Applying the Sliding Scale Approach to Quantifying Functional Outcomes Up to Two Years After Severe Traumatic Brain Injury

Eagle, Shawn R.; Nwachuku, Enyinna; Deng, Hansen; Okonkwo, David O.; Elmer, Justin; Pease, Matthew

doi:10.1089/neu.2023.0258

Journal of Neurotrauma

2024

DOI: 10.1089/neu.2023.0258

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Applying the Sliding Scale Approach to Quantifying Functional Outcomes Up to Two Years After Severe Traumatic Brain Injury

Shawn R. Eagle,

Enyinna Nwachuku,

Hansen Deng

et al.

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2024

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Cited by 2 publications

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“…1 Long-term recovery after hospitalized TBI is variable and difficult to predict with existing tools, leading to their infrequent use in clinical practice. [1][2][3][4][5] Post-TBI recovery and disability are commonly assessed using the validated TBI clinical trial endpoint, the Glasgow Outcome Scale-Extended (GOSE). [6][7][8][9] The GOSE is an 8-tiered scale that organizes outcomes based on survival, level of consciousness, work status, and return to independence.…”

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confidence: 99%

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Maiga,

Cook,

Nordness

et al. 2024

Annals of Surgery

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Objective: To quantify health utilities of the Glasgow Outcome Scale-Extended (GOSE) states after actual Traumatic Brain Injury (TBI). Background: Recovery after TBI is measured using the GOSE, a validated clinical trial endpoint. A recent public survey quantified the health utilities of some GOSE states after hypothetical TBI as worse than death. However, no health utilities exist for disability after actual TBI. Methods: This national computer-adaptive survey followed EQUATOR-CHERRIES guidelines and recruited adult TBI survivors (injury>1 y prior) via their available surrogates. Using a standard gamble approach in randomized order, participants gave preferences for post-TBI categorical health states ranging from GOSE 2-8. We calculated median [interquartile range, IQR] health utilities for each GOSE state, from -1 (worse than death) to 1 (full health), with 0 as reference (death, GOSE 1). Results: Of 515 eligible, 298 surrogates (58%) consented and completed the scenarios on TBI survivors’ behalf. TBI survivors had a current median GOSE 5 [3-7]. GOSE 2, GOSE 3, and GOSE 4 were rated worse than death by 89%, 64%, and 38%, respectively. The relationship was nonlinear, and intervals were unequal between states, with a bimodal distribution for GOSE 4. Conclusions: In this index study of actual post-TBI disability, poor neurologic outcomes represented by GOSE 2-4 were perceived as worse than death by at least one in three survivors. Similar to previously reported public perceptions after a hypothetical TBI, these long-term perceptions may inform earlier post-TBI shared decision making, as well as help shape value-based research and quality of care. Level of Evidence: II, Economic & Value-based Evaluations

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confidence: 99%

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Maiga,

Cook,

Nordness

et al. 2024

Annals of Surgery

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Improvement in Functional Outcome from 6 to 12 Months After Moderate and Severe Traumatic Brain Injury Is Frequent, But May Not Be Detected With the Glasgow Outcome Scale Extended

Pantelatos,

Stenberg,

Follestad

et al. 2024

Neurotrauma Reports

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Applying the Sliding Scale Approach to Quantifying Functional Outcomes Up to Two Years After Severe Traumatic Brain Injury

Cited by 2 publications

References 35 publications

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Improvement in Functional Outcome from 6 to 12 Months After Moderate and Severe Traumatic Brain Injury Is Frequent, But May Not Be Detected With the Glasgow Outcome Scale Extended

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