Development and content validity of the military concussion readiness inventory for service members

The aim of this study was to develop and establish content validity of a new questionnaire entitled the Military Concussion Readiness Inventory (MCRI). The MCRI was designed to identify functional impairments and predict readiness for return-to-duty in service members (SM) who experienced mild traumatic brain injury (mTBI) due to a blast. The items on the MCRI were linked to the The International Classification of Functioning, Disability and Health (ICF) classifications. Nineteen male SM participated in a nominal group technique process to generate items for the MCRI. The items were classified according to the ICF before sending items to the Delphi group. Subsequently, thirteen physical therapy experts participated in a Delphi survey to determine content validity of the items generated. Consensus was defined as agreement with an item by at least 70% of participants. After round two of the Delphi survey, consensus was achieved to keep sixty-two items and delete eleven items. No consensus was achieved on twenty-one items. However, eleven items that had 60-70% agreement were considered by the investigators and four of these items were retained, and seventeen were excluded. In this study we successfully combined the use of SMs experiences to develop survey items and with expert opinion determined the content validity of the MCRI. The development of the MCRI is an instrument that may be used for assessment of SM who have experienced mTBI to help identify functional activities, environmental factors, and body functions that may limit these SM from safely and efficiently performing their duties. The MCRI may be useful as a tool to determine return-to-duty status. Further research is needed to fully develop psychometric qualities of this survey.