title: Use of the King's Outcome Scale for Childhood Head Injury in the evaluation of outcome in childhood traumatic brain injury.
abstract: OBJECTIVE
  To examine the inter-rater reliability of The King's Outcome Scale for Childhood Head Injury (KOSCHI) with clinicians of varying experience in paediatric traumatic brain injury (TBI); and to examine change in outcome during long-term follow-up of children following traumatic brain injury (TBI) using KOSCHI.
  
  
  METHODS
  Retrospective assessment of detailed clinic reports of 97 children followed-up by a tertiary specialist paediatric brain injury service. Investigators were blinded to each other's scores.
  
  
  RESULTS
  Inter-rater reliability was substantial (weighted kappa 0.71) and similar for investigators of varying experience. KOSCHI outcome was strongly associated with markers of injury severity (p = 0.028). In longitudinal follow-up, KOSCHI score worsened in 7 (23%) children who were injured under 8 years but in no older children (p = 0.02).
  
  
  CONCLUSIONS
  KOSCHI has high inter-rater reliability for investigators of different experience. Long-term KOSCHI outcome is associated with injury severity. Some young children may develop worse disability over time.
authors.affiliation: Kids Rehab, The Children's Hospital at Westmead, Westmead, Sydney, New South Wales, Australia. simon.paget@health.nsw.gov.au
authors.forename: Simon Paul
authors.initials: SP
authors.lastname: Paget
authors.forename: Alexander William John
authors.initials: AW
authors.lastname: Beath
authors.forename: Elizabeth Helen
authors.initials: EH
authors.lastname: Barnes
authors.forename: Mary-Clare
authors.initials: MC
authors.lastname: Waugh
mesh_terms: D000293:Adolescent; D001930:Brain Injuries / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000175:diagnosis*; D005260:Female; D005500:Follow-Up Studies; D023261:Glasgow Outcome Scale; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D015203:Reproducibility of Results; D012189:Retrospective Studies