Brain Injury Functional Outcome Measure (BI-FOM): A Single Instrument Capturing the Range of Recovery in Moderate-Severe Traumatic Brain Injury.
John Whyte, Joseph T Giacino, Allen W Heinemann and 9 others
PMID 33022273WHAT IT FOUND
A new 31-item measure tracks recovery from moderate to severe brain injury more accurately than standard scales.
It captures patients who are nearly normal and those with profound impairment, avoiding the common problem where scores bunch up at the very top or bottom.
Key findings
01The new measure reduced the percentage of patients whose scores stuck at the extreme low or high ends from 14.1% to 2.7%.
02The new measure covers a wider range of functional ability (14.98 logits) compared to the standard Functional Independence Measure (11.71 logits).
03All items except those assessing consciousness levels can be administered via telephone, increasing feasibility for follow-up.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was conducted at specialized rehabilitation centers, so results may not apply to patients treated in less specialized settings. The measure was developed for moderate to severe brain injury and its sensitivity for mild TBI is unknown. Patients with disorders of consciousness were underrepresented in the sample. The measure still has a slight ceiling effect (2.7% of patients scored at the maximum), meaning it may not distinguish between exceptional and normal function. Some items require in-person administration, limiting full telephone use for patients with disorders of consciousness.
The easy way to misread this
Do not assume this measure replaces specialized cognitive or communication assessments. It is a global functional scale, and specific domains like detailed cognitive testing or aphasia severity still require dedicated instruments.