Defense and Veterans Brain Injury Center, Neurology Service, Brooke Army Medical Center, 3551 Roger Brooke Dr, JBSA Ft Sam Houston, TX 78234.
General Dynamics Information Technology, San Antonio, TX 78234.
Mil Med. 2020 Feb 13;185(1-2):e43-e46. doi: 10.1093/milmed/usz173.
Headaches are the most common complaint after traumatic brain injury (TBI) and a significant cause of morbidity and disability among military personnel. Currently, there are a several measures which can assess headache disability, but there is a significant burden to assess each individual symptom given this heterogeneous polymorbid population. The objective of this proposed study was to validate the single headache item from the Neurobehavioral Symptom Inventory (NSI) compared to the 6-item Headache Impact Test (HIT-6).
Participants included consecutive treatment-seeking outpatients at the Brain Injury Rehabilitation Service at the Brooke Army Medical Center from August 2007 to January 2010 who were administered a battery of assessment measures at initial intake, as part of usual care. Archival record review was conducted using procedures approved by the local Institutional Review Board. Inclusionary criteria included completion of both the HIT-6 and NSI. Participants with a cut-off score of >22 on the NSI Validity-10 were excluded in a post hoc analysis to validate findings among those who passed validity screen.
The Pearson correlation between the single-item NSI headache measure and the HIT-6 revealed at least 64% shared variance in this military sample (r = 0.8, p < 0.001), indication a high association between the two measures.
The NSI single-item headache measure adequately captured headache severity in this military cohort. Use of the single-item NSI headache measure may minimize survey burden on participants whose primary complaint is not headaches, or who present with multiple symptoms. Future studies are needed to validate the single-item headache measure in other samples.
头痛是创伤性脑损伤（TBI）后最常见的主诉，也是军人发病率和失能的重要原因。目前，有几种方法可以评估头痛残疾，但考虑到这一异质性的多疾病人群，评估每个个体症状的负担很大。本研究的目的是验证神经行为症状量表（NSI）中的单一头痛项目与 6 项头痛影响测试（HIT-6）的相关性。
参与者包括 2007 年 8 月至 2010 年 1 月在布鲁克陆军医疗中心脑损伤康复服务中心连续就诊的门诊患者，他们在初始摄入时接受了一系列评估措施，作为常规护理的一部分。档案记录审查是根据当地机构审查委员会批准的程序进行的。纳入标准包括完成 HIT-6 和 NSI。在事后分析中，排除了 NSI 效度 10 得分>22 的患者，以验证通过效度筛查的患者的结果。
在这个军事样本中，NSI 单一头痛测量值与 HIT-6 的 Pearson 相关系数显示至少有 64%的共同方差（r = 0.8，p < 0.001），表明这两种测量方法之间存在高度关联。
NSI 单一头痛测量值充分捕捉了这个军事队列的头痛严重程度。在参与者的主要主诉不是头痛，或表现出多种症状时，使用 NSI 单一头痛测量值可能会最小化调查负担。需要进一步的研究来验证其他样本中单一头痛测量值的有效性。
