Faculty Bibliography
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116
Narrative review of clinical practice guidelines for treating people with moderate or severe traumatic brain injury
BACKGROUND:Practice guidelines (CPGs) provide informed treatment recommendations from systematic reviews and assessment of the benefits and harms that are intended to optimize patient care. Review of CPGs addressing rehabilitation for people with moderate/severe traumatic brain injury (TBI), has not been fully investigated. OBJECTIVE:Identify published, vetted, clinical practice guidelines that address rehabilitation for people with moderate/severe TBI. METHODS:Six data bases were accessed using key word search terms: "Traumatic Brain Injury" and "Clinical Practice Guidelines" and "Rehabilitation". Further inclusions included "adult" and "moderate or severe". Exclusions included: "mild" and "concussive injury". Three reviewers read abstracts and manuscripts for final inclusion. The AGREE II template was applied for additional appraisal. RESULTS:There were 767 articles retrieved using the search terms, 520 were eliminated because of content irrelevance; and 157 did not specify rehabilitation treatment or did not follow a process for CPGs. A total of 17 CPGs met all criteria and only 4 of these met all AGREE II criteria. CONCLUSION/CONCLUSIONS:There are few CPGs addressing rehabilitation for people with moderate/severe TBI. More interventional trials are needed to determine treatment effectiveness. Timely and methodologically sound vetting of studies are needed to ensure CPG reliability and facilitate access to quality, effective treatment for people with moderate/severe TBI.
PMID: 34057100
ISSN: 1878-6448
CID: 4910382
The effects of neuroplasticity-based auditory information processing remediation in adults with chronic traumatic brain injury
BACKGROUND:Adults with chronic traumatic brain injury (TBI) may experience long-term deficits in multiple cognitive domains. Higher-order functions, such as verbal memory, are impacted by deficits in the ability to acquire verbal information. OBJECTIVE:This study investigated the effects of a neuroplasticity-based computerized cognitive remediation program for auditory information processing in adults with a chronic TBI. METHODS:Forty-eight adults with TBI were randomly assigned to an intervention or control group. Both groups underwent a neuropsychological assessment at baseline and post-training. The Intervention group received 40 one-hour cognitive training sessions with the Brain Fitness Program. RESULTS:The intervention group improved in performance on measures of the Woodcock-Johnson-III Understanding Directions subtest and Trail Making Test Part-A. They also reported improvement on the cognitive domain of the Cognitive Self-Report Questionnaire. CONCLUSIONS:The present study demonstrated that a neuroplasticity-based computerized cognitive remediation program may improve objective and subjective cognitive function in adults with TBI several years post-injury.
PMID: 34420987
ISSN: 1878-6448
CID: 5026582
Journal of women's health (Larchmont, N.Y. : 2002). 2020:29(11):1427-1436.DOI: 10.1089/jwh.2019.8174
Reproductive Health in Women with Physical Disability: A Conceptual Framework for the Development of New Patient-Reported Outcome Measures
PMID: 32429740
ISSN: 1931-843x
CID: 4444232
Development and Calibration of the TBI-QOL Ability to Participate in Social Roles and Activities and TBI-QOL Satisfaction with Social Roles and Activities Item Banks and Short Forms
OBJECTIVE:To develop traumatic brain injury (TBI)-optimized versions of the Neuro-QoL Ability to Participate in Social Roles and Activities (SRA) and Satisfaction with Participation in SRA item banks; evaluate the psychometric properties of the item banks developed for adults with TBI; develop short form and computer adaptive test (CAT) versions; and report information to facilitate research and clinical applications. DESIGN/METHODS:We used a mixed-methods design to develop and evaluate Ability to Participate in SRA and Satisfaction with SRA items. Focus groups defined the constructs; cognitive interviews guided item revisions; and confirmatory factor analysis and item response theory methods helped calibrate item banks and evaluate differential item functioning related to demographic and injury characteristics. SETTING/METHODS:Five TBI Model Systems centers in the United States. PARTICIPANTS/METHODS:556 community-dwelling adults with TBI. INTERVENTIONS/METHODS:None. OUTCOME MEASURES/METHODS:Traumatic Brain Injury-Quality of Life (TBI-QOL) Ability to Participate in SRA and TBI-QOL Satisfaction with SRA item banks. RESULTS:Forty-five Ability to Participate in SRA and 41 Satisfaction with SRA items demonstrated good psychometric properties. Although some of the items are new, most were drawn from analogous banks in the Quality of Life in Neurological Disorders (Neuro-QoL) measurement system. Consequently, the two TBI-QOL item banks were linked to the Neuro-QoL metric and scores are comparable to the general population. All CAT and short forms correlated highly (> 0.90) with the full item banks and demonstrate comparable construct coverage and measurement error. CONCLUSION/CONCLUSIONS:The TBI-QOL Ability to Participate in SRA and TBI-QOL Satisfaction with SRA item banks are TBI-optimized versions of the Neuro-QoL Ability to Participate in SRA and Satisfaction with SRA item banks and demonstrate excellent measurement properties in individuals with TBI. These measures, particularly in CAT or short form format, are suitable for efficient and precise measurement of social outcomes in clinical and research applications.
