Psychometric analysis of the behavioral assessment screening tool (BAST) in adults with stroke

ABSTRACT

Purpose

The purpose of this study was to examine the initial psychometric properties of the Behavioral Assessment Screening Tool (BAST), a self-reported measure of neurobehavioral symptoms, in adults with stroke.

Methods

We assessed subscale and item-level reliabilities of the five BAST subscales in 75 community-dwelling adults with stroke. We further assessed the known-groups validity of the BAST to differentiate individuals with and without self-reported lifetime stroke history (n = 47 with stroke and n = 1843 neurologically healthy controls).

Results

Cronbach’s alpha coefficients of all subscales were >0.7, demonstrating acceptable to good internal consistency reliabilities, and corrected item-total correlations were all >.30 demonstrating good item-level reliabilities. ROC curves demonstrated strong known-groups validity of the negative affect, executive function, and fatigue subscales for classifying stroke versus healthy controls (AUC = .669-.758, p < .001).

Conclusion

The BAST demonstrates good initial psychometric properties as a screening tool to identify neurobehavioral symptoms in community-dwelling adults with stroke. Future work will add stroke-specific items, further assess the validity of the BAST, and employ item response theory or Rasch analyses to identify highly discriminative items for potential smart device-based ecological momentary assessments.

KEYWORDS:

• Stroke
• measurement
• neurobehavioral
• validity
• psychometrics

Ethical Statements

All participants provided written informed consent or documented as assent approved by the [redacted] Institutional Review Board.

The authors have no relevant financial or non-financial competing interests to report.