The psychometric validation of the Dutch version of the Rivermead Post-Concussion Symptoms Questionnaire (RPQ) after Traumatic Brain Injury (TBI)

Abstract

23Background 24 Traumatic brain injury (TBI) is one of the most common neurological conditions. It can have wide-25 ranging physical, cognitive and psychosocial effects. Most people recover within weeks to months after 26 the injury, but a substantial proportion are at risk of developing lasting post-concussion symptoms. 27The Rivermead Post-Concussion Syndrome Questionnaire (RPQ) is a short validated 16-items self-28 report instrument to evaluate post-concussive symptoms. The aim of this study was to test 29 psychometrics characteristics of the current Dutch translation of the RPQ. 30 Methods 31 To determine the psychometric characteristics of the Dutch RPQ, 472 consecutive patients six months 32 after they presented with a traumatic brain injury in seven medical centers in the Netherlands (N=397), 33 and in two in Belgium (Flanders) (N=75) took part in the study which is part of the large prospective 34 longitudinal observational CENTER-TBI-EU-study. Psychometric properties at six months post TBI, were 35 assessed using exploratory and confirmatory factor analyses. Sensitivity was analyzed by comparing 36 RPQ scores of patients after mild vs. moderate and severe TBI. 37 Findings 38 The Dutch version of RPQ proved good, showing excellent psychometric characteristics: high internal 39 consistency (Cronbach's α .93), and good construct validity, being sensitive to self-reported recovery 40 status at six months post TBI. Moreover, data showed a good fit to the three dimensions structure of 41 separate cognitive, emotional and somatic factors (Chi 2 =119; df=117; p=.4; CFI=.99; RMSEA=.006), 42 reported earlier in the literature.43 Discussion 44 Psychometric characteristics of the Dutch version of RPQ proved excellent to good, and can the 45 instrument therefore be applied for research purposes and in daily clinical practice.47

A randomized trial comparing prescribed light exercise to standard management for emergency department patients with acute mild traumatic brain injury

“…The RPQ collected at baseline provided information about acute symptom severity during the index ED visit. The RPQ was chosen for measurement of the primary outcome because of its good test–retest reliability, its external validity, being sensitive to self‐reported recovery status 6 months post–head injury, and its extensive use in studies assessing patients with PCS 27‐29 . Secondary outcomes included change in RPQ from baseline to 7, 14, and 30 days after the initial ED visit; number of missed days of school or work; and repeat visits to a health care provider.…”

“…The RPQ was chosen for measurement of the primary outcome because of its good test-retest reliability, its external validity, being sensitive to self-reported recovery status 6 months post-head injury, and its extensive use in studies assessing patients with PCS. [27][28][29] Secondary outcomes included change in RPQ from baseline to 7, 14, and 30 days after the initial ED visit; number of missed days of school or work; and repeat visits to a health care provider. To assess compliance with ED discharge instructions, participants were asked about their physical activity following ED discharge.…”

“…33 However, the RPQ was chosen because of its consistency, good construct validity, and being sensitive to self-reported recovery status 6 months post-head injury and has its wide use studies assessing patients with PCS. [27][28][29]…”

“…Including more objective measures such as balance and cognitive testing may have resulted in different findings, as prior studies evaluating both objective and subjective measures have shown increased symptom perception when functional outcomes were equivalent 33 . However, the RPQ was chosen because of its consistency, good construct validity, and being sensitive to self‐reported recovery status 6 months post–head injury and has its wide use studies assessing patients with PCS 27‐29 …”

Prediction of Global Functional Outcome and Post-Concussive Symptoms after Mild Traumatic Brain Injury: External Validation of Prognostic Models in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) Study

“…Psychometric properties of the instruments have been investigated using criteria of the classical test and item response theory (other publications in preparation). [30][31][32]…”