Validating Multi-Dimensional Outcome Assessment Using the Traumatic Brain Injury Common Data Elements: An Analysis of the TRACK-TBI Pilot Study Sample

Lindsay D. Nelson, Jana Ranson, Adam R. Ferguson, Joseph Giacino, David O. Okonkwo, Alex B. Valadka, Geoffrey T. Manley, Michael A. McCrea

Research output: Contribution to journalArticlepeer-review

35 Scopus citations

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 functional 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 multi-dimensional 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 three emergency departments with a TBI of any severity enrolled in TRACK-TBI prospectively after injury; outcome measures were collected at 3 and 6 months post-injury. 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 (mean [M] Spearman's rho = 0.21 and 0.49 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 multi-dimensional nature of TBI recovery and the limitations of applying only a single outcome measure.

Original languageEnglish (US)
Pages (from-to)3158-3172
Number of pages15
JournalJournal of neurotrauma
Volume34
Issue number22
DOIs
StatePublished - Nov 15 2017
Externally publishedYes

Keywords

  • common data elements
  • Glasgow Outcome Scale
  • neuropsychological
  • outcome assessment
  • traumatic brain injury

ASJC Scopus subject areas

  • Clinical Neurology

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