Assessing traumatic brain injury outcome measures for long-term follow-up of community-based individuals

Hall, Karyl M.; Bushnik, Tamara; Lakisic-Kazazic, Bajazeda; Wright, Jerry; Cantagallo, Anna

doi:10.1053/apmr.2001.21525

Cited by 170 publications

(93 citation statements)

References 39 publications

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“…The Disability Rating Scale (DRS) is a frequently used, well-validated rating scale of disability following brain injury that measures the patient's level of functioning from coma to community reentry (Gouvier et al, 1987;Hall et al, 1985Hall et al, , 2001McCauley et al, 2001a;Rappaport et al, 1981). The Supervision Rating Scale (SRS) measures the level of supervision that a patient with TBI actually receives from staff or other caregivers on a 13-level rating scale (Boake, 1996).…”

Section: Outcome Measures Used For Validationmentioning

confidence: 99%

The Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI): II. Reliability and Convergent Validity

McCauley

Wilde

Kelly

et al. 2010

Journal of Neurotrauma

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A standardized measure of neurological dysfunction specifically designed for TBI currently does not exist and the lack of assessment of this domain represents a substantial gap. To address this, the Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI) was developed for TBI outcomes research through the addition to and modification of items specifically relevant to patients with TBI, based on the National Institutes of Health Stroke Scale. In a sample of 50 participants (mean age ¼ 33.3 years, SD ¼ 12.9) 18 months (mean ¼ 3.1, SD ¼ 3.2) following moderate (n ¼ 8) to severe (n ¼ 42) TBI, internal consistency of the NOS-TBI was high (Cronbach's alpha ¼ 0.942). Test-retest reliability also was high (r ¼ 0.97, p < 0.0001), and individual item kappas between independent raters were excellent, ranging from 0.83 to 1.0. Overall inter-rater agreement between independent raters (Kendall's coefficient of concordance) for the NOS-TBI total score was excellent (W ¼ 0.995). Convergent validity was demonstrated through significant Spearman rank-order correlations between the NOS-TBI and the concurrently administered Disability Rating Scale (r ¼ 0.75, p < 0.0001), Rancho Los Amigos Scale (r ¼ À0.60, p < 0.0001), Supervision Rating Scale (r ¼ 0.59, p < 0.0001), and the FIM Ô (r ¼ À0.68, p < 0.0001). These results suggest that the NOS-TBI is a reliable and valid measure of neurological functioning in patients with moderate to severe TBI.

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Section: Outcome Measures Used For Validationmentioning

confidence: 99%

The Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI): II. Reliability and Convergent Validity

McCauley

Wilde

Kelly

et al. 2010

Journal of Neurotrauma

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“…The dependent measure used, the FIL, is ordinal. Although the literature is replete with studies that treat ordinal data as interval, 5,56,57 this remains a violation of the assumptions of multiple regression analysis. In addition, the multiple regression analyses conducted in this study, specifically stepwise analysis, have the potential to capitalize on the relationships between predictor variables, and thus produce spurious results.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Assessment of Rehabilitation Outcome After Traumatic Brain Injury

