The Predictive Validity of a Brief Inpatient Neuropsychologic Battery for Persons With Traumatic Brain Injury

Hanks RA, Millis SR, Ricker JH, Giacino JT, Nakese-Richardson R, Frol AB, Novack TA, Kalmar K, Sherer M, Gordon WA. The predictive validity of a brief inpatient neuropsychologic battery for persons with traumatic brain injury. Objective To examine the predictive validity of a brief neuropsychologic test battery consisting of the Galveston Orientation and Amnesia Test, the California Verbal Learning Test–II, Trail-Making Test (TMT), Symbol Digit Modalities Test, grooved pegboard, phonemic and categorical word generation tasks, the Wechsler Test of Adult Reading (WTAR), and the Wisconsin Card Sorting Test–64 relative to functional outcome at 1 year in persons with traumatic brain injury. Design Inception cohort study. Follow-up period of 12 months. Setting Seven Traumatic Brain Injury Model System centers. Neuropsychologic testing was conducted during the acute inpatient rehabilitation stay and functional outcome measures were obtained at 1-year outpatient follow-up. Participants Adults (N=174) who met criteria for admission to inpatient brain injury rehabilitation. Interventions Not applicable. Main Outcome Measures FIM instrument, Disability Rating Scale, Supervision Rating Scale, Satisfaction With Life Scale (SWLS), and Glasgow Outcome Scale−Extended. Results Multiple regression analyses revealed that performance on the neuropsychologic test battery was predictive of outcome at 1 year postinjury for all outcome measures, except FIM motor scores and the SWLS. Cognitive performance using this battery was found to predict 1-year outcomes above and beyond functional variables and injury severity variables collected during inpatient rehabilitation, thereby indicating incremental validity for this test battery. Individual tests that were found to be significant predictors of 1-year outcomes included the WTAR and TMT part B. Conclusions These findings support the clinical utility and ecological validity of this battery with respect to level of disability, functional independence, and supervision required.