Reliability and validity of the disability rating scale and the levels of cognitive functioning scale in monitoring recovery from severe head injury

1987 ◽  
Vol 2 (4) ◽  
pp. 91 ◽  
Author(s):  
WD Gouvier ◽  
PD Blanton ◽  
KK LaPorte
2001 ◽  
Vol 7 (4) ◽  
pp. 457-467 ◽  
Author(s):  
STEPHEN R. McCAULEY ◽  
H. JULIA HANNAY ◽  
PAUL R. SWANK

Rapid rate of recovery has been associated with better outcome following closed-head injuries, but few studies have compellingly demonstrated this. This study used growth curve analyses of Disability Rating Scale (DRS) scores at acute hospitalization discharge, 1, 3, and 6 months post injury in a sample of 55 patients with a closed-head injury. Six month post-injury outcome measures were taken from significant other (SO) responses on the NYU Head Injury Family Interview (NYU-HIFI) including severity and burden ratings of affective/neurobehavioral disturbance, cognitive deficits, and physical/dependency status. Rate of recovery (linear and curvilinear recovery curve components) was significantly related to the level of affective/neurobehavioral severity, and the severity and burden of SO-perceived cognitive deficits. Only the intercept of the DRS recovery curve was associated with the SO-perceived severity and burden of physical/dependency status. Growth curve modeling is a meaningful and powerful tool in predicting head injury outcome. (JINS, 2001, 7, 457–467.)


2004 ◽  
Vol 10 (6) ◽  
pp. 807-817 ◽  
Author(s):  
NICHOLAS J. PASTOREK ◽  
H. JULIA HANNAY ◽  
CHARLES S. CONTANT

Delaying assessment until emergence from post-traumatic amnesia increases completion rates, but this practice causes variable time delays from the date of injury to testing, which can complicate the interpretation of research findings. In the current study, the performance of 105 head injury survivors on simple tests of language comprehension and attention was used to predict global outcome. It was hypothesized that 1 month performance on these measures would aid in the prediction of Disability Rating Scale (DRS) and Glasgow Outcome Scale (GOS) scores collected at 6 months post injury. Only raw scores on the modified Test of Complex Ideational Material accounted for a significant amount of the variance in DRS scores (4.4%) above that accounted for by age, education, Glasgow Coma Scale score, and pupil response. However, testability at 1 month post injury on all four tests consistently accounted for a larger portion of the variance in DRS scores (10.1–13.2%) and significantly improved prediction of GOS scores. Galveston Orientation and Amnesia Test scores collected at 1 month post injury accounted for substantially less variance in DRS scores (7.7–8.4%). Neuropsychological data, including the testability of patients, collected uniformly at 1 month following injury can contribute to the prediction of global outcome. (JINS, 2004, 10, 807–817.)


2015 ◽  
Vol 20 (5) ◽  
pp. 1341-1352 ◽  
Author(s):  
Helena Maria Silveira Fraga-Maia ◽  
Guilherme Werneck ◽  
Inês Dourado ◽  
Rita de Cássia Pereira Fernandes ◽  
Luciara Leite Brito

Objective: To translate, adapt, and validate the "Community Integration Questionnaire (CIQ)," a tool that evaluates community integration after traumatic brain injury (TBI).Methods: A study of 61 TBI survivors was carried out. The appraisal of the measurement equivalence was based on a reliability assessment by estimating inter-rater agreement, item-scale correlation and internal consistency of CIQ scales, concurrent validity, and construct validity.Results: Inter-rater agreement ranged from substantial to almost perfect. The item-scale correlations were generally higher between the items and their respective domains, whereas the intra-class correlation coefficients were high for both the overall scale and the CIQ domains. The correlation between the CIQ and Disability Rating Scale (DRS), the Extended Glasgow Outcome Scale (GOSE), and the Rancho Los Amigos Level of Cognitive Functioning Scale (RLA) reached values considered satisfactory. However, the factor analysis generated four factors (dimensions) that did not correspond with the dimensional structure of the original tool.Conclusion: The resulting tool herein may be useful in globally assessing community integration after TBI in the Brazilian context, at least until new CIQ psychometric assessment studies are developed with larger samples.


