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Incremental validity of neuropsychological evaluations to computed tomography scans for predicting long-term outcomes among persons with traumatic brain injury
Date of Award
Lisa J. Rapport
Research evaluating the incremental utility of neuropsychological tests to computed tomography (CT) in predicting long-term outcomes of traumatic brain injury (TBI) is sparse. The purpose of this study was to learn more about efficiently assessing and developing accurate prognoses for individuals with TBI, as well as to evaluate the incremental utility of neuropsychological evaluations to information obtained via CT. Participants were 288 adults with moderate to severe TBI who were assessed at the time of acute injury and inpatient rehabilitation stay, then followed at 1 and 2 years post injury. Predictors including demographic characteristics, injury severity, CT characteristics, and neuropsychological evaluations were regressed to outcomes of disability, functional independence, life satisfaction, and employment status at 1 and 2 years after injury. Prediction of life satisfaction was not improved with the use of CT characteristics or neuropsychological tests. However, hierarchical multiple regression analyses indicated that neuropsychological evaluations substantially contributed to outcome predictions of functional disability, even after considering demographic and injury severity characteristics, including information from CT: At 1 year post injury, neuropsychological evaluation showed a global effect; at 2-year follow up, specific neuropsychological indices showed unique predictive value (visuospatial, executive, and graphomotor processing speed), which likely reflects the recovery process of TBI. Over time, hallmark deficits of TBI that persist are most associated with functional ability. In contrast, CT characteristics were not predictive of long-term functional disability at 1 or 2 years post TBI. Results for overall functional independence were similar to those observed for functional disability, as were the results of logistic regressions that examined employment status at 1 and 2 years post injury. The findings highlight the utility and unique contributions of neuropsychological evaluation for predicting long-term functional outcome after TBI.
Williams, Michael William, "Incremental validity of neuropsychological evaluations to computed tomography scans for predicting long-term outcomes among persons with traumatic brain injury" (2011). Wayne State University Theses. 84.