Brooks, Brian L; Holdnack, James A; Iverson, Grant L
To Change is Human: "Abnormal" Reliable Change Memory Scores are Common in Healthy Adults and Older Adults Journal Article
In: Archives of Clinical Neuropsychology, vol. 31, no. 8, pp. 1026–1036, 2016, ISBN: 08876177.
Abstract | Links | BibTeX | Tags: cognition, Cognition Disorders, COGNITIVE testing, Geropsychology, Memory testing, mild cognitive impairment, Multivariate, MULTIVARIATE analysis, Psychometrics, Reliable change index, test-retest
@article{Brooks2016bc,
title = {To Change is Human: "Abnormal" Reliable Change Memory Scores are Common in Healthy Adults and Older Adults},
author = {Brooks, Brian L and Holdnack, James A and Iverson, Grant L},
doi = {10.1093/arclin/acw079},
isbn = {08876177},
year = {2016},
date = {2016-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {31},
number = {8},
pages = {1026--1036},
abstract = {Objective: The rate at which people obtain reliably improved or declined cognitive test scores when retested, in the absence of a change in clinical condition, is largely unknown. The purpose of this study was to illustrate the prevalence of statistically reliable change scores on memory test batteries in healthy adults and older adults. Method: Participants included three adult and older adult test-retest samples from memory test batteries. Reliable change scores (reliable change index with 90% confidence interval and practice effects) were calculated for the indexes and subtests of each battery. Multivariate analyses involved calculating the frequencies of healthy people obtaining one or more reliably declined or one or more reliably improved scores when considering all change scores simultaneously within each battery. Results: Across all batteries, having one or more reliably changed index or subtest score on retest was common. With most batteries, having two or more reliably changed scores was uncommon. Those with higher intellectual abilities were more likely to have a change on retest; however, no significant differences in base rates were found based on education level, sex, or ethnic minority status. Those older adults who did not have any low memory scores were more likely to improve than decline on retest. Conclusions: Having a single reliably changed score on retest is common when interpreting a battery of memory measures. This has implications for determining cognitive decline and cognitive recovery, suggesting that multivariate interpretation is necessary. [ABSTRACT FROM AUTHOR]},
keywords = {cognition, Cognition Disorders, COGNITIVE testing, Geropsychology, Memory testing, mild cognitive impairment, Multivariate, MULTIVARIATE analysis, Psychometrics, Reliable change index, test-retest},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
van der Horn, Harm J; Spikman, Jacoba M; Jacobs, Bram; van der Naalt, Joukje
Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 94, no. 5, pp. 867–874, 2013, ISBN: 00039993.
Abstract | BibTeX | Tags: *ANXIETY, *BRAIN -- Wounds & injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work
@article{VanderHorn2013,
title = {Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury},
author = {van der Horn, Harm J and Spikman, Jacoba M and Jacobs, Bram and van der Naalt, Joukje},
isbn = {00039993},
year = {2013},
date = {2013-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {94},
number = {5},
pages = {867--874},
abstract = {Abstract: Objectives: To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences. Design: A prospective cross-sectional cohort study. Setting: Level I trauma center. Participants: Adults (N=242) with TBI of various severity. Interventions: Not applicable. Main Outcome Measures: Extended Glasgow Outcome Scale, return to work (RTW), Head Injury Symptom Checklist, and Hospital Anxiety and Depression Scale. Results: In 67% of the patients, complaints were present; 22% were anxious, and 18% were depressed. The frequency of complaints increased significantly with injury severity, in contrast to anxiety and depression. Frequencies of patients with anxiety and depression (9% and 5%) were lower with complete RTW than with incomplete RTW (42% and 37%; P\<.001). Patients with minor TBI with complaints were more anxious (50% vs 27%; P\<.05) and depressed (46% vs 23%; P\<.05) compared with patients with other severity categories and patients with incomplete RTW (67% vs 36% and 60% vs 30%, respectively). A higher percentage of women with minor TBI were depressed (45% vs 13%; P=.01) and had incomplete RTW (50% vs 18%; P\<.05) compared with men. Multiple regression analysis showed that injury severity, complaints, anxiety, and depression were all predictive of RTW (explained variance 45%). In all severity categories, anxiety and depression were predictive of RTW, complaints, and sex only for minor TBI. Conclusions: Anxiety and depression are related to vocational outcome after TBI, with a different profile in the minor TBI category, partly due to sex differences. Copyright \&y\& Elsevier},
keywords = {*ANXIETY, *BRAIN -- Wounds \& injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work},
pubstate = {published},
tppubtype = {article}
}
Brooks, Brian L; Holdnack, James A; Iverson, Grant L
To Change is Human: "Abnormal" Reliable Change Memory Scores are Common in Healthy Adults and Older Adults Journal Article
In: Archives of Clinical Neuropsychology, vol. 31, no. 8, pp. 1026–1036, 2016, ISBN: 08876177.
