Examining Test-Retest Reliability and Reliable Change for Cognition Endpoints for the CENTER-TBI Neuropsychological Test Battery

Abstract

Objective: Seven candidate cognition composite scores have been developed and evaluated as part of a research program designed to validate a cognition endpoint for traumatic brain injury (TBI) research and clinical trials, but these composites have yet to be examined longitudinally. This study examined test-retest reliability and methods for determining reliable change for these seven candidate composite scores, using the neuropsychological test battery from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI).Methods: Participants (18-59 years-old) with mild TBI (n = 124), orthopedic trauma without head injury (n = 67), and healthy community controls (n = 63) from the Trondheim MTBI follow-up study completed the CENTER-TBI neuropsychological test battery at 2 weeks and 3 months after injury. The battery included both traditional paper-and-pencil tests and computerized tests from the Cambridge Neuropsychological Test Automated Battery (CANTAB). Seven composite scores were calculated for the paper-and-pencil tests, the CANTAB tests, and all tests combined (i.e., 21 composites in total on each assessment): the overall test battery mean (OTBM); global deficit score (GDS); neuropsychological deficit score-weighted (NDS-W); low score composite (LSC); and the number of scores ≤5th percentile, ≤16th percentile, or <50th percentile. The OTBM was calculated by averaging T scores for all tests. The other composite scores were deficit-based scores, assigning different weights to low scores.Results: All composites revealed better cognitive performance at the 3-month assessment compared to the 2-week assessment and the magnitude of improvement was similar across groups. Differences, in terms of effect sizes, were largest on the OTBMs. In the combined composites, the test-retest correlation was highest for the Stenberg et al.Cognition Endpoints-Test-Retest OTBM (Spearman's rho = 0.87, in the community control group) and lowest for the number of scores ≤5th percentile (rho = 0.41). Conclusion:The high test-retest reliability of the OTBM appears to favor its use in TBI research; however, future studies are needed to examine these candidate composite scores in participants with more severe TBIs and cognitive deficits and the association of the composites with functional outcomes.

Discapacidad cognitiva in-visibilizada: rutas de evaluación y certificación en Costa Rica

“…En la evaluación de una persona con DCA, se plantea la necesidad de un proceso específico y especializado de valoración que puede realizarse en los primeros días, semanas o meses después de la lesión, según la gravedad de esta (Maas et al, 2017). La literatura enfatiza que se deben utilizar métodos sensibles al DCA en varios momentos a lo largo del tiempo, puesto que el funcionamiento, las capacidades y la reintegración de estas personas suelen modificarse (Platz & Owolabi, 2021;Stenberg et al, 2020). De no contar con pruebas estandarizadas, se han de implementar entrevistas adaptadas al contexto que permitan indagar los cambios con paciente y sus familiares acerca de las percepciones del deterioro cognitivo (Dromer et al, 2021;Wilson, Winegardner et al, 2017).…”

“…En segundo lugar, es limitante la ausencia de una perspectiva de ciclo vital que reconozca el aumento de la variabilidad interindividual a lo largo del desarrollo, en la cual las variables sociodemográficas y las experiencias de vida interactúan para diversificar las variables a la base de la funcionalidad y la discapacidad de personas adultas que continuarán en su proceso de envejecimiento con necesidades cambiantes. Por ello, la selección de instrumentos dependerá de este juicio de criterio especializado en coherencia con el tipo de DCA y su evolución en el tiempo con medidas sensibles al cambio (Stenberg et al, 2020), la conciencia subjetiva sobre esos cambios (Brown et al, 2021) y el manejo rehabilitador compensatorio o habilitador que de ese rendimiento realice la persona, su familia y su contexto, que implica valoraciones del entorno y contextos de desarrollo de las personas en congruencia con un enfoque de derecho (Schalock et al, 2021).…”

Poor sleep quality is associated with greater negative consequences for cognitive control function and psychological health after mild traumatic brain injury than after orthopedic injury.

“…This allows for comparisons of group means, while still taking advantage of the larger total sample size for a more robust estimate of the mean and SD . Composite scores calculated by averaging of individual test scores typically have higher test–retest reliability than other types of composites (e.g., deficit-based), and considerably higher test–retest reliability than the individual tests included in the composite score (Stenberg, Karr, et al, 2020). The raw scores for each speed and accuracy measure were positively skewed, which is often the case for these types of data (Lo & Andrews, 2015).…”

Trajectories of Persistent Postconcussion Symptoms and Factors Associated With Symptom Reporting After Mild Traumatic Brain Injury

“…We therefore used the natural distribution of change scores to calculate reliable change. 41,42 First, data from the CCs were used to create cutoffs for reliable change for the BC-PSI total score. The change scores were calculated by subtracting the 3-month assessment score from the 12-month assessment score.…”