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J Neurotrauma. 2017 Jun 8. doi: 10.1089/neu.2017.5139. [Epub ahead of print]

Validating Multidimensional Outcome Assessment Using the TBI Common Data Elements: An Analysis of the TRACK-TBI Pilot Sample.

Author information

1
Medical College of Wisconsin, Neurosurgery , 8701 West Watertown Plank Road , Milwaukee, Wisconsin, United States , 53226 ; linelson@mcw.edu.
2
Medical College of Wisconsin, Neurosurgery , 8701 Watertown Plank Road , Milwaukee, Wisconsin, United States , 53226 ; jranson@mcw.edu.
3
UCSF, Brain and Spinal Injury Center, Dept Neurosurgery , 1001 Potrero Ave , 1001 Potrero Ave , San Francisco, California, United States , 94110 ; adam.ferguson@ucsf.edu.
4
Boston, United States ; jgiacino@mgh.harvard.edu.
5
University of Pittsburgh Medical Center, Neurosurgery , 200 Lothrop Street , Suite B-400 , Pittsburgh, Pennsylvania, United States , 15213 ; okonkwodo@upmc.edu.
6
Virginia Commonwealth University , Department of Neurosurgery , 417 North 11th Street, Sixth Floor , P.O. Box 980631 , Richmond, Virginia, United States , 23298-0631 ; avaladka@gmail.com.
7
University of California, San Francisco, Neurosurgery, San Francisco, California, United States ; manleyg@ucsf.edu.
8
Medical College of Wisconsin, Neurosurgery, Milwaukee, Wisconsin, United States ; mmccrea@mcw.edu.

Abstract

The Glasgow Outcome Scale-Extended (GOSE) is often the primary outcome measure in clinical trials for traumatic brain injury (TBI). Although the GOSE's capture of global function outcome has several strengths, concerns have been raised about its limited ability to identify mild disability and failure to capture the full scope of problems patients exhibit after TBI. This analysis examined the convergence of disability ratings across a multidimensional set of outcome domains in the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Pilot study. The study collected measures recommended by the TBI Common Data Elements (CDE) Workgroup. Patients presenting to 3 emergency departments with a TBI of any severity enrolled in TRACK-TBI prospectively after injury; outcome measures were collected at 3 and six months postinjury. Analyses examined frequency of impairment and overlap between impairment status across the CDE outcome domains of Global Level of Functioning (GOSE), Neuropsychological (cognitive) Impairment, Psychological Status, TBI Symptoms, and Quality of Life. GOSE score correlated in the expected direction with other outcomes (M Spearman's rho = .21 and .49 with neurocognitive and self-report outcomes, respectively). The subsample in the Upper Good Recovery (GOSE 8) category appeared quite healthy across most other outcomes, although 19.0% had impaired executive functioning (Trail Making Test Part B). A significant minority of participants in the Lower Good Recovery subgroup (GOSE 7) met criteria for impairment across numerous other outcome measures. The findings highlight the multidimensional nature of TBI recovery and the limitations of applying only a single outcome measure.

KEYWORDS:

ADULT BRAIN INJURY; ASSESSMENT TOOLS; BEHAVIORAL ASSESSMENTS; COGNITIVE FUNCTION; PROSPECTIVE STUDY

PMID:
28595478
PMCID:
PMC5678361
[Available on 2018-11-15]
DOI:
10.1089/neu.2017.5139

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