• Yelena G Bodien, Jason Barber, Sabrina R Taylor, Kim Boase, John D Corrigan, Sureyya Dikmen, Raquel C Gardner, Joel H Kramer, Harvey Levin, Joan Machamer, Thomas McAllister, Lindsay D Nelson, Laura B Ngwenya, Mark Sherer, Murray B Stein, Mary Vassar, John Whyte, John K Yue, Amy Markowitz, Michael A McCrea, Geoffrey T Manley, Nancy Temkin, and Joseph T Giacino.
• Massachusetts General Hospital, Boston, Massachusetts, USA.
• J. Neurotrauma. 2023 Feb 1; 40 (3-4): 337348337-348.

AbstractThe effects of traumatic brain injury (TBI) are difficult to measure in longitudinal cohort studies, because disparate pre-injury characteristics and injury mechanisms produce variable impairment profiles and recovery trajectories. In preparation for the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study, which followed patients with injuries ranging from uncomplicated mild TBI to coma, we designed a multi-dimensional Flexible outcome Assessment Battery (FAB). The FAB relies on a decision-making algorithm that assigns participants to a Comprehensive (CAB) or Abbreviated Assessment Battery (AAB) and guides test selection across all phases of recovery. To assess feasibility of the FAB, we calculated the proportion of participants followed at 2 weeks (2w) and at 3, 6, and 12 months (3m, 6m, 12m) post-injury who completed the FAB and received valid scores. We evaluated utility of the FAB by examining differences in 6m and 12m Glasgow Outcome Scale-Extended (GOSE) scores between participant subgroups derived from the FAB-enabled versus traditional approach to outcome assessment applied at 2w. Among participants followed at 2w (n = 2094), 3m (n = 1871), 6m (n = 1736), and 12m (n = 1607) post-injury, 95-99% received valid completion scores on the FAB, in full or in part, either in person or by telephone. Level of function assessed by the FAB-enabled approach at 2w was associated with 6m and 12m GOSE scores (proportional odds p < 0.001). These findings suggest that the participant classification methodology afforded by the FAB may enable more effective data collection to improve detection of natural history changes and TBI treatment effects.

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