PMID: 31473208
ISSN: 1532-821x
CID: 4066822
Measuring Pain in TBI: Development of the TBI-QOL Pain Interference Item Bank and Short Form
OBJECTIVE:To develop a pain interference item bank, computer adaptive test (CAT), and short form for use by individuals with traumatic brain injury (TBI). DESIGN/METHODS:Cross-sectional survey study. SETTING/METHODS:Five TBI Model Systems rehabilitation hospitals. PARTICIPANTS/METHODS:Five hundred ninety individuals with TBI. INTERVENTIONS/METHODS:Not Applicable. OUTCOME MEASURES/METHODS:TBI-QOL Pain Interference item bank. RESULTS:(740) = 3254.030, p < .001; Comparative Fix Index = .988; Tucker Lewis Index = .980; Root Mean Square Error of Approximation = .076) and a graded response model (GRM) supported item fit of 40 Pain Interference items. Items did not exhibit differential item functioning or local item dependence. GRM calibration data were used to inform the selection of a 10-item static short form, and to program a TBI-QOL Pain Interference CAT. Comparative analyses indicated excellent comparability and reliability across test administration formats. CONCLUSION/CONCLUSIONS:The 40-item TBI-QOL Pain Interference item bank demonstrated strong psychometric properties. End users can administer this measure as either a 10-item short form or CAT.
PMID: 31562878
ISSN: 1532-821x
CID: 4105762
Factors associated with the remission of insomnia after traumatic brain injury: a traumatic brain injury model systems study
Objective: To examine the factors associated with the remission of insomnia by examining a sample of individuals who had insomnia within the first two years after traumatic brain injury (TBI) and assessing their status at a secondary time point. Design and Methods: Secondary data analysis from a multicenter longitudinal cohort study. A sample of 40 individuals meeting inclusion criteria completed a number of self-report scales measuring sleep/wake characteristics (Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, Insomnia Severity Index, Sleep Hygiene Index), fatigue and depression (Multidimensional Assessment of Fatigue, Patient Health Questionnaire-9), and community participation (Participation Assessment with Recombined Tools-Objective). One cohort was followed at 1 and 2 years post-injury (n = 19) while a second cohort was followed at 2 and 5 years post-injury (n = 21). Results: Remission of insomnia was noted in 60% of the sample. Those with persistent insomnia had significantly higher levels of fatigue and depression at their final follow-up and poorer sleep hygiene across both follow-up time-points. A trend toward reduced community participation among those with persistent insomnia was also found. Conclusion: Individuals with persistent post-TBI insomnia had poorer psychosocial outcomes. The chronicity of post-TBI insomnia may be associated with sleep-related behaviors that serve as perpetuating factors.
PMID: 31640430
ISSN: 1362-301x
CID: 4190452
Archives of physical medicine & rehabilitation. 2019:Conference:(2019).DOI: 10.1016/j.apmr.2019.08.117
Assessing Educational and Resource Materials Needs for Patients and Caregivers Post-TBI [Meeting Abstract]
Objective: To capture the need for TBI educational materials and resources for those affected by traumatic brain injury (TBI) years after inpatient rehabilitation discharge.
Design(s): This observational study tracked the different types of resources and educational TBI factsheets from Model Systems Knowledge Translation Center (MSKTC) shared with TBI Model Systems (TBIMS) participants and caregivers who completed Form II at Year 1, 2 and 5.
