Developing and Validating a Big-Store Multiple Errands Test

Abstract

The Multiple Errands Test (MET) is an ecologically valid assessment that characterizes how executive dysfunction manifests in everyday activities. Due to the naturalistic nature of this assessment, clinicians and researchers have had to develop site-specific versions resulting in numerous published versions and making it difficult to establish standard psychometric properties. The aim of this study was to develop a standardized, community version of the MET designed to be used in large department stores meeting set criteria that would not require site specific modifications. This paper reports on the development, content validity, feasibility, and inter-rater reliability of a Big-Store MET, and the performance of healthy participants on this test. Items were selected to match previously published versions in relation to quantity and complexity. Content validity was established by having experts (n = 4) on the MET review the proposed Big-Store version and evaluate the task consistency with previously published versions. To assess feasibility of administration, and inter-rater reliability, a convenience sample of 14 community dwelling adults, self-reporting as healthy, were assessed by two trained raters. We found the Big-Store MET to be feasible to deliver (completed within 30 min, scores show variability, acceptable to participants in community environment) and inter-rater reliability to be very high (ICCs = 0.92–0.99) with the exception of frequency of strategy use. This study introduces the Big-Store MET to the literature, establishes its preliminary validity and reliability thus laying the foundation for a standardized, community-based version of the MET.

The Oxford Digital Multiple Errands Test (OxMET): Validation of a Simplified Computer Tablet Based Multiple Errands Test

“…Though executive functions, defined from any theory, are now most often framed to be supported by a diffuse network of white and grey matter (e.g. Sasson, Doniger, Pasternak, Tarrasch, & Assaf, 2013), this network is thought to be mediated by the frontal lobes (Bettcher et al, 2016;Dawson, 2019).…”

“…The goal was for the participants to complete the errands efficiently before reporting back to the researcher. This assessed the patient's problem solving, planning, and monitoring abilities (Dawson, 2019). The patients presented different types of errors, in terms of rule breaks, inefficiencies, interpretation failures, and task failures.…”

“…This test was subsequently known as the Multiple Errands Test (MET), characterised as a naturalistic and ecologically valid assessment of executive function. It has been suggested since that the MET may not directly measure executive function, and instead measures the effects of executive dysfunction (Dawson, 2019). As an overall broad-spectrum assessment, it is indeed not a highly controlled domain-specific test but has huge potential as a screening test.…”

“…Several versions of the MET have since been created (see review Rotenberg et al, 2020) to work around some of these issues. Real-world versions have been adapted for patients in hospitals (Dawson et al, 2009;Knight, Alderman, & Burgess, 2002), shopping centers (Alderman, Burgess, Knight, & Henman, 2003) and large stores (Antoniak et al, 2019), as well as a home-based version (Burns et al, 2018), addressing some of the barriers. However, patients with neurological conditions often have co-occurring motor impairments restricting their ability to complete the task.…”

“…With regards to the shop and shopkeeper images, these could similarly be replaced within the code and cultural adaptations and translations would be encouraged, with new and appropriate norm and acceptability testing required for these versions. There has been a push towards a standardised and adaptable scoring system that can be used across many settings and cultures (see Antoniak et al, 2019 andBurns et al, 2018 for examples), and we feel that although the initial and normed design is UK centric, there is definite scope for adaptation. This approach fits strongly with similar approaches taken by our research group on translations for the Oxford Cognitive Screen (e.g.…”