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Concussion Rehabilitation

Systematic Review ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Neurol. | doi: 10.3389/fneur.2019.00353

Measuring change over time: A systematic review of evaluative measures of cognitive functioning in traumatic brain injury.

 Andrea D'Souza1, Shirin Mollayeva2, Nicole Pacheco3,  Fiza Javed4,  Angela Colantonio1 and  Tatyana Mollayeva5, 6*
  • 1Rehabilitation Sciences Institute, University of Toronto, Canada
  • 2Acquired Brain Injury Research Lab, University of Toronto, Canada
  • 3McMaster University, Canada
  • 4University of Toronto Mississauga, Canada
  • 5Toronto Rehabilitation Institute, University Health Network, Canada
  • 6Department of Occupational Science and Occupational Therapy, University of Toronto, Canada

Objectives: The purpose of evaluative instruments is to measure the magnitude of change in a construct of interest over time. The measurement properties of these instruments, as they relate to the instrument’s ability to fulfil its purpose, determine the degree of certainty with which the results yielded can be viewed. This work systematically reviews all instruments that have been used to evaluate cognitive functioning in persons with traumatic brain injury (TBI), and critically assesses their evaluative measurement properties: construct validity, test-retest reliability, and responsiveness.

Data Sources: MEDLINE, Central, EMBASE, Scopus, PsycINFO were searched from inception to December 2016 to identify longitudinal studies focused on cognitive evaluation of persons with TBI, from which instruments used for measuring cognitive functioning were abstracted. MEDLINE, instrument manuals, and citations of articles identified in the primary search were then screened for studies on measurement properties of instruments utilised at least twice within the longitudinal studies.

Study Selection: All English-language, peer-reviewed studies of longitudinal design that measured cognition in adults with a TBI diagnosis over any period of time, identified in the primary search, were used to identify instruments. A secondary search was carried out to identify all studies that assessed the evaluative measurement properties of the instruments abstracted in the primary search.

Data Extraction: Data on psychometric properties, cognitive domains covered and clinical utility were extracted for all instruments.

Results: In total, 38 longitudinal studies from the primary search, utilizing 15 instruments, met inclusion and quality criteria. Following review of studies identified in the secondary search, it was determined that none of the instruments utilized had been assessed for all the relevant measurement properties in the TBI population. The most frequently assessed property was construct validity.

Conclusions: There is insufficient evidence for the validity and reliability of instruments measuring cognitive functioning, longitudinally, in persons with TBI. Several instruments with well-defined construct validity in TBI samples warrant further assessment for test-retest reliability and responsiveness.

Registration Number: CRD42017055309

Keywords: Measurements, Neuropsychological Tests, Psychometrics, Clinimetrics, Systematic review

Received: 22 Oct 2018; Accepted: 22 Mar 2019.

Edited by:

Karen M. Barlow, University of Queensland, Australia

Reviewed by:

Marina Zettin, Centro Puzzle, Italy
David F. Tate, School of Medicine, University of Utah, United States  

Copyright: © 2019 D'Souza, Mollayeva, Pacheco, Javed, Colantonio and Mollayeva. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Dr. Tatyana Mollayeva, Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada,