title: Development and external validation of a new PTA assessment scale.
abstract: BACKGROUND
  Post-traumatic amnesia (PTA) is a key symptom of traumatic brain injury (TBI). Accurate assessment of PTA is imperative in guiding clinical decision making. Our aim was to develop and externally validate a short, examiner independent and practical PTA scale, by selecting the most discriminative items from existing scales and using a three-word memory test.
  
  
  METHODS
  Mild, moderate and severe TBI patients and control subjects were assessed in two separate cohorts, one for derivation and one for validation, using a questionnaire comprised of items from existing PTA scales. We tested which individual items best discriminated between TBI patients and controls, represented by sensitivity and specificity. We then created our PTA scale based on these results. This new scale was externally evaluated for its discriminative value using Receiver Operating Characteristic (ROC) analysis and compared to existing PTA scales.
  
  
  RESULTS
  The derivation cohort included 126 TBI patients and 31 control subjects; the validation cohort consisted of 132 patients and 30 controls. A set of seven items was eventually selected to comprise the new PTA scale: age, name of hospital, time, day of week, month, mode of transport and recall of three words. This scale demonstrated adequate discriminative values compared to existing PTA scales on three consecutive administrations in the validation cohort.
  
  
  CONCLUSIONS
  We introduce a valid, practical and examiner independent PTA scale, which is suitable for mild TBI patients at the emergency department and yet still valuable for the follow-up of more severely injured TBI patients.
authors.affiliation: Department of Neurology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.
authors.forename: Bram
authors.initials: B
authors.lastname: Jacobs
authors.forename: Janneke
authors.initials: J
authors.lastname: van Ekert
authors.forename: Lotje Pl
authors.initials: LP
authors.lastname: Vernooy
authors.forename: Peter
authors.initials: P
authors.lastname: Dieperink
authors.forename: Teuntje M J C
authors.initials: TM
authors.lastname: Andriessen
authors.forename: Marc P H
authors.initials: MP
authors.lastname: Hendriks
authors.forename: Arie B
authors.initials: AB
authors.lastname: van Vugt
authors.forename: Marjolein A A
authors.initials: MA
authors.lastname: Emons
authors.forename: George F
authors.initials: GF
authors.lastname: Borm
authors.forename: Pieter E
authors.initials: PE
authors.lastname: Vos
mesh_terms: D000328:Adult; D000647:Amnesia / Q000175:diagnosis* / Q000209:etiology*; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009483:Neuropsychological Tests; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index