Retrospective baseline measurement of self-reported health status and health-related quality of life versus population norms in the evaluation of post-injury losses

Abstract

Background: Owing to the difficulty in prospectively measuring pre-injury health status and health-related quality of life (HRQL) in an injured cohort, population norms or retrospective baseline scores are often used as comparators for evaluating post-injury losses. However, there has been little discussion in the literature or research into the soundness of these approaches for this purpose. Objectives: To investigate the appropriateness of the retrospectively measured baseline health status and HRQL in an injured population for the purpose of evaluating post-injury losses. Methods: A cohort of injured admitted to hospital (n = 186) was followed up for 12 months after injury. Retrospectively measured pre-injury health status and HRQL scores were compared with those at 12 months after injury for participants who reported complete recovery (n = 61) and those who did not. Retrospective baseline scores for the whole cohort were also compared with Australian population norms. Results: For participants who completely recovered, no significant difference was observed between scores at baseline (measured retrospectively) and those at 12 months after injury ( Retrospectively measured pre-injury scores were consistently higher than Australian norms for all measures. Conclusions: The injured population may not be representative of the general population. Consequently, retrospective baseline measurement of pre-injury health states may be more appropriate than general population norms for the purpose of evaluating post-injury losses in this population.

Predicting health-related quality of life 2 years after moderate-to-severe traumatic brain injury

“…Population norms have been used to provide reference values for post-injury HRQL data (35). As expected, the study sample showed lower HRQL in all SF-36 domains compared with the general population of Norway (14).…”

Does recall of preinjury disability change over time?

“…Watson et al 8 found no difference between preinjury health status recalled within 1 week of injury, and the results of the same measures at 12 months postinjury in a group of patients who reported complete recovery from injury, and concluded that the retrospective recall of preinjury status shortly after injury was a valid method for estimating preinjury disability. Similarly, the results of the UK Burden of Injuries study found that while preinjury EQ-5D scores were 3% higher than age-weighted and gender-weighted norms, the difference was not affected by the timing of assessment of ‘preinjury’ status within a 4-week period postinjury 18.…”

“…Watson et al 8 argued that retrospective recall of preinjury status is more valid than prospective or population assessments for comparison with postinjury status because they are presumed to be completed with the same internal standard. However, for this argument to be valid, any shift in internal standard must be consistent and sustained.…”

“…However, following injury, patients consistently report better preinjury physical and mental health status than population norms,6–8 suggesting that the use of population norms may overestimate preinjury disability compared with patient reports 1. While authors have suggested that the differences occur due to the younger and more physically active characteristics of trauma patients,7 others have suggested that there are difficulties with recall that increase with time, and that the injury causes a response shift, with patients valuing their preinjury health and disability differently 1 8. The consensus view is that preinjury disability should be measured as soon as possible following trauma in order to reduce recall bias, a systematic or unidirectional error due to incomplete or inaccurate recall 9 10.…”

Predictors and Mediators of Long-term Functional Limitations in the Older Adult Population

“…Adverse psychological outcomes are also more common in women including depression, acute stress reaction, and post-traumatic stress disorder (PTSD) (Holbrook et al, 2001;Holbrook, Hoyt, Stein, & Sieber, 2002;McGeary et al, 2003, Holbrook & Hoyt, 2004Aitken, Chaboyer, Kendall, & Burmeister, 2012;Soberg et al, 2012;Langley et al, 2013). Studies have also found that women are less likely than men to reach full recovery, more likely to suffer disability, and less likely to return to work Holbrook & Hoyt, 2004;Watson, Ozanne-Smith, & Richardson, 2007;Kendrick et al, 2012;Brede, Mayer, & Gatchel, 2012).…”