Setting(s): Two urban hospitals in New York City. Participants (or Animals, Specimens, Cadavers): Participants and caregivers (N=94) followed between June 2018 and February 2019. Participants were primarily male (83%), Hispanic (37.2%) or White (34.0%), and spoke English (77.7%); and had an average age of 52.
Intervention(s): Provided resources and educational information after each completed follow-up. Main Outcome Measure(s): MSKTC factsheets and resources include hospital-outpatient services and TBI internet resources including advocacy and support.
Result(s): Descriptive statistics were used to analyze the most requested materials at years 1, 2 and 5. At year 1, participants (N=35) requested internet resources (63.6%) and hospital-outpatient services (22.7%), and the following TBI educational materials: introduction to TBI (59.1%), seizures, alcohol use, cognitive problems, balance problems, and memory (22.7% per topic). At year 2, participants (N=25) requested internet resources (48.0%), and educational materials: introduction to TBI (64.0%), headaches, cognitive problems, and seizures (16.0% per topic). At Year 5, participants (N=10) requested internet resources (100.0%) and hospital-outpatient services (40.0%).
Conclusion(s): As scientific evidence classifies TBI as a chronic condition, it is important to understand the needs and knowledge gaps of those affected by TBI. These results suggest case management is necessary throughout inpatient rehabilitation and immediately after discharge, but also throughout the post-injury period in order to help individuals attain and access appropriate service referrals, resources and educational materials as needs change over time. Author(s) Disclosures: Nothing to disclose. Key Words: Traumatic Brain Injury, Cross-cultural, Community Integration, Community Outreach, Case Management
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Design(s): This observational study tracked the different types of resources and educational TBI factsheets from Model Systems Knowledge Translation Center (MSKTC) shared with TBI Model Systems (TBIMS) participants and caregivers who completed Form II at Year 1, 2 and 5.
Setting(s): Two urban hospitals in New York City. Participants (or Animals, Specimens, Cadavers): Participants and caregivers (N=94) followed between June 2018 and February 2019. Participants were primarily male (83%), Hispanic (37.2%) or White (34.0%), and spoke English (77.7%); and had an average age of 52.
Intervention(s): Provided resources and educational information after each completed follow-up. Main Outcome Measure(s): MSKTC factsheets and resources include hospital-outpatient services and TBI internet resources including advocacy and support.
Result(s): Descriptive statistics were used to analyze the most requested materials at years 1, 2 and 5. At year 1, participants (N=35) requested internet resources (63.6%) and hospital-outpatient services (22.7%), and the following TBI educational materials: introduction to TBI (59.1%), seizures, alcohol use, cognitive problems, balance problems, and memory (22.7% per topic). At year 2, participants (N=25) requested internet resources (48.0%), and educational materials: introduction to TBI (64.0%), headaches, cognitive problems, and seizures (16.0% per topic). At Year 5, participants (N=10) requested internet resources (100.0%) and hospital-outpatient services (40.0%).
Conclusion(s): As scientific evidence classifies TBI as a chronic condition, it is important to understand the needs and knowledge gaps of those affected by TBI. These results suggest case management is necessary throughout inpatient rehabilitation and immediately after discharge, but also throughout the post-injury period in order to help individuals attain and access appropriate service referrals, resources and educational materials as needs change over time. Author(s) Disclosures: Nothing to disclose. Key Words: Traumatic Brain Injury, Cross-cultural, Community Integration, Community Outreach, Case Management
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EMBASE:2002952920
ISSN: 1532-821x
CID: 4120032
Linking the GAD-7 and PHQ-9 to the TBI-QOL Anxiety and Depression Item Banks
OBJECTIVE:To link scores on commonly used measures of anxiety (7-item Generalized Anxiety Disorder Scale; GAD-7) and depression (9-item Patient Health Questionnaire; PHQ-9) to the Traumatic Brain Injury Quality of Life (TBI-QOL) measurement system. SETTING/METHODS:5 Traumatic Brain Injury Model Systems. PARTICIPANTS/METHODS:A total of 385 individuals with traumatic brain injury (TBI) (31% complicated mild; 14% moderate; and 54% severe). DESIGN/METHODS:Observational cohort. MAIN MEASURES/METHODS:GAD-7, PHQ-9, TBI-QOL Anxiety v1.0 and TBI-QOL Depression v1.0. RESULTS:Item response theory-based linking methods were used to create crosswalk tables that convert scores on the GAD-7 to the TBI-QOL Anxiety metric and scores on the PHQ-9 to the TBI-QOL Depression metric. Comparisons between actual and crosswalked scores suggest that the linkages were successful and are appropriate for group-level analysis. Linking functions closely mirror crosswalks between the GAD-7/PHQ-9 and the Patient-Reported Outcomes Measurement Information System (PROMIS), suggesting that general population linkages are similar to those from a TBI sample. CONCLUSION/CONCLUSIONS:Researchers and clinicians can use the crosswalk tables to transform scores on the GAD-7 and the PHQ-9 to the TBI-QOL metric for group-level analyses.
