External validation of the Memory Assessment Clinics Scale for Epilepsy (MAC-E)

Kayela Arrotta; Brittany Lapin; Margaret Miller; Thomas Hogan; William B Barr; Daniel Friedman; Erica Cotton; Stephan Schuele; Samuel Wiebe; Lara Jehi; Robyn M Busch

doi:10.1016/j.yebeh.2024.110168

External validation of the Memory Assessment Clinics Scale for Epilepsy (MAC-E)

Epilepsy Behav. 2024 Dec 5:163:110168. doi: 10.1016/j.yebeh.2024.110168. Online ahead of print.

Authors

Kayela Arrotta¹, Brittany Lapin², Margaret Miller³, Thomas Hogan⁴, William B Barr⁵, Daniel Friedman⁶, Erica Cotton⁷, Stephan Schuele⁸, Samuel Wiebe⁹, Lara Jehi¹⁰, Robyn M Busch¹¹

Affiliations

¹ Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA; Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA. Electronic address: arrottk@ccf.org.
² Center for Outcomes Research and Evaluation, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA; Quantitative Health Sciences, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA.
³ OhioHealth Physician Group, OhioHealth, Columbus, OH, USA.
⁴ Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.
⁵ Departments of Neurology and Psychiatry, NYU-Langone Medical Center and NYU Grossman School of Medicine, New York, NY, USA.
⁶ Comprehensive Epilepsy Center, NYU Grossman School of Medicine, New York, NY, USA.
⁷ Psychiatry and Behavioral Sciences, Northwestern Memorial Hospital, Chicago, IL, USA.
⁸ Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁹ Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
¹⁰ Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA; Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA; Center for Computational Life Sciences, Cleveland Clinic, Cleveland, OH, USA.
¹¹ Department of Neurology, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA; Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA.

PMID: 39642672
DOI: 10.1016/j.yebeh.2024.110168

Abstract

Objective: This study aimed to externally validate the Memory Assessment Clinics Scale for Epilepsy (MAC-E), a brief self-report measure of subjective memory complaints in adults with epilepsy.

Methods: A cross-sectional study was conducted including adults with focal pharmacoresistant epilepsy from three Level 4 epilepsy centers in the U.S., who completed the MAC-E as part of a clinical neuropsychological evaluation. Confirmatory factor analysis was conducted, and goodness-of-fit criteria were calculated to assess model fit: comparative fit index (CFI), root mean square error of approximation (RMSEA), and standardized root mean residual (SRMR). Item response theory models were constructed, and Mokken analysis was used to assess discrimination and unidimensionality. Internal consistency was evaluated with McDonald's Omega.

Results: There were 191 patients included in the study (mean age = 41 ± 14, 51 % female, 87 % white race). Confirmatory factor analysis supported the 5-factor structure of the MAC-E identified in prior research (CFI = 0.989, RMSEA = 0.056, SRMR = 0.069) with high standardized loadings and R² values for each of the 5 factors (0.58-0.91 and 0.34-0.82, respectively). MAC-E items demonstrated high levels of discrimination as well as the ability to evaluate across the entirety of each latent trait. Score responses were uniformly distributed across latent traits, and unidimensionality was established by factor (all H coefficients > 0.4). Internal consistency was high across factors (omega range: 0.77-0.88).

Conclusions: Results of this study demonstrate good external validation of the MAC-E in an independent, multicenter cohort of adults with epilepsy. These findings provide further support that the MAC-E is a psychometrically valid, self-report instrument to assess every-day memory abilities in adults with epilepsy in both clinical and research settings.

Keywords: Epilepsy; MAC-E; Memory; Memory Assessment Clinics Scale for Epilepsy; Self-report.