Comparison of subjective and objective assessments of outcome after traumatic brain injury using the International Classification of Functioning, Disability and Health (ICF)

Abstract

Purpose. The aim is to examine two aspects of outcome after traumatic brain injury (TBI). Functional outcome was assessed by the Glasgow Outcome Scale – Extended (GOSE) and by clinician ratings, while health-related quality of life (HRQoL) was assessed by the Quality of Life after Brain Injury (QOLIBRI).

Method. The GOSE and the QOLIBRI were linked to the International Classification of Functioning, Disability and Health (ICF) to analyse their content. Functional outcome on ICF categories was assessed by rehabilitation clinicians in 55 participants with TBI and was compared to the participants' own judgements of their HRQoL.

Results. The QOLIBRI was linked to 42 and the GOSE to 57 two-level ICF categories covering 78%% of the categories on the ICF brief core set for TBI. The closest agreement in the views of the professionals and the participants was found on the Physical Problems and Cognition scales of the QOLIBRI.

Conclusions. The problems encountered after TBI are well covered by the QOLIBRI and the GOSE. They capture important domains that are not traditionally sufficiently documented, especially in the domains of interpersonal relationships, social and leisure activities, self and the environment. The findings indicate that they are useful and complementary outcome measures for TBI. In rehabilitation, they can serve as tools in assessment, setting meaningful goals and creating therapeutic alliance.

Keywords:

• Outcome
• HRQoL
• TBI
• ICF
• QOLIBRI
• GOSE

Acknowledgements

The authors would like to express their gratitude to Dr Alarcos Cieza from the ICF Research Branch, Germany, and to Dr Seija Talo from the National Research and Development Centre for Welfare and Health, Finland, for their valuable help in acting as the specialists and leading the consensus conferences when linking the GOSE and the QOLIBRI the ICF. We also thank Dr Laura Hokkanen from the University of Helsinki for her valuable comments.

Declaration of interest:

The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper. This study was funded by EVO funding of the Käpylä Rehabilitation Centre, and by grants from the Alfred Kordelin Foundation, Finland, and the Finnish Cultural Foundation.