PMID: 31498233
ISSN: 1550-509x
CID: 4087572
Measuring Fatigue in TBI: Development of the TBI-QOL Fatigue Item Bank and Short Form
OBJECTIVE:To develop a traumatic brain injury (TBI)-specific, item response theory (IRT)-calibrated Fatigue item bank, short form, and computer adaptive test (CAT) as part of the Traumatic Brain Injury-Quality of Life (TBI-QOL) measurement system. SETTING/METHODS:Five TBI Model Systems rehabilitation centers in the US PARTICIPANTS:: Adults with complicated mild, moderate, or severe TBI confirmed by medical record review. DESIGN/METHODS:Cross-sectional field testing via phone or in-person interview. MAIN MEASURES/METHODS:TBI-QOL Fatigue item bank, short form, and CAT. RESULTS:A total of 590 adults with TBI completed 95 preliminary fatigue items, including 86 items from the Patient-Reported Outcomes Measurement Information System (PROMIS) and 9 items from the Quality of Life in Neurological Disorders (Neuro-QOL) system. Through 4 iterations of factor analysis, 22 items were deleted for reasons such as local item dependence, misfit, and low item-total correlations. Graded response model IRT analyses were conducted on the 73-item set, and Stocking-Lord equating was used to transform the item parameters to the PROMIS (general population) metric. A short form and CAT, which demonstrate similar reliability to the full item bank, were developed. Test-retest reliability of the CAT was established in an independent sample (Pearson's r and intraclass correlation coefficient = 0.82 [95% confidence interval: 0.72-0.88]). CONCLUSIONS:The TBI-QOL Fatigue item bank, short form, and CAT provide rehabilitation researchers and clinicians with TBI-optimized tools for assessment of the patient-reported experience and impact of fatigue on individuals with TBI.
PMID: 31498228
ISSN: 1550-509x
CID: 4087522
Impact of racial-ethnic minority status and systemic vulnerabilities on time to acute TBI rehabilitation admission in an urban public hospital setting
PURPOSE/OBJECTIVE/OBJECTIVE:Racial/ethnic minorities and other vulnerable social groups experience health care disparities. There is a lack of research exploring how time to acute rehabilitation admission is impacted by race/ethnicity and other marginalizing systemic vulnerabilities. The purpose of this study is to investigate whether race/ethnicity and other sociodemographic vulnerabilities impact expediency of acute rehabilitation admission following traumatic brain injury (TBI). Research Method/Design: This study is a secondary analysis of an existing dataset of 111 patients admitted for acute TBI rehabilitation at an urban public hospital. Patient groups were defined by race/ethnicity (People of color or White) and vulnerable group status (high or low vulnerable group membership [VGM]). RESULTS:White patients are admitted to acute TBI rehabilitation significantly faster than people of color. After taking vulnerabilities into account, high VGM people of color experience the most severe injuries and take the longest to receive acute TBI rehabilitation. Despite small differences in injury severity, low VGM people of color take longer to be admitted to acute TBI rehabilitation than White patients. High VGM White patients have less severe injuries yet take longer to be admitted to acute rehabilitation than low VGM White patients. Finally, notable differences exist between White patients and patients of color on rater-based injury severity scales that are discordant with severity as measured by more objective markers. CONCLUSIONS/IMPLICATIONS/CONCLUSIONS:Overall, findings indicate that sociodemographic factors including race/ethnicity and systemic vulnerabilities impact injury severity and time to acute TBI rehabilitation admission. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
PMID: 30688481
ISSN: 1939-1544
CID: 3626012
