@article{ref1,
title="Neurocognitive models of medical decision-making capacity in traumatic brain injury across injury severity",
journal="Journal of head trauma rehabilitation",
year="2015",
author="Triebel, Kristen L. and Novack, Thomas A. and Kennedy, Richard and Martin, Roy C. and Dreer, Laura E. and Raman, Rema and Marson, Daniel C.",
volume="31",
number="3",
pages="E49-59",
abstract="OBJECTIVE: To identify neurocognitive predictors of medical decision-making capacity (MDC) in participants with mild and moderate/severe traumatic brain injury (TBI). SETTING: Academic medical center. PARTICIPANTS: Sixty adult controls and 104 adults with TBI (49 mild, 55 moderate/severe) evaluated within 6 weeks of injury. <br><br>DESIGN: Prospective cross-sectional study. MAIN MEASURES: Participants completed the Capacity to Consent to Treatment Instrument to assess MDC and a neuropsychological test battery. We used factor analysis to reduce the battery test measures into 4 cognitive composite scores (verbal memory, verbal fluency, academic skills, and processing speed/executive function). We identified cognitive predictors of the 3 most clinically relevant Capacity to Consent to Treatment Instrument consent standards (appreciation, reasoning, and understanding). <br><br>RESULTS: In controls, academic skills (word reading, arithmetic) and verbal memory predicted understanding; verbal fluency predicted reasoning; and no predictors emerged for appreciation. In the mild TBI group, verbal memory predicted understanding and reasoning, whereas academic skills predicted appreciation. In the moderate/severe TBI group, verbal memory and academic skills predicted understanding; academic skills predicted reasoning; and academic skills and verbal fluency predicted appreciation. <br><br>CONCLUSIONS: Verbal memory was a predictor of MDC in controls and persons with mild and moderate/severe TBI. In clinical practice, impaired verbal memory could serve as a &quot;red flag&quot; for diminished consent capacity in persons with recent TBI.<p /> <p>Language: en</p>",
language="en",
issn="0885-9701",
doi="10.1097/HTR.0000000000000163",
url="http://dx.doi.org/10.1097/HTR.0000000000000163"
}