Measurement Properties of the BESTest Scale in People With Neurological Conditions: A Systematic Review With Meta-Analysis.

The neurological populations were pooled, and for most single conditions only one to three small studies existed, so the quality of evidence for any one condition is low or very low. Only Parkinson disease and stroke had enough studies to reach high-quality evidence; people with Alzheimer disease, multiple sclerosis, cerebral palsy, spinocerebellar ataxia, cervical spondylotic myelopathy or traumatic brain injury are represented by very few participants. Most of the reliability and measurement-error studies were rated only fair, largely because the authors did not report whether patients stayed stable between sessions or which form of the agreement statistic they used. The three studies of whether the scale's items hang together as intended were small; all had fewer than the 180 participants the reviewers considered necessary for a 36-item scale. Only English and Italian peer-reviewed articles were included, so relevant work published elsewhere may be missing. No study stated in advance what it expected the scale to relate to, so the reviewers supplied their own expectations when judging validity, and how well the scale detects change was only examined in Parkinson disease and subacute stroke.

Funded by the Ricerca Corrente Funding Scheme of the Italian Ministry of Health. The authors state the funders played no role in the design, conduct or reporting of the study. No other conflicts of interest are reported in the text supplied.

Do not read the overall high-quality ratings as applying to every neurological condition. Only Parkinson disease and stroke had enough studies to reach high-quality evidence; for Alzheimer disease, multiple sclerosis, cerebral palsy and the other conditions the evidence was low or very low, mainly because so few patients were studied.