Tyner Callie E, Kisala Pamela A, Boulton Aaron J, Sherer Mark, Chiaravalloti Nancy D, Sander Angelle M, Bushnik Tamara, Tulsky David S
Center for Health Assessment Research and Translation, University of Delaware, Newark, DE, United States.
TIRR Memorial Hermann Research Center, Houston, TX, United States.
Front Hum Neurosci. 2022 Mar 4;16:763311. doi: 10.3389/fnhum.2022.763311. eCollection 2022.
Patient report of functioning is one component of the neurocognitive exam following traumatic brain injury, and standardized patient-reported outcomes measures are useful to track outcomes during rehabilitation. The Traumatic Brain Injury Quality of Life measurement system (TBI-QOL) is a TBI-specific extension of the PROMIS and Neuro-QoL measurement systems that includes 20 item banks across physical, emotional, social, and cognitive domains. Previous research has evaluated the responsiveness of the TBI-QOL measures in community-dwelling individuals and found clinically important change over a 6-month assessment interval in a sample of individuals who were on average 5 years post-injury. In the present study, we report on the responsiveness of the TBI-QOL Cognition-General Concerns and Executive Function item bank scores and the Cognitive Health Composite scores in a recently injured sample over a 1-year study period. Data from 128 participants with complicated mild, moderate, or severe TBI within the previous 6 months were evaluated. The majority of the sample was male, white, and non-Hispanic. The participants were 18-92 years of age and were first evaluated from 0 to 5 months post-injury. Eighty participants completed the 1-year follow-up assessment. Results show acceptable standard response mean values (0.47-0.51) for all measures and minimal detectable change values ranging from 8.2 to 8.8 T-score points for Cognition-General Concerns and Executive Functioning measures. Anchor rating analysis revealed that changes in scores on the Executive Function item bank and the Cognitive Health Composite were meaningfully associated with participant-reported changes in the areas of attention, multitasking, and memory. Evaluation of change score differences by a variety of clinical indicators demonstrated a small but significant difference in the three TBI-QOL change scores by TBI injury severity grouping. These results support the responsiveness of the TBI-QOL cognition measures in newly injured individuals and provides information on the minimal important differences for the TBI-QOL cognition measures, which can be used for score interpretation by clinicians and researchers seeking patient-reported outcome measures of self-reported cognitive QOL after TBI.
患者功能报告是创伤性脑损伤后神经认知检查的一个组成部分，标准化的患者报告结局测量对于跟踪康复期间的结局很有用。创伤性脑损伤生活质量测量系统（TBI-QOL）是PROMIS和Neuro-QoL测量系统中针对TBI的特定扩展，包括身体、情感、社会和认知领域的20个条目库。先前的研究评估了TBI-QOL测量在社区居住个体中的反应性，并发现平均受伤后5年的个体样本在6个月的评估间隔内有临床重要变化。在本研究中，我们报告了TBI-QOL认知-一般问题和执行功能条目库得分以及认知健康综合得分在最近受伤的样本中1年研究期间的反应性。对128名在过去6个月内患有复杂轻度、中度或重度TBI的参与者的数据进行了评估。样本中的大多数是男性、白人且非西班牙裔。参与者年龄在18-92岁之间，受伤后0至5个月首次接受评估。80名参与者完成了1年的随访评估。结果显示所有测量的标准反应均值（0.47-0.51）可接受，认知-一般问题和执行功能测量的最小可检测变化值范围为8.2至8.8 T分。锚定评级分析表明，执行功能条目库和认知健康综合得分的变化与参与者报告的注意力、多任务处理和记忆领域的变化有显著关联。通过各种临床指标对变化得分差异的评估表明，TBI-QOL三个变化得分在TBI损伤严重程度分组上存在微小但显著的差异。这些结果支持TBI-QOL认知测量在新受伤个体中的反应性，并提供了TBI-QOL认知测量的最小重要差异信息，可用于临床医生和研究人员对TBI后自我报告的认知生活质量的患者报告结局测量进行得分解释。
