Measuring long-term outcome after traumatic brain injury.

We report the results of the first stage of development of an instrument to measure long-term functional outcome after traumatic brain injury. The instrument focuses on both the person with a disability and the impact on the family caregiver. We illustrate the early stages of instrument development, focusing on one approach to standardized reviewer feedback to evaluate content validity. The results of the pilot testing are discussed in terms of: purpose, instrument construction, and clinical utility. While the complete details of the instrument are not presented, example items are used as illustration. A number of methodological issues in instrument development in rehabilitation are described including the logistics of reviewer feedback, the use of family caregivers in instrument development and the reliability of self-report in brain-injured population.