title: Relating quality of life to Glasgow outcome scale health states.
abstract: There has recently been a call for the adoption of comparative effectiveness research (CER) and related research approaches for studying traumatic brain injury (TBI). These methods allow researchers to compare the effectiveness of different therapies in producing patient-oriented outcomes of interest. Heretofore, the only measures by which to compare such therapies have been mortality and rate of poor outcome. Better comparisons can be made if parametric, preference-based quality-of-life (QOL) values are available for intermediate outcomes, such as those described by the Glasgow Outcome Scale Extended (GOSE). Our objective was therefore to determine QOL for the health states described by the GOSE. We interviewed community members at least 18 years of age using the standard gamble method to assess QOL for descriptions of GOSE scores of 2-7 derived from the structured interview. Linear regression analysis was also performed to assess the effect of age, gender, and years of education on QOL. One hundred and one participants between the ages of 18 and 83 were interviewed (mean age 40 ± 19 years), including 55 men and 46 women. Functional impairment and QOL showed a strong inverse relationship, as assessed by both linear regression and the Spearman rank order coefficient. No consistent effect or age, gender, or years of education was seen. As expected, QOL decreased with functional outcome as described by the GOSE. The results of this study will provide the groundwork for future groups seeking to apply CER methods to clinical studies of TBI.
authors.affiliation: Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kosty
authors.forename: Luke
authors.initials: L
authors.lastname: Macyszyn
authors.forename: Kevin
authors.initials: K
authors.lastname: Lai
authors.forename: James
authors.initials: J
authors.lastname: McCroskery
authors.forename: Hae-Ran
authors.initials: HR
authors.lastname: Park
authors.forename: Sherman C
authors.initials: SC
authors.lastname: Stein
mesh_terms: D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000175:diagnosis / Q000523:psychology / Q000534:rehabilitation*; D057186:Comparative Effectiveness Research / Q000379:methods* / Q000592:standards; D005260:Female; D023261:Glasgow Outcome Scale / Q000592:standards*; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic / Q000379:methods / Q000592:standards; D008297:Male; D008875:Middle Aged; D011785:Quality Assurance, Health Care / Q000379:methods / Q000592:standards; D011788:Quality of Life / Q000523:psychology*; D055815:Young Adult