Faculty Collaboration Database

Functional Status Examination Yields Higher Measurement Precision than the Glasgow Outcome Scale-Extended after Moderate-to-Severe Traumatic Brain Injury. J Neurotrauma 2021 Dec;38(23):3288-3294

Date

06/12/2021

Pubmed ID

34114492

Pubmed Central ID

PMC8820283

DOI

10.1089/neu.2021.0152

Scopus ID

2-s2.0-85120884358 (requires institutional sign-in at Scopus site)   2 Citations

Abstract

A limited evidence base supports the Functional Status Examination (FSE) as superior to the more commonly used Glasgow Outcome Scale-Extended (GOSE) for precisely characterizing injury-related functional limitations. The aim of this study was to use modern psychometric tools to test the hypothesis that the FSE is more precise than the GOSE in characterizing individual differences in functional limitations after moderate-to-severe traumatic brain injury (TBI). Secondarily, we sought to confirm that the type of interviewee (patient, significant other) does not affect the test performance of the FSE. Using data from 357 individuals with TBI who participated in the Magnesium Sulfate clinical trial and had six-month outcome data, we performed item response theory (IRT) analyses comparing the FSE and GOSE at six months post-injury. Results showed that the FSE yielded higher measurement precision (IRT test information) than the GOSE across most of the disability severity spectrum. The GOSE yielded more information than the FSE at a very high level of disability, because of the GOSE's assignment of a unique score for individuals who are in a vegetative state. Finally, the FSE showed no evidence of differential item functioning by interviewee, indicating it is appropriate to interview either persons with TBI or significant others and combine data across respondents as is typically done. The findings support the FSE as a viable and oftentimes advantageous substitute for the GOSE in clinical trials and translational studies of TBI.

Author List

Nelson LD, Magnus BE, Temkin NR, Dikmen S, Balsis S

Author

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
Clinical Trials as Topic
Female
Follow-Up Studies
Glasgow Outcome Scale
Humans
Male
Middle Aged
Psychometrics
Severity of Illness Index
Young Adult