The current validation project is led by Sam Webb and funded by a Stroke Association Postgraduate Fellowship.
Many patients suffer from changes in how they think and control their behaviour after stroke. This makes it difficult to make complex decisions or organise daily life activities once back home. Although it is easy in clinical practice to get a snapshot of one type of executive function – or complex mental abilities – through for example a neuropsychological test like trail making, these tests are have little direct relation to everyday life (known as ‘face validity’).
In addition, the available test batteries to detect deficits in executive function are often too burdensome to be completed on acute or other hospital wards with stroke survivors, and most of the best tests that relate to real life behaviour rely on intact language or motor abilities which may be impaired after stroke.
We created the Oxford Digital Multiple Errands Test or OxMET to be a short screening tool for impairments in complex mental abilities – executive functions – that can be used with stroke survivors with multiple complex impairments. The OxMET uses an everyday shopping scenario on a classic British high street (international translations are underway) that requires participants to buy 6 items and answer two questions within time and rule constraints. It runs on a computer tablet or desktop and was designed in collaboration with a stroke survivors focus group. The OxMET measures performance looking at overall accuracy of test completion, as well as different errors scores such as how many rules were broken, which ones, and whether tests were done completely or partially etc. Instructions for the test are both verbal and pictorial and images are used in the test to allow participants with dysphasia to participate. To see the OxMET being completed, see the following video:
The OxMET has been psychometrically validated, investigating its validity (relation to other executive function tests) and reliability both internally and across time. The present project is focussed on predictive validity and assesses whether the OxMET can provide meaningful information with regards to functional outcomes after stroke.
We want to establish the interpretation of real life behaviour that we can make from the OxMET to help clinicians with decision making when in stroke units.
Webb, S. S., Jespersen, A., Chiu, E. G., Payne, F., Basting, R., Duta, M. D., & Demeyere, N.. (2021). The Oxford digital multiple errands test (OxMET): Validation of a simplified computer tablet based multiple errands test. Neuropsychological rehabilitation, 1–26.