Review article (meta-analysis)| Volume 99, ISSUE 9, P1848-1875, September 2018

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Systematic Review of Measurement Property Evidence for 8 Financial Management Instruments in Populations With Acquired Cognitive Impairment

  • Lisa Engel
    Corresponding author Lisa Engel, PhD, Rehabilitation Sciences Institute, University of Toronto, 500 University Ave, Suite 160, Toronto, ON, M5G 1V7, Canada.
    Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada

    Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
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  • Adora Chui
    Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada
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  • Dorcas E. Beaton
    Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada

    Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada

    Institute for Work & Health, University of Toronto, Toronto, Ontario, Canada

    Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Ontario, Canada
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  • Robin E. Green
    Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada

    Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada

    Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
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  • Deirdre R. Dawson
    Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada

    Rotman Research Institute, Baycrest Health Sciences, Toronto, Ontario, Canada

    Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada

    Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
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Published:March 07, 2018DOI:


      • Results from the 8 financial management instruments reviewed should be interpreted with caution.
      • Most instruments reviewed have supporting construct validity (hypothesis-testing) evidence from studies of low risk of bias, but there is a paucity of content validity, reliability, and responsiveness evidence.
      • Systematic reviews of assessment instruments should include a critical appraisal of measurement property evidence study quality to ensure evidence has adequate methodologic quality (ie, low risk of bias).



      To critically appraise the measurement property evidence (ie, psychometric) for 8 observation-based financial management assessment instruments.

      Data sources

      Seven databases were searched in May 2015.

      Study selection

      Two reviewers used an independent decision-agreement process to select studies of measurement property evidence relevant to populations with adulthood acquired cognitive impairment, appraise the quality of the evidence, and extract data. Twenty-one articles were selected.

      Data extraction

      This review used the COnsensus-based Standards for the selection of health Measurement Instruments review guidelines and 4-point tool to appraise evidence. After appraising the methodologic quality, the adequacy of results and volume of evidence per instrument were synthesized. Measurement property evidence with high risk of bias was excluded from the synthesis.

      Data synthesis

      The volume of measurement property evidence per instrument is low; most instruments had 1 to 3 included studies. Many included studies had poor methodologic quality per measurement property evidence area examined. Six of the 8 instruments reviewed had supporting construct validity/hypothesis-testing evidence of fair methodologic quality. There is a dearth of acceptable quality content validity, reliability, and responsiveness evidence for all 8 instruments.


      Rehabilitation practitioners assess financial management functions in adults with acquired cognitive impairments. However, there is limited published evidence to support using any of the reviewed instruments. Practitioners should exercise caution when interpreting the results of these instruments. This review highlights the importance of appraising the quality of measurement property evidence before examining the adequacy of the results and synthesizing the evidence.


      List of abbreviations:

      CCT (Cognitive Competency Test), COSMIN (COnsensus-based Standards for the selection of health Measurement Instruments research group), EFB/FIA (Everyday Functioning Battery/Functional Impact Assessment), FCAI (Financial Competency Assessment Inventory), FCI (Financial Capacity Instrument), FM (financial management), ILS (Independent Living Scales), KELS (Kohlman Evaluation of Living Skills), MAFS (Measurement for Awareness of Financial Skills), MP (measurement property), SCIFC (Semi-structured Clinical Interview of Financial Capacity)
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