• Military medicine · Feb 2020

    Single-Item Versus Multiple-Item Headache Ratings in Service Members Seeking Treatment for Brain Injury.

    • Lisa H Lu, Amy O Bowles, Jan E Kennedy, Blessen C Eapen, and Douglas B Cooper.
    • Defense and Veterans Brain Injury Center, Neurology Service, Brooke Army Medical Center, 3551 Roger Brooke Dr, JBSA Ft Sam Houston, TX 78234.
    • Mil Med. 2020 Feb 13; 185 (1-2): e43-e46.

    IntroductionHeadaches are the most common complaint after traumatic brain injury (TBI) and a significant cause of morbidity and disability among military personnel. Currently, there are a several measures which can assess headache disability, but there is a significant burden to assess each individual symptom given this heterogeneous polymorbid population. The objective of this proposed study was to validate the single headache item from the Neurobehavioral Symptom Inventory (NSI) compared to the 6-item Headache Impact Test (HIT-6).Materials And MethodsParticipants included consecutive treatment-seeking outpatients at the Brain Injury Rehabilitation Service at the Brooke Army Medical Center from August 2007 to January 2010 who were administered a battery of assessment measures at initial intake, as part of usual care. Archival record review was conducted using procedures approved by the local Institutional Review Board. Inclusionary criteria included completion of both the HIT-6 and NSI. Participants with a cut-off score of >22 on the NSI Validity-10 were excluded in a post hoc analysis to validate findings among those who passed validity screen.ResultsThe Pearson correlation between the single-item NSI headache measure and the HIT-6 revealed at least 64% shared variance in this military sample (r = 0.8, p < 0.001), indication a high association between the two measures.ConclusionThe NSI single-item headache measure adequately captured headache severity in this military cohort. Use of the single-item NSI headache measure may minimize survey burden on participants whose primary complaint is not headaches, or who present with multiple symptoms. Future studies are needed to validate the single-item headache measure in other samples.Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2019. This work is written by (a) US Government employee(s) and is in the public domain in the US.

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