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17. Assessment of Outcomes Following Acquired Brain Injury

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17. Assessment of Outcomes Following Acquired Brain Injury 17. Assessment of Outcomes Following Acquired Brain Injury Katherine Salter BA Robert Teasell MD Amanda McIntyre MSc Denise Johnson PT Jeff Jutai PhD erabi.ca Version 12.0 Table of Contents 17.0 Introduction .................................................................................................................................... 1 17.1 Agitated Behavior Scale .................................................................................................................. 4 17.2 Berg Balance Scale .......................................................................................................................... 5 17.3 Community Balance and Mobility Scale .......................................................................................... 8 17.4 Community Integration Questionnaire ........................................................................................... 9 17.5 Disability Rating Scale ................................................................................................................... 14 17.6 Fatigue Severity Scale ................................................................................................................... 17 17.7 Functional Independence Measure ............................................................................................... 19 17.8 Functional Assessment Measure ................................................................................................... 22 17.9 Galveston Orientation and Amnesia Test ...................................................................................... 25 17.10 Glasgow Coma Scale ................................................................................................................... 27 17.11 Glasgow Outcome Scale/Extended Glasgow Coma Scale ............................................................ 30 17.12 Hospital Anxiety and Depression Scale ....................................................................................... 34 17.13 Mayo-Portland Adaptability Inventory ....................................................................................... 36 17.14 Medical Outcomes Study Short Form 36 ..................................................................................... 40 17.15 Mini Mental Status Examination ................................................................................................. 46 17.16 Neurobehavioral Functioning Inventory ..................................................................................... 49 17.17 Rancho Los Amigos Levels of Cognitive Functioning Scale........................................................... 52 17.18 Satisfaction with Life Scale (SWLS) .............................................................................................. 53 17.19 Quality of Life after Traumatic Brain Injury ................................................................................. 56 This review has been prepared based on the scientific and professional information available up to December 2018. The ERABI information is provided for informational and educational purposes only. If you have or suspect you have a health problem, you should consult your health care provider. The ERABI contributors shall not be liable for any damages, claims, liabilities, costs, or obligations arising from the use or misuse of this material. Salter K, Teasell R, McIntyre A, Johnson D, Jutai J. (2017). Assessment of Outcomes Following Acquired Brain Injury. In Teasell R, Cullen N, Marshall S, Janzen S, Bayley M, editors. Evidence-Based Review of Moderate to Severe Acquired Brain Injury. Version 11.0: p1-75. erabi.ca Version 12.0 Abbreviations ABI Acquired Brain Injury ABS Agitated Behavior Scale BBS Berg Balance Scale CBMS Community Balance and Mobility Scale CIQ Community Integration Questionnaire DRS Disability Rating Scale FAM Functional Assessment Measure FIM Functional Independence Measure FSS Fatigue Severity Scale GCS Glasgow Coma Scale GOS Glasgow Outcome Scale GOSE Glasgow Outcome Scale–Extended GOAT Galveston Orientation and Amnesia Test HADS Hospital Anxiety and Depression Scale LCFS Rancho Los Amigos Levels of Cognitive Functioning Scale MMSE Mini Mental State Examination MPAI Mayo Portland Adaptability Inventory NFI Neurobehavioural Functioning Inventory QOLIBRI Quality of Life After Brain Injury SWLS Satisfaction With Life Scale TBI Traumatic Brain Injury erabi.ca i Version 12.0 Assessment of Outcomes Following Acquired Brain Injury 17.0 Introduction The following chapter is a review of measurement tools used to assess individuals after a brain injury. The list of tools appearing here was derived by a consensus of experts