@article{Brooks2016bc,
title = {To Change is Human: "Abnormal" Reliable Change Memory Scores are Common in Healthy Adults and Older Adults},
author = {Brooks, Brian L and Holdnack, James A and Iverson, Grant L},
doi = {10.1093/arclin/acw079},
isbn = {08876177},
year = {2016},
date = {2016-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {31},
number = {8},
pages = {1026--1036},
abstract = {Objective: The rate at which people obtain reliably improved or declined cognitive test scores when retested, in the absence of a change in clinical condition, is largely unknown. The purpose of this study was to illustrate the prevalence of statistically reliable change scores on memory test batteries in healthy adults and older adults. Method: Participants included three adult and older adult test-retest samples from memory test batteries. Reliable change scores (reliable change index with 90% confidence interval and practice effects) were calculated for the indexes and subtests of each battery. Multivariate analyses involved calculating the frequencies of healthy people obtaining one or more reliably declined or one or more reliably improved scores when considering all change scores simultaneously within each battery. Results: Across all batteries, having one or more reliably changed index or subtest score on retest was common. With most batteries, having two or more reliably changed scores was uncommon. Those with higher intellectual abilities were more likely to have a change on retest; however, no significant differences in base rates were found based on education level, sex, or ethnic minority status. Those older adults who did not have any low memory scores were more likely to improve than decline on retest. Conclusions: Having a single reliably changed score on retest is common when interpreting a battery of memory measures. This has implications for determining cognitive decline and cognitive recovery, suggesting that multivariate interpretation is necessary. [ABSTRACT FROM AUTHOR]},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
van der Horn, Harm J; Spikman, Jacoba M; Jacobs, Bram; van der Naalt, Joukje
Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 94, no. 5, pp. 867–874, 2013, ISBN: 00039993.
@article{VanderHorn2013,
title = {Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury},
author = {van der Horn, Harm J and Spikman, Jacoba M and Jacobs, Bram and van der Naalt, Joukje},
isbn = {00039993},
year = {2013},
date = {2013-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {94},
number = {5},
pages = {867--874},
abstract = {Abstract: Objectives: To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences. Design: A prospective cross-sectional cohort study. Setting: Level I trauma center. Participants: Adults (N=242) with TBI of various severity. Interventions: Not applicable. Main Outcome Measures: Extended Glasgow Outcome Scale, return to work (RTW), Head Injury Symptom Checklist, and Hospital Anxiety and Depression Scale. Results: In 67% of the patients, complaints were present; 22% were anxious, and 18% were depressed. The frequency of complaints increased significantly with injury severity, in contrast to anxiety and depression. Frequencies of patients with anxiety and depression (9% and 5%) were lower with complete RTW than with incomplete RTW (42% and 37%; P\<.001). Patients with minor TBI with complaints were more anxious (50% vs 27%; P\<.05) and depressed (46% vs 23%; P\<.05) compared with patients with other severity categories and patients with incomplete RTW (67% vs 36% and 60% vs 30%, respectively). A higher percentage of women with minor TBI were depressed (45% vs 13%; P=.01) and had incomplete RTW (50% vs 18%; P\<.05) compared with men. Multiple regression analysis showed that injury severity, complaints, anxiety, and depression were all predictive of RTW (explained variance 45%). In all severity categories, anxiety and depression were predictive of RTW, complaints, and sex only for minor TBI. Conclusions: Anxiety and depression are related to vocational outcome after TBI, with a different profile in the minor TBI category, partly due to sex differences. Copyright \&y\& Elsevier},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Brooks, Brian L; Holdnack, James A; Iverson, Grant L
To Change is Human: "Abnormal" Reliable Change Memory Scores are Common in Healthy Adults and Older Adults Journal Article
In: Archives of Clinical Neuropsychology, vol. 31, no. 8, pp. 1026–1036, 2016, ISBN: 08876177.