Schatz

Hillary

Moelter

et al. 2002

Journal of Head Trauma Rehabilitation

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Objective: To develop a measure suitable for retrospective analysis of qualitative brain injury outcome data, the Functional Independence Level (FIL), and document its reliability, validity, and utility. Design: Retrospective analysis of existing records, with inclusion based on availability of records, and quantitative or qualitative documentation of functional status at a minimum of 1.5 years after injury. Setting: Statewide acute and postacute rehabilitation facilities, as part of a State Head Injury Program. Participants: A total of 338 individuals, with documented moderate to severe traumatic brain injury; primarily males ages 16 to 45. Main Outcome Measures: Disability Rating Scale (DRS) at discharge from primary rehabilitation, Living Situation and Functional Independence Level coded from information in postacute rehabilitation reports, at an average of approximately 6 years after injury. Results: Inter-rater reliability coefficients for FIL ratings extracted from rehabilitation records, and between retrospective and in vivo assessments were highly significant. DRS scores at discharge from primary rehabilitation predicted a significant amount of variance in FIL scores at an average of 5 years after injury, and DRS scores remained a stable and significant predictor of FIL scores as the time period between discharge from rehabilitation and outcome ratings increased to 10 years after injury. FIL ratings were significantly lower for individuals living in residential facilities than those living with their families, as compared to living alone. Conclusions: The FIL is a reliable and useful tool for retrospective and prospective assessments of rehabilitation outcome. Gains made during primary rehabilitation by people with severe traumatic brain injury are generally maintained at long-term follow up. Retrospective ratings using the DRS and FIL can help guide postacute rehabilitation planning within state or regional head injury programs.

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“…The GOS-E 2 is an expanded version of the GOS that subdivides good recovery, moderate disability, and severe disability into upper and lower levels for a total of eight categories. The Disability Rating Scale (DRS) is a frequently used, well-validated rating scale of disability following TBI measuring a patient's level of function from coma to community reentry [12][13][14][15][16] that has demonstrated predictive validity.…”

Section: Methodsmentioning

confidence: 99%

Neurological Outcome Scale for Traumatic Brain Injury: III. Criterion-Related Validity and Sensitivity to Change in the NABIS Hypothermia-II Clinical Trial

McCauley

Wilde

Moretti

et al. 2013

Journal of Neurotrauma

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The Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI) is a measure assessing neurological functioning in patients with TBI. We hypothesized that the NOS-TBI would exhibit adequate concurrent and predictive validity and demonstrate more sensitivity to change, compared with other well-established outcome measures. We analyzed data from the National Acute Brain Injury Study: Hypothermia-II clinical trial. Participants were 16-45 years of age with severe TBI assessed at 1, 3, 6, and 12 months postinjury. For analysis of criterion-related validity (concurrent and predictive), Spearman's rank-order correlations were calculated between the NOS-TBI and the Glasgow Outcome Scale (GOS), GOSExtended (GOS-E), Disability Rating Scale (DRS), and Neurobehavioral Rating Scale-Revised (NRS-R). Concurrent validity was demonstrated through significant correlations between the NOS-TBI and GOS, GOS-E, DRS, and NRS-R measured contemporaneously at 3, 6, and 12 months postinjury (all p < 0.0013). For prediction analyses, the multiplicityadjusted p value using the false discovery rate was < 0.015. The 1-month NOS-TBI score was a significant predictor of outcome in the GOS, GOS-E, and DRS at 3 and 6 months postinjury (all p < 0.015). The 3-month NOS-TBI significantly predicted GOS, GOS-E, DRS, and NRS-R outcomes at 6 and 12 months postinjury (all p < 0.0015). Sensitivity to change was analyzed using Wilcoxon's signed rank-sum test of subsamples demonstrating no change in the GOS or GOS-E between 3 and 6 months. The NOS-TBI demonstrated higher sensitivity to change, compared with the GOS ( p < 0.038) and GOS-E ( p < 0.016). In summary, the NOS-TBI demonstrated adequate concurrent and predictive validity as well as sensitivity to change, compared with gold-standard outcome measures. The NOS-TBI may enhance prediction of outcome in clinical practice and measurement of outcome in TBI research.

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Assessing traumatic brain injury outcome measures for long-term follow-up of community-based individuals

Cited by 170 publications

References 39 publications

The Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI): II. Reliability and Convergent Validity

The Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI): II. Reliability and Convergent Validity

Retrospective Assessment of Rehabilitation Outcome After Traumatic Brain Injury

Neurological Outcome Scale for Traumatic Brain Injury: III. Criterion-Related Validity and Sensitivity to Change in the NABIS Hypothermia-II Clinical Trial

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