Evaluation of outcome measures in a brain injured population

• Main Author: Cudmore, Sarah Frances
• Published: University of Edinburgh 1999
• Subjects: 616.8
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.648989

Relatively few studies have focused on outcome following traumatic brain injury (TBI) many years after injury. It was evident from the first study that the EHIEC would not be a practical and reliable tool to assess outcome at a later stage and therefore two alternative approaches were used - an interview study and a larger postal survey. The interview study (n=78) used a variety of disease specific and generic outcome measures [including the Glasgow Outcome Scale (GOS), Functional Assessment Measure (FIM+FAM), Community Integration Questionnaire (CIQ), Edinburgh Rehabilitation Status Scale (ERSS), Short Form 36 (SR-36) and Functional Limitations Profile (FLP)] whilst the postal survey (n=525) included the GOS, SF-36 and FLP. Although the SF-36 has been used with many other populations, results had not been reported for the traumatically brain injured. Few statistically significant results were found between the age and injury severity groups for the various outcome measures but this, in itself, is an interesting finding. The lack of differences between the severity groups may indicate that outcome tends to converge over time; that the Glasgow Coma Scale, which was used to determine severity of injury, is not a valuable predictor of outcome in the longer term; or that the measures used were not sufficiently sensitive for this setting. These studies have demonstrated that certain outcome measures (e.g. GOS, FIM+FAM, EHIEC) have serious limitations for longitudinal use. In contrast the CIQ, ERSS and SF-36 provide interesting material on aspects of outcome although were also found to have disadvantages such as missing data and substantial ceiling effects.