The consequences of traumatic brain injury (TBI) for health-related quality of life (HRQoL) are poorly investigated, and a TBI-specific instrument has not previously been available. The cross-cultural development of a new measure to assess HRQoL after TBI is described.An international TBI Task Force derived a conceptual model from previous work, constructed an initial item bank of 148 items, and then reduced the item set through two successive multi-centre validation studies. The first study with eight language versions of the QOLIBRI recruited 1528 participants with TBI and the second with six language versions 921 participants. The data from 795 participants from the second study who had complete GCS and GOS data were used to finalise the instrument.The final version of the QOLIBRI consists of 37 items in six scales. Satisfaction is assessed in the areas of "Cognition", "Self", "Daily life and Autonomy", and "Social Relationships" and feeling bothered by "Emotions "and "Physical Problems". The QOLIBRI scales meet standard psychometric criteria (internal consistency,  = .75 to .89, test-retest reliability, r tt = .78 to .85). Test-retest reliability (r tt = 0.68 to 0.87) as well as internal consistency ( = .81 to .91) was also good in a subgroup of participants with lower cognitive performance. Although there is one strong HRQoL factor, a six scale structure explaining additional variance was validated by exploratory and confirmatory factor analyses and with Rasch modelling.The QOLIBRI is a new cross-culturally developed instrument for assessing HRQoL after TBI that fulfils standard psychometric criteria. It is potentially useful for clinicians and researchers conducting clinical trials, assessing the impact of rehabilitation or other interventions, or carrying out epidemiological surveys.

The QOLIBRI (Quality of Life after Brain Injury) is a novel health-related quality-of-life (HRQoL) instrument specifically developed for traumatic brain injury (TBI). It provides a profile of HRQoL in six domains together with an overall score. Scale validity and factors associated with HRQoL were investigated in a multi-center international study. A total of 795 adults with brain injury were studied from 3 months to 15 years post-injury. The majority of participants (58%) had severe injuries as assessed by 24-h worst Glasgow Coma Scale (GCS) score. Systematic relationships were observed between the QOLIBRI and the Glasgow Outcome Scale-Extended (GOSE), Hospital Anxiety and Depression Scale (HADS), and SF-36. Within each scale patients with disability reported having low HRQoL in two to three times as many areas as those who had made a good recovery. The main correlates of the total QOLIBRI score were emotional state (HADS depression and anxiety), functional status (amount of help needed and outcome on the GOSE), and comorbid health conditions. Together these five variables accounted for 58% of the variance in total QOLIBRI scores. The QOLIBRI is the first tool developed to assess disease-specific HRQoL in brain injury, and it contains novel information not given by other currently available assessments.

The QOLIBRI provides information about patient's subjective perception of his/her HRQoL which supplements clinical measures and measures of functional outcome. It can be applied across different populations and cultures. It allows the identification of personal needs, the prioritization of therapeutic goals and the evaluation of individual progress. It may also be useful in clinical trials and in longitudinal studies of TBI recovery.

The QOLIBRI-OS assesses a similar construct to the QOLIBRI total score and can be used as a brief index of HRQoL for TBI.

The Quality of Life after Brain Injury (QOLIBRI) instruments are traumatic brain injury-specific assessments of health-related quality of life (HRQoL), with established validity and reliability. The purpose of the study is to help improve the interpretability of the two QOLIBRI summary scores (the QOLIBRI Total score and the QOLBRI Overall Scale score). An analysis was conducted of 761 patients with traumatic brain injury (TBI) that took part in the QOLIBRI validation studies. A cross-walk between QOLIBRI scores and the SF-36 Mental Component Summary norm-based scoring system was performed using geometric mean regression analysis. The exercise supports a previous suggestion that QOLIBRI Total scores < 60 indicate low or impaired HRQoL, and indicate that the corresponding score on the QOLIBRI-OS is <52. The percentage of cases in the sample that fell into the 'impaired HRQoL' category were 36% for the Mental Component Summary, 38% for the QOLIBRI Total, and 39% for the QOLIBRI-OS. Relationships between the QOLIBRI scales and the Glasgow Outcome Scale -Extended (GOSE), as a measure of global function, are presented in the form of means and standard deviations that allow comparison with other studies, and data on age and gender are presented for the QOLIBRI-OS. While bearing in mind the potential imprecision of the comparison, the findings provide a framework for evaluating QOLIBRI summary scores in relation to generic HRQoL that improves their interpretability.