working on the Evidence-Based Review of Acquired Brain Injury (ABI) literature. The tools were chosen based on a 3-step process. The first was the development of an inventory of current outcome measures based on both the literature and discussions held with rehabilitation team members who actually use the tools. The second was a consensus agreement among a panel of experts as to which tools are most important. Finally, there had to be sufficient research on the outcome measure in ABI populations to allow a meaningful analysis of the psychometric qualities of the tools. Those outcome measures that made it through this process were selected for review. An exhaustive list of outcome tools is not listed here as there are over 700 measures related to function following Traumatic Brain Injury (TBI) (Tate et al., 2013). Table 17.1 Selected Tools for Assessment of Outcome in ABI Tool Agitated Behavior Scale Berg Balance Scale Community Balance and Mobility Scale Community Integration Questionnaire Disability Rating Scale Fatigue Severity Scale Functional Independence Measure Functional Assessment Measure Galveston Orientation and Amnesia Test Glasgow Coma Scale Glasgow Outcome Scale Hamilton Anxiety and Depression Scale Mayo-Portland Adaptability Inventory Medical Outcomes Study SF-36 Mini Mental State Evaluation Neurobehavioural Functioning Inventory Rancho Los Amigos Level of Cognitive Functioning Scale Satisfaction with Life Scale Quality of Life after TBI Evaluation Criteria for Outcome Measures It is necessary to have a set of criteria to guide the selection of outcomes measures. Reliability, validity and responsiveness have widespread use and are discussed as being essential to the evaluation of outcome measures (Duncan et al., 2002; Law, 2002; Roberts & Counsell, 1998; van der Putten et al., 1999). Finch et al. (2002) provide a good tutorial on issues for outcome measure selection. The Health Technology Assessment programme (Fitzpatrick et al., 1998) examined 413 articles focusing on methodological aspects of the use and development of patient-based outcome measures. In their report, they recommend the use of eight evaluation criteria (Table 17.2). These criteria, including some additional considerations described below, were applied to each of the outcome measures reviewed in this chapter. Outcome Measures 1 Table 17.2-Evaluation Criteria and Standards Criterion Definition Standard 1. Appropriateness The match of the instrument to the Depends upon the specific purpose for which the purpose/question under study. One must measurement is intended. determine what information is required and what use will be made of the information gathered (Wade 1992) 2. Reliability Refers to the reproducibility and internal Test-retest or interobserver reliability (ICC; kappa consistency of the instrument. statistics; (Andresen & Meyers, 2000) (Hsueh et al., Reproducibility addresses the degree 2001) (Wolfe et al., 1991). to which the score is free from Excellent:0.75; random error. Test re-test & inter- Adequate: 0.4-0.74; observer reliability both focus on this Poor:0.40 aspect of reliability and are commonly Note: Fitzpatrick et al. (1998) recommend a evaluated using correlation statistics minimum test-retest reliability of 0.90 if the including Intra-Class Correlation measure is to be used to evaluate the ongoing Coefficient (ICC), Pearson’s or progress of an individual in a treatment situation. Spearman’s coefficients and kappa Internal consistency (split-half or Cronbach’s coefficients (weighted or unweighted). statistics; (Andresen & Meyers, 2000): Internal consistency assesses the Excellent:0.80; homogeneity of the scale items. It is Adequate: 0.70-0.79; generally examined using split-half Poor<0.70 reliability or Cronbach’s alpha Note: Fitzpatrick et al. (1998) caution that values statistics. Item-to-item and item-to in excess of 0.90 may indicate redundancy. scale correlations are also accepted Adequate levels of Inter-item & item-to-scale methods. correlation coefficients (Hobart et al., 2001); (Fitzpatrick et al., 1998): inter-item: between 0.3 and 0.9; item-to-scale: between 0.2 and 0.9 3. Validity Does the instrument measure what it Construct/convergent and concurrent correlations purports to measure? Forms of validity (Andresen & Meyers, 2000); (McDowell & Newell, include face, content, construct, and 1996); (Fitzpatrick et al., 1998); (Cohen et al.): criterion. Concurrent, convergent or Excellent:0.60, Adequate: 0.31-0.59, discriminative, and predictive validity are all Poor:0.30 considered to be forms of criterion validity. ROC analysis-AUC (McDowell & Newell, 1996): However, concurrent, convergent and Excellent:0.90, Adequate: 0.70-0.89, discriminative validity all depend on the Poor:<0.70 existence of a “gold standard” to provide a There are no agreed on standards by which to basis for
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