Development of Composite Scores for the TBI-QOL

Callie E Tyner; Aaron J Boulton; Mark Sherer; Pam A Kisala; Joseph J Glutting; David S Tulsky

doi:10.1016/j.apmr.2018.05.036

Development of Composite Scores for the TBI-QOL

Arch Phys Med Rehabil. 2020 Jan;101(1):43-53. doi: 10.1016/j.apmr.2018.05.036. Epub 2018 Jul 3.

Authors

Callie E Tyner¹, Aaron J Boulton², Mark Sherer³, Pam A Kisala², Joseph J Glutting⁴, David S Tulsky⁵

Affiliations

¹ Center for Health Assessment Research and Translation, University of Delaware, Newark, DE. Electronic address: ctyner@udel.edu.
² Center for Health Assessment Research and Translation, University of Delaware, Newark, DE.
³ TIRR Memorial Hermann, Houston, TX.
⁴ University of Delaware School of Education, Newark, DE.
⁵ Center for Health Assessment Research and Translation, University of Delaware, Newark, DE; Departments of Physical Therapy and Psychological and Brain Sciences, University of Delaware, Newark, DE.

PMID: 31875840
DOI: 10.1016/j.apmr.2018.05.036

Abstract

Objective: To develop a set of composite scores that can be used for interpreting quality of life (QOL) after traumatic brain injury (TBI) using 9 of the patient-reported outcomes measures from the Traumatic Brain Injury Quality of Life (TBI-QOL) measurement system.

Design: Participants completed 20 item banks from the TBI-QOL as part of a larger assessment. Composite index scores were created with normalized transformation with nonlinear area conversion using scores from 9 of the banks, and are expressed in index score units, with higher composite scores indicating better functioning. For descriptive purposes, associations among composites and individual banks were evaluated using regression, along with patterns of composite scores by injury severity groups using analysis of variance.

Setting: Three medical centers in the United States.

Participants: Community-dwelling adults (n=504) with a history of TBI.

Interventions: Not applicable.

Main outcomes measure: TBI-QOL.

Results: Five composite indices were generated: global QOL, physical health, emotional health, cognitive health, and social health. Lookup tables are provided herein. Composite scores were highly intercorrelated (all r>.60, P<.0001), and individual TBI-QOL banks all correlate strongly with the global QOL composite in the expected direction (all r>.50, P<.0001).

Conclusion: Researchers and clinicians can use the TBI-QOL global QOL, physical health, emotional health, cognitive health, and social health composite scores to aggregate results from multiple TBI-QOL banks, which is anticipated to ease interpretation and reliability. This work additionally highlights the importance of considering nonphysical symptoms as outcomes variables for TBI research, as cognitive, social, and emotional domains were some of the most strongly correlated banks with the global QOL composite.

Keywords: Health-related quality of life; Patient reported outcome measures; Psychometrics; Rehabilitation; Traumatic brain injury.

Publication types

Multicenter Study
Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

Adult
Analysis of Variance
Brain Injuries, Traumatic / psychology*
Female
Health Status Indicators*
Humans
Male
Middle Aged
Patient Reported Outcome Measures*
Psychometrics
Quality of Life / psychology*
Reference Values
Regression Analysis
Reproducibility of Results
Surveys and Questionnaires / standards*
United States