Identification of clinically-useful cut scores of the Traumatic Injuries Distress Scale (TIDS) for predicting rate of recovery following musculoskeletal trauma

Abstract

Objective The Traumatic Injuries Distress Scale (TIDS) is a 12-item self-report tool intended for prognostic risk phenotyping in people with acute musculoskeletal (MSK) trauma. The initial validation study showed good associations with outcomes 12 weeks later in a cohort of 72 acutely injured patients from one region in Canada. This study aims to provide further clinical utility through identification of meaningful cut scores in a larger, mixed geography sample, and expands the prediction window from 12 to 52 weeks. Methods Data were drawn from databanks in London, Canada and Chicago, United States. Participants were recruited within 3 weeks of non-catastrophic MSK trauma and followed for 12 months. Using outcomes trajectories, the TIDS underwent linear regression-based analysis to predict 52-week outcomes, and area under the receiver operating characteristic curves to identify discriminative accuracy and meaningful cut scores. Results N = 224 participants with acute trauma were followed and both %Interference and Pain Severity were captured at intake and 3 follow-ups to establish curvilinear recovery trajectories. The TIDS explained significant variance in both the interference and severity outcomes after controlling for sex, region of injury, and baseline scores. ROC analysis revealed significant discriminative accuracy for predicting both the trajectories and the distal outcomes over 52 weeks. The TIDS was more accurate for identifying the low-risk than high-risk patients. Conclusion The TIDS is a useful tool for ‘ruling out’ high risk of poor outcome in a mixed sample of participants from two different countries. Impact statement The TIDS will be a useful tool for clinicians to predict the rate of recovery by displaying meaningful cut-scores for their patients after an acute musculoskeletal injury. This could lead to reduced burden of care for low risk patients and more informed treatment options for higher risk patients.

How Is the Probability of Reporting Various Levels of Pain 12 Months After Noncatastrophic Injuries Associated with the Level of Peritraumatic Distress?

“…Currently, there is no set MCID for the TIDS. The psychometric properties of the TIDS, including predictive validity and discriminative accuracy in this patient population, have been reported but only through the use of statistical techniques that assume linear associations and normal distribution of outcomes [35,36], which might not provide the most complete estimates for populations that are not normally distributed. The TIDS is a freely accessible tool, and it has been translated to French, Spanish, and Persian [25].…”

Exploring Social Determinants of Posttraumatic Pain, Distress, Depression, and Recovery Through Cross-Sectional, Longitudinal, and Nonlinear Trends

“… The Traumatic Injuries Distress Scale (TIDS) is a 12-item self-report tool designed to capture the experiences of traumatic distress in the acute postinjury stage 20. It has demonstrated a stable 3-factor structure (uncontrolled pain, negative affect, intrusion/hyperarousal), good internal consistency, and evidence of both concurrent and predictive validity 20,21. Each item is scored on a frequency-based scale of 0 (not at all) to 2 (often) for a total scale range of 0 (no distress) to 24 (severe distress).…”

“…20 It has demonstrated a stable 3-factor structure (uncontrolled pain, negative affect, intrusion/hyperarousal), good internal consistency, and evidence of both concurrent and predictive validity. 20,21 Each item is scored on a frequency-based scale of 0 (not at all) to 2 (often) for a total scale range of 0 (no distress) to 24 (severe distress). The TIDS has previously demonstrated prognostic validity in predicting 12-month trajectories BPI scores.…”

Effects of childhood trauma on pain‐related distress in adults

“…The TIDS is better targeted to the construct of acute post‐trauma distress than would be a PTSD screening tool, the latter requiring symptoms to have been present for at least 1 month per DSM‐V criteria. (American Psychiatric Association., 2013) Further, the TIDS has demonstrated strong evidence of concurrent and factorial validity, and in the initial development cohort showed significant prognostic value in predicting 12‐week (Walton et al., 2016) and 12‐month (Walton et al., 2021) pain and disability ratings with ≥75% accuracy. The Brief Pain Inventory—short form (BPI). The BPI is a widely used patient‐reported outcome (PRO) in the pain field (Cronbach's alpha ≥0.85) (Tan et al., 2004).…”