Faculty Collaboration Database

Validity of the Brief Test of Adult Cognition by Telephone in Level 1 Trauma Center Patients Six Months Post-Traumatic Brain Injury: A TRACK-TBI Study. J Neurotrauma 2021 Apr 15;38(8):1048-1059

Date

10/28/2020

Pubmed ID

33107388

Pubmed Central ID

PMC8054514

DOI

10.1089/neu.2020.7295

Scopus ID

2-s2.0-85103941227 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

Our objective was to examine the construct validity of the Brief Test of Adult Cognition by Telephone (BTACT) and its relationship to traumatic brain injury (TBI) of differing severities. Data were analyzed on 1422 patients with TBI and 170 orthopedic trauma controls (OTC) from the multi-center Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study. Participants were assessed at 6 months post-injury with the BTACT and an in-person neuropsychological battery. We examined the BTACT's factor structure, factorial group invariance, convergent and discriminant validity, and relationship to TBI and TBI severity. Confirmatory factor analysis supported both a 1-factor model and a 2-factor model comprising correlated Episodic Memory and Executive Function (EF) factors. Both models demonstrated strict invariance across TBI severity and OTC groups. Correlations between BTACT and criterion measures suggested that the BTACT memory indices predominantly reflect verbal episodic memory, whereas the BTACT EF factor correlated with a diverse range of cognitive tests. Although the EF factor and other BTACT indices showed significant relationships with TBI and TBI severity, some group effect sizes were larger for more comprehensive in-person cognitive tests than the BTACT. The BTACT is a promising, brief, phone-based cognitive screening tool for patients with TBI. Although the BTACT's memory items appear to index verbal Episodic Memory, items that purport to assess EFs may reflect a broader array of cognitive domains. The sensitivity of the BTACT to TBI severity is lower than domain-specific neuropsychological measures, suggesting it should not be used as a substitute for comprehensive, in-person cognitive testing at 6 months post-TBI.

Author List

Nelson LD, Barber JK, Temkin NR, Dams-O'Connor K, Dikmen S, Giacino JT, Kramer MD, Levin HS, McCrea MA, Whyte J, Bodien YG, Yue JK, Manley GT, British Neurosurgical Trainee Research Collaborative (BNTRC)

Authors

Michael McCrea PhD Professor in the Neurosurgery department at Medical College of Wisconsin
Lindsay D. Nelson PhD Associate Professor in the Neurosurgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adult
Brain Injuries, Traumatic
Cognition
Cognition Disorders
Female
Follow-Up Studies
Humans
Male
Mental Recall
Middle Aged
Neuropsychological Tests
Prospective Studies
Reproducibility of Results
Telephone
Time Factors
Trauma Centers