The Effect of Varying Diagnostic Terminology Within Patient Discharge Information on Expected Mild Traumatic Brain Injury Outcome

Abstract

This study aimed to determine if systematic variation of the diagnostic terminology embedded within written discharge information (i.e., concussion or mild traumatic brain injury, mTBI) would produce different expected symptoms and illness perceptions. We hypothesized that compared to concussion advice, mTBI advice would be associated with worse outcomes. Sixty-two volunteers with no history of brain injury or neurological disease were randomly allocated to one of two conditions in which they read a mTBI vignette followed by information that varied only by use of the embedded terms concussion (n = 28) or mTBI (n = 34). Both groups reported illness perceptions (timeline and consequences subscale of the Illness Perception Questionnaire-Revised) and expected Postconcussion Syndrome (PCS) symptoms 6 months post injury (Neurobehavioral Symptom Inventory, NSI). Statistically significant group differences due to terminology were found on selected NSI scores (i.e., total, cognitive and sensory symptom cluster scores (concussion > mTBI)), but there was no effect of terminology on illness perception. When embedded in discharge advice, diagnostic terminology affects some but not all expected outcomes. Given that such expectations are a known contributor to poor mTBI outcome, clinicians should consider the potential impact of varied terminology on their patients.

Keywords:

• Neuropsychology
• Head injury
• Acquired brain injury
• Neurocognitive disorder
• Posttraumatic stress disorder
• Postconcussion syndrome
• Mild traumatic brain injury
• Patient information

Notes

1. The MAA brochure, “Mild Head Injury Advice”, was adapted from “Mild Head Injury Discharge Advice” discharge advice developed by Dr Duncan Reed (2007).