1998 ◽  
Vol 89 (6) ◽  
pp. 939-943 ◽  
Author(s):  
Laura E. L. Pettigrew ◽  
J. T. Lindsay Wilson ◽  
Graham M. Teasdale

Object. The Glasgow Outcome Scale (GOS) is widely used to assess outcome after head injury, but is recognized as having a number of shortcomings that are highlighted and investigated in this study. The authors pursued two goals: 1) investigating the practicality of using a standard set of questions as part of a structured interview to assign GOS scores, and 2) studying the role of preinjury problems in confounding postinjury assessment of disability. Methods. Several of the major limitations of the GOS appear to arise from the use of a format that encourages impressionistic ratings. In the present study the authors examined the use of a standard interview for assessing the GOS covering five areas of social disability. Ratings were made for 80 head-injured patients. The results show that the rating based on the GOS provides an assessment of disability that is more complete than that given by an alternative scale of functional disability (Disability Rating Scale [DRS]) and much more complete than an assessment of physical disability (Barthel Activities of Daily Living [ADL] index). A measure of preinjury dependency was made revealing that, within this sample, 20% of patients required supervision in basic ADL before their injury. Conclusions. Assignment of GOS scores based on information obtained using a structured interview format provides a more comprehensive assessment of disability than using the DRS or the ADL index. There is a need to standardize attitudes about preinjury dependency in assessing disability after head injury.


Author(s):  
S. Gauthier ◽  
R. Bouchard ◽  
Y. Bacher ◽  
P. Bailey ◽  
H. Bergman ◽  
...  

ABSTRACT:Since the discovery of a significant depletion of acetylcholine in discrete areas of the brain of patients affected by Alzheimer's disease, attempts at symptomatic therapy have concentrated on acetylcholine supplementation, an approach that is based upon the efficacy of dopaminergic supplementation therapy for Parkinson's disease. Choline, then lecithin, used orally, failed to improve symptoms but the hypothesis that long-term choline supplementation might stabilize the course of Alzheimer's disease remains to be tested. Nerve growth factor may also offer that possibility. Bethanechol administered intracerebroventricularly did not help when a fixed dose was used but individual titration of more selective muscarinic agonists may prove more effective. In this article we report that tetrahydroaminoacridine (THA), given together with highly concentrated lecithin, appears to bring improvement in cognition and in functional autonomy using the Mini Mental State and the Rapid Disability Rating Scale-2 respectively, without change in behavior as reflected by the Behave-AD. Double-blind cross-over studies are in progress to establish its efficacy. Improvement in study design and means of assessment of cognition, functional autonomy and behavior have been made possible by these drug trials.


2019 ◽  
Vol 25 (3) ◽  
pp. 293-301 ◽  
Author(s):  
Julia S. Benoit ◽  
H. Julia Hannay ◽  
Jose-Miguel Yamal ◽  
David J. Francis ◽  
Imoigele Aisiku ◽  
...  

AbstractObjectives:Long-term neurological response to treatment after a severe traumatic brain injury (sTBI) is a dynamic process. Failure to capture individual heterogeneity in recovery may impact findings from single endpoint sTBI randomized controlled trials (RCT). The present study re-examined the efficacy of erythropoietin (Epo) and transfusion thresholds through longitudinal modeling of sTBI recovery as measured by the Disability Rating Scale (DRS). This study complements the report of primary outcomes in the Epo sTBI RCT, which failed to detect significant effects of acute treatment at 6 months post-injury.Methods:We implemented mixed effects models to characterize the recovery time-course and to examine treatment efficacy as a function of time post-injury and injury severity.Results:The inter-quartile range (25th–75thpercentile) of DRS scores was 20–28 at week1; 8–24 at week 4; and 3–17 at 6 months. TBI severity group was found to significantly interact with Epo randomization group on mean DRS recovery curves. No significant differences in DRS recovery were found in transfusion threshold groups.Conclusions:This study demonstrated the value of taking a comprehensive view of recovery from sTBI in the Epo RCT as a temporally dynamic process that is shaped by both treatment and injury severity, and highlights the importance of the timing of primary outcome measurement. Effects of Epo treatment varied as a function of injury severity and time. Future studies are warranted to understand the possible moderating influence of injury severity on treatment effects pertaining to sTBI recovery. (JINS, 2019,25, 293–301)


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