Abstract | Links | BibTeX | Tags: cognition, Cognition Disorders, COGNITIVE testing, Geropsychology, Memory testing, mild cognitive impairment, Multivariate, MULTIVARIATE analysis, Psychometrics, Reliable change index, test-retest
@article{Brooks2016bc,
title = {To Change is Human: "Abnormal" Reliable Change Memory Scores are Common in Healthy Adults and Older Adults},
author = {Brooks, Brian L and Holdnack, James A and Iverson, Grant L},
doi = {10.1093/arclin/acw079},
isbn = {08876177},
year = {2016},
date = {2016-01-01},
journal = {Archives of Clinical Neuropsychology},
volume = {31},
number = {8},
pages = {1026--1036},
abstract = {Objective: The rate at which people obtain reliably improved or declined cognitive test scores when retested, in the absence of a change in clinical condition, is largely unknown. The purpose of this study was to illustrate the prevalence of statistically reliable change scores on memory test batteries in healthy adults and older adults. Method: Participants included three adult and older adult test-retest samples from memory test batteries. Reliable change scores (reliable change index with 90% confidence interval and practice effects) were calculated for the indexes and subtests of each battery. Multivariate analyses involved calculating the frequencies of healthy people obtaining one or more reliably declined or one or more reliably improved scores when considering all change scores simultaneously within each battery. Results: Across all batteries, having one or more reliably changed index or subtest score on retest was common. With most batteries, having two or more reliably changed scores was uncommon. Those with higher intellectual abilities were more likely to have a change on retest; however, no significant differences in base rates were found based on education level, sex, or ethnic minority status. Those older adults who did not have any low memory scores were more likely to improve than decline on retest. Conclusions: Having a single reliably changed score on retest is common when interpreting a battery of memory measures. This has implications for determining cognitive decline and cognitive recovery, suggesting that multivariate interpretation is necessary. [ABSTRACT FROM AUTHOR]},
keywords = {cognition, Cognition Disorders, COGNITIVE testing, Geropsychology, Memory testing, mild cognitive impairment, Multivariate, MULTIVARIATE analysis, Psychometrics, Reliable change index, test-retest},
pubstate = {published},
tppubtype = {article}
}
Zemek, R; Barrowman, N; Freedman, S B; Gravel, J; Gagnon, I; McGahern, C; Aglipay, M; Sangha, G; Boutis, K; Beer, D; Craig, W; Burns, E; Farion, K J; Mikrogianakis, A; Barlow, K; Dubrovsky, A S; Meeuwisse, W; Gioia, G; Meehan 3rd, W P; Beauchamp, M H; Kamil, Y; Grool, A M; Hoshizaki, B; Anderson, P; Brooks, B L; Yeates, K O; Vassilyadi, M; Klassen, T; Keightley, M; Richer, L; DeMatteo, C; Osmond, M H; Pediatric Emergency Research Canada Concussion, Team
Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED Journal Article
In: JAMA, vol. 315, no. 10, pp. 1014–1025, 2016.
Abstract | BibTeX | Tags: *Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics & Numerical Data
@article{Zemek2016,
title = {Clinical Risk Score for Persistent Postconcussion Symptoms Among Children With Acute Concussion in the ED},
author = {Zemek, R and Barrowman, N and Freedman, S B and Gravel, J and Gagnon, I and McGahern, C and Aglipay, M and Sangha, G and Boutis, K and Beer, D and Craig, W and Burns, E and Farion, K J and Mikrogianakis, A and Barlow, K and Dubrovsky, A S and Meeuwisse, W and Gioia, G and {Meehan 3rd}, W P and Beauchamp, M H and Kamil, Y and Grool, A M and Hoshizaki, B and Anderson, P and Brooks, B L and Yeates, K O and Vassilyadi, M and Klassen, T and Keightley, M and Richer, L and DeMatteo, C and Osmond, M H and {Pediatric Emergency Research Canada Concussion}, Team},
year = {2016},
date = {2016-01-01},
journal = {JAMA},
volume = {315},
number = {10},
pages = {1014--1025},
abstract = {IMPORTANCE: Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE: To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS: Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-\<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES: All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES: The primary outcome was PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS: In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n=2006 in the derivation cohort; n=1057 in the validation cohort) and 2584 of whom (n=1701 [85%] in the derivation cohort; n=883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n=510 [30.0%] in the derivation cohort and n=291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95% CI, 0.69-0.74) for the derivation cohort and 0.68 (95% CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE: A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.},
keywords = {*Post-Concussion Syndrome/di [Diagnosis], Accidents, Adolescent, Age Factors, Area Under Curve, Athletic Injuries/co [Complications], Brain Concussion/di [Diagnosis], Brain Concussion/et [Etiology], Child, Emergency Service, Female, Follow-Up Studies, Hospital, Humans, Male, MEDICAL history taking, MULTIVARIATE analysis, Observer Variation, Outcome Assessment (Health Care), Post-Concussion Syndrome/et [Etiology], Preschool, Prospective Studies, RISK assessment, Sensitivity and Specificity, Sex Factors, Time Factors, Traffic/sn [Statistics \& Numerical Data},
pubstate = {published},
tppubtype = {article}
}
van der Horn, Harm J; Spikman, Jacoba M; Jacobs, Bram; van der Naalt, Joukje
Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury Journal Article
In: Archives of Physical Medicine & Rehabilitation, vol. 94, no. 5, pp. 867–874, 2013, ISBN: 00039993.
Abstract | BibTeX | Tags: *ANXIETY, *BRAIN -- Wounds & injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work
@article{VanderHorn2013,
title = {Postconcussive Complaints, Anxiety, and Depression Related to Vocational Outcome in Minor to Severe Traumatic Brain Injury},
author = {van der Horn, Harm J and Spikman, Jacoba M and Jacobs, Bram and van der Naalt, Joukje},
isbn = {00039993},
year = {2013},
date = {2013-01-01},
journal = {Archives of Physical Medicine \& Rehabilitation},
volume = {94},
number = {5},
pages = {867--874},
abstract = {Abstract: Objectives: To investigate the relation of postconcussive complaints, anxiety, and depression with vocational outcome in patients with traumatic brain injury (TBI) of various severities and to assess sex differences. Design: A prospective cross-sectional cohort study. Setting: Level I trauma center. Participants: Adults (N=242) with TBI of various severity. Interventions: Not applicable. Main Outcome Measures: Extended Glasgow Outcome Scale, return to work (RTW), Head Injury Symptom Checklist, and Hospital Anxiety and Depression Scale. Results: In 67% of the patients, complaints were present; 22% were anxious, and 18% were depressed. The frequency of complaints increased significantly with injury severity, in contrast to anxiety and depression. Frequencies of patients with anxiety and depression (9% and 5%) were lower with complete RTW than with incomplete RTW (42% and 37%; P\<.001). Patients with minor TBI with complaints were more anxious (50% vs 27%; P\<.05) and depressed (46% vs 23%; P\<.05) compared with patients with other severity categories and patients with incomplete RTW (67% vs 36% and 60% vs 30%, respectively). A higher percentage of women with minor TBI were depressed (45% vs 13%; P=.01) and had incomplete RTW (50% vs 18%; P\<.05) compared with men. Multiple regression analysis showed that injury severity, complaints, anxiety, and depression were all predictive of RTW (explained variance 45%). In all severity categories, anxiety and depression were predictive of RTW, complaints, and sex only for minor TBI. Conclusions: Anxiety and depression are related to vocational outcome after TBI, with a different profile in the minor TBI category, partly due to sex differences. Copyright \&y\& Elsevier},
keywords = {*ANXIETY, *BRAIN -- Wounds \& injuries, *EPIDEMIOLOGY, *MENTAL depression, *POSTCONCUSSION syndrome, Anxiety, CHI-squared test, COMPLICATIONS, computed tomography ( CT ), confidence interval ( CI ), CONFIDENCE intervals, CROSS-sectional method, DATA analysis, DATA analysis -- Software, depression, DESCRIPTIVE statistics, EMPLOYMENT (Economic theory) -- Psychological aspe, EMPLOYMENT reentry, Glasgow Coma Scale, Glasgow Coma Scale ( GCS ), Hospital Anxiety and Depression Scale ( HADS ), LONGITUDINAL method, MULTIVARIATE analysis, odds ratio ( OR ), PSYCHOLOGICAL aspects, Rehabilitation, return to work ( RTW ), sex, SEX distribution (Demography), STATISTICS, Traumatic Brain Injuries, traumatic brain injury ( TBI ), Work},
pubstate = {published},
tppubtype = {article}
}