title: The Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI): II. Reliability and convergent validity.
abstract: A standardized measure of neurological dysfunction specifically designed for TBI currently does not exist and the lack of assessment of this domain represents a substantial gap. To address this, the Neurological Outcome Scale for Traumatic Brain Injury (NOS-TBI) was developed for TBI outcomes research through the addition to and modification of items specifically relevant to patients with TBI, based on the National Institutes of Health Stroke Scale. In a sample of 50 participants (mean age = 33.3 years, SD = 12.9) <or=18 months (mean = 3.1, SD = 3.2) following moderate (n = 8) to severe (n = 42) TBI, internal consistency of the NOS-TBI was high (Cronbach's alpha = 0.942). Test-retest reliability also was high (rho = 0.97, p < 0.0001), and individual item kappas between independent raters were excellent, ranging from 0.83 to 1.0. Overall inter-rater agreement between independent raters (Kendall's coefficient of concordance) for the NOS-TBI total score was excellent (W = 0.995). Convergent validity was demonstrated through significant Spearman rank-order correlations between the NOS-TBI and the concurrently administered Disability Rating Scale (rho = 0.75, p < 0.0001), Rancho Los Amigos Scale (rho = -0.60, p < 0.0001), Supervision Rating Scale (rho = 0.59, p < 0.0001), and the FIM (rho = -0.68, p < 0.0001). These results suggest that the NOS-TBI is a reliable and valid measure of neurological functioning in patients with moderate to severe TBI.
authors.affiliation: Physical Medicine and Rehabilitation Alliance of Baylor College of Medicine and the University of Texas-Houston Medical School, and the Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA. mccauley@bcm.edu
authors.forename: Stephen R
authors.initials: SR
authors.lastname: McCauley
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Wilde
authors.forename: Tara M
authors.initials: TM
authors.lastname: Kelly
authors.forename: Annie M
authors.initials: AM
authors.lastname: Weyand
authors.forename: Ragini
authors.initials: R
authors.lastname: Yallampalli
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Waldron
authors.forename: Claudia
authors.initials: C
authors.lastname: Pedroza
authors.forename: Kathleen P
authors.initials: KP
authors.lastname: Schnelle
authors.forename: Corwin
authors.initials: C
authors.lastname: Boake
authors.forename: Harvey S
authors.initials: HS
authors.lastname: Levin
authors.forename: Paolo
authors.initials: P
authors.lastname: Moretti
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001930:Brain Injuries / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009460:Neurologic Examination / Q000379:methods*; D015203:Reproducibility of Results; D015599:Trauma Severity Indices; D016896:Treatment Outcome