Assessment of Health-Related Quality of Life after TBI: Comparison of a Disease-Specific (QOLIBRI) with a Generic (SF-36) Instrument

Nicole von Steinbuechel, Amra Covic, Suzanne Polinder, Thomas Kohlmann, Ugne Cepulyte, Herbert Poinstingl, Joy Backhaus, Wilbert Bakx, Monika Bullinger, Anne-Lise Christensen, Rita Formisano, Henning Gibbons, Stefan Höfer, Sanna Koskinen, Andrew Maas, Edmund Neugebauer, Jane Powell, Jaana Sarajuuri, Nadine Sasse, Silke Schmidt, Holger Mühlan, Klaus von Wild, George Zitnay, Jean-Luc Truelