Abstract
Objective: The Extended Glasgow Outcome Scale (GOS-E) is used for objective assessment of functional outcome in traumatic brain injury (TBI). In situations where face-to-face contact is not feasible, telephonic assessment of the GOS-E might be desirable. The aim of this study is to assess the level of agreement between face-to-face and telephonic assessment of the GOS-E.
Setting: Multicenter study in 2 Dutch University Medical Centers. Inclusion was performed in the outpatient clinic (face-to-face assessment, by experienced neurologist), followed by assessment via telephone of the GOS-E after +/-2 weeks (by trained researcher).
Participants: Patients +/-6 months after TBI.
Design: Prospective validation study.
Main Measures: Interrater agreement of the GOS-E was assessed with Cohen's weighted [kappa].
Results: From May 2014 until March 2018, 50 patients were enrolled; 54% were male (mean age 49.1 years). Median time between trauma and in-person GOS-E examination was 158 days and median time between face-to-face and telephonic GOS-E was 15 days. The quadratic weighted [kappa] was 0.79. Sensitivity analysis revealed a quadratic weighted [kappa] of 0.77, 0.78, and 0.70 for moderate-severe, complicated mild, and uncomplicated mild TBI, respectively.
Conclusion: No disagreements of more than 1 point on the GOS-E were observed, with the [kappa] value representing good or substantial agreement. Assessment of the GOS-E via telephone is a valid alternative to the face-to-face interview when in-person contact is not feasible.