Pre-injury assessment of everyday executive function in moderate to severe traumatic brain injury.
Tessa Hart, Amanda R Rabinowitz, John Whyte and 1 others
PMID 28832248WHAT IT FOUND
Family or friend raters gave more consistent pre-injury executive-function ratings than patients did after moderate to severe TBI.
They also rated patients as more impaired than patients rated themselves, both before and after injury.
Key findings
01For pre-injury ratings across 3 time points, family or friend ratings showed good consistency, while patient self-ratings were poor or moderate on some scales.
02The gap between family or friend ratings and patient self-ratings was significantly larger after injury than before injury.
03Family or friend raters marked more participants as abnormal than self-raters did, even in healthy controls.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The sample was relatively small, especially the 36 participants tested at 3, 6, and 12 months. The analyses were exploratory, with alpha set at .05. Before-injury ratings were retrospective, so memory and response shift could affect them. The researchers did not verify whether self or collateral reports were true. Collateral ratings were more consistent, but consistency does not prove accuracy. The FrSBe has not been studied as thoroughly in healthy people as in people with neurologic impairment. Controls were not tested longitudinally.
The easy way to misread this
Do not read family or friend ratings as more accurate just because they are more consistent. The study could not verify pre-injury reports, and family or friend raters also rated healthy controls as more impaired than the controls rated themselves.