Citation

Beers SR, Wisniewski SR, Garcia-Filion P, Tian Y, Hahner T, Berger RP, Bell MJ, Adelson PD. J. Neurotrauma 2012; 29(6): 1126-1139.

Affiliation

University of Pittsburgh School of Medicine, Psychiatry, WPIC, 3811 O'Hara Street, Pittsburgh, Pennsylvania, United States, 15213, 412 246-5419, 412 246-5425; beerssr@upmc.edu.

Copyright

(Copyright © 2012, Mary Ann Liebert Publishers)

DOI

10.1089/neu.2011.2272

PMID

22220819

PMCID

PMC3325553

Abstract

The Glasgow Outcome Scale (GOS) and its most recent revision, the GOS-Extended (GOS-E), provide the gold standard for measuring traumatic brain injury (TBI) outcome. The GOS-E, exhibits validity when used with adults and some adolescents but validity with younger children is not established. Because the GOS-E lacks the developmental specificity necessary to evaluate children, toddlers, and infants, we modified the original version to create the GOS-E Pediatric revision (GOS-E Peds), a developmentally appropriate structured interview, to classify younger patients. The criterion, predictive, and discriminant validity of the GOS-E Peds was measured in 159 subjects following TBI (Mild: 36%; Moderate: 12%; Severe: 50%) at 3 and 6 mos after injury. Participants were included from two studies completed at the Pediatric Neurotrauma Center at Children's Hospital of Pittsburgh. We assessed the relationship between GOS-E Peds and the GOS and the Vineland Adaptive Behavior Scales as well as other standardized measures of functional, behavioral, intellectual, and neuropsychological outcome. Premorbid function was assessed 24 - 36 hrs after injury. The GOS-E Peds showed a strong correlation with the GOS at 3- and 6-mo time points. Criterion-related validity was also indicated by GOS-E Peds' association with most measures at both time points and at injury severity levels. The 3-mo GOS-E Peds was associated with the 6-mo GOS-E Peds, everyday function, behavior, and most cognitive abilities. Discriminant validity is suggested by weak correlations between both 3- and 6-mo GOS-E Peds and premorbid measures. The GOS-E Peds is sensitive to severity of injury and associated with changes in TBI sequelae over time. This pediatric revision provides a valid outcome measure in infants, toddlers, and children through age 16. Findings support using the GOS-E Peds as the primary outcome variable in pediatric clinical trials.

Language: en