC) of the scale will also improve its utility as an outcome measure for resilience-based interventions. This study aimed to determine the test-retest reliability and MDC of the MSRS.

Methods: Participants were 62 persons with MS who completed the MSRS twice, with a mean ± SD of 16.60 ± 3.97 days (range, 14-30 days) between assessments. Test-retest reliability was evaluated using a 2-way, random-effects, single-measurement intraclass correlation coefficient (ICC), with agreement between time 1 and time 2 visualized with a Bland-Altman plot. The MDC was calculated using the standard error of measurement with a 95% CI.

Results: At time 1, the mean ± SD MSRS score was 77.19 ± 11.97 (range, 45.83-97.00); at time 2, the mean ± SD score was 76.38 ± 12.75 (range, 46-98). The MSRS total score had good test-retest reliability (ICC = 0.88), with the subscale ICCs ranging from 0.77 (MS Peer Support) to 0.93 (Spirituality). The MDC for the total score was 11.95.

Conclusions: These findings suggest that the MSRS has good test-retest reliability and that persons with MS with a difference of 12 points or more between assessments have experienced a reliable change. The results support the utility of the MSRS as a potential outcome measure for MS-related resilience.

Keywords: multiple sclerosis; resilience; test construction; test-retest reliability.

Grants and funding

FUNDING/SUPPORT: The study was funded by a BestCare grant from St Francis Hospital and Medical Center. Dr Gromisch is a Harry Weaver Scholar of the National Multiple Sclerosis Society.