Multiple Errands Test (MET)

Multiple Errands Test (MET) Evaluation Summary

What does the tool measure? The effect of executive function deficits on everyday functioning.
What types of clients can the tool be used for? The Multiple Errands Test can be used with, but is not limited to, clients with stroke.
Is this a screening or assessment tool? Assessment
Time to administer Baycrest MET: approximately 60 minutes (Dawson et al., 2009).
Versions – Multiple Errands Test (MET) (Shallice and Burgess, 1991)
– MET – Simplified Version (MET-SV) (Alderman et al., 2003)
– MET – Hospital Version (MET-HV) (Knight, Alderman & Burgess, 2002)
– Virtual MET (Rand, Rukan, Weiss & Katz, 2009)
– Baycrest MET (Dawson et al., 2009)
– Modified version of the MET-SV and MET-HV (including 3 alternate versions) (Novakovic-Agopian et al., 2011, 2012)
Other Languages N/A
Measurement Properties
Reliability Internal consistency
– 1 study reported adequate internal consistency of the MET-HV in a sample of patients with chronic acquired brain injury including stroke.

Inter-rater
– 1 study reported excellent inter-rater reliability of the MET-HV in a sample of patients with chronic acquired brain injury including stroke.

– 1 study reported adequate to excellent inter-rater reliability of the BMET in a sample of patients with acquired brain injury including stroke.

Intra-rater
– No studies have reported on the intra-rater reliability of the MET with a population of patients with stroke.

Test-retest
– No studies have reported on the test-retest reliability of the MET with a population of patients with stroke.

Validity Content
– No studies have examined content validity of the MET with a population of patients with stroke.

Criterion
Predictive Validity
– 1 study examined predictive validity of the MET-HV with a sample of patients with acquired brain injury including stroke and reported poor to adequate correlations between discharge MET-HV performance and community participation measured by the Mayo-Portland Adaptability Inventory (MPAI-4).

Concurrent Validity
– No studies have reported on the concurrent validity of the MET in a stroke population.

Sensitivity/ Specificity
– 1 study reported 85% sensitivity and 95% specificity when using a cut-off score ? 7 errors on the MET-HV with clients with chronic acquired brain injury including stroke.
– 1 study reported 82% sensitivity and 95.3% specificity when using a cut-off score ? 12 errors on the MET-SV with clients with brain injury including stroke.

Construct
Known Groups Validity
– 2 studies reported that the MET-HV is able to differentiate between individuals with acquired brain injury (including stroke) vs. healthy adults, and between healthy older adults vs. healthy younger adults.
– 1 study reported that the MET-SV is able to differentiate between clients with brain injury including stroke vs. healthy adults.
– 1 study reported that the BMET is able to differentiate between clients with stroke vs. healthy adults.

– 3 studies reported that the VMET is able to differentiate between clients with stroke vs. healthy adults, and between healthy older adults vs. healthy younger adults.

Convergent/Discriminant Validity
– 3 studies* examined convergent validity of the MET-HV and reported excellent correlations with the Modified Wisconsin Card Sorting Test (MWCST), Behavioural Assessment of Dysexecutive Syndrome battery (BADS), Dysexecutive questionnaire (DEX), IADL questionnaire and FIM Cognitive score; and an adequate correlation with the Rivermead Behavioural Memory Test (RBMT).
– 1 study* examined convergent validity of the MET-SV and reported adequate correlations with the Weschler Adult Intelligence Scale – Revised Full Scale IQ (WAIS-R FSIQ), MWCST, BADS and Cognitive Estimates test; and poor to adequate correlations with the DEX.
– 1 study* examined convergent validity of the BMET and reported adequate to excellent correlations with the Sickness Impact Profile and Assessment of Motor and Process Skills.
– 3 studies* examined convergent validity of the VMET and reported excellent correlations with the MET-HV, BADS, IADL questionnaire, Semantic Fluencies test, Tower of London test, Trail Making Test, Corsi’s supra-span test, Street’s Completion Test and the Test of Attentional Performance.

*NOTE: Correlations between the MET and other measures of everyday executive functioning and IADLs used in these studies also provide support for the ecological validity of the MET.

Floor/Ceiling Effects No studies have reported on the floor/ceiling effects of the MET.
Does the tool detect change in patients? Responsiveness of the MET has not been formally evaluated, however:
– 1 study used a modified version of the MET-HV and MET-SV to measure change following intervention;
– 1 study used the MET-HV and the VMET to detect change in multi-tasking skills of clients with stroke following intervention.
Acceptability The MET provides functional assessment of executive function as it enables clients to participate in real-world activities.
Feasibility Administration of the MET requires access to a shopping area and so is not always feasible in a typical clinical setting. Some tasks may need to be adapted depending on the rehabilitation setting. Administration time can be lengthy. Ecological validity is supported.
How to obtain the tool? Baycrest MET is available from the author: ddawson@research.baycrest.org