title: Cross-Validation of a Classification System for Persons With Traumatic Brain Injury in the Posthospital Period.
abstract: To (1) identify groupings of persons with traumatic brain injury (TBI) in the posthospital period in a cohort recruited in Australia; (2) compare groupings from the Australian cohort to groupings previously developed for a US cohort.
  
  
  
  Rehabilitation centers in the US and Australia.
  
  
  
  A total of 170 persons with TBI from Australia and 504 persons with TBI from the United States. Participants were aged 18 to 64 years, greater than 6 months postinjury, had capacity to give consent, and had definitive contemporaneous medical evidence of TBI.
  
  
  
  Observational study.
  
  
  
  Cognitive tests-Wechsler Letter-Number Sequencing and Coding, Rey Auditory Verbal Learning Test, Trail Making Test, Verbal Fluency. Questionnaires-9 scales from the Traumatic Brain Injury Quality-of-Life system; Neurobehavioral Symptom Inventory; Economic Quality of Life, Family Assessment Device-General Functioning. Performance validity-Word Memory Test.
  
  
  
  Agreement in classification for the 2 samples was only moderate with 63.5% correctly classified and Cohen's κ = 0.53. A post hoc analysis placing all persons showing poor performance validity in the same group improved classification to 73% and Cohen's κ = 0.65 indicating substantial agreement.
  
  
  
  Results provided support for the patient groups developed for the US sample and indicate that these groupings largely replicated in a new cohort.
authors.affiliation: TIRR Memorial Hermann, Houston, Texas (Drs Sherer and Sander); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas (Drs Sherer and Sander); School of Psychological Sciences, Monash University and Epworth Hospital, Melbourne, Australia (Dr Ponsford and Ms Hicks); School of Public Health, University of Texas Health Science Center at Houston, Texas (Dr Leon-Novelo and Ms Ngan); Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Department of Psychiatry, Baylor College of Medicine, Houston, Texas (Dr Sander); and Physical Medicine and Rehabilitation, Harris Health System, Houston, Texas (Dr Sander).
authors.forename: Mark
authors.initials: M
authors.lastname: Sherer
authors.forename: Jennie
authors.initials: J
authors.lastname: Ponsford
authors.forename: Amelia
authors.initials: A
authors.lastname: Hicks
authors.forename: Luis
authors.initials: L
authors.lastname: Leon-Novelo
authors.forename: Esther
authors.initials: E
authors.lastname: Ngan
authors.forename: Angelle M
authors.initials: AM
authors.lastname: Sander
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D000070642:Brain Injuries, Traumatic / Q000145:classification* / Q000175:diagnosis / Q000534:rehabilitation*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010351:Patient Discharge; D011788:Quality of Life; D012047:Rehabilitation Centers; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States; D055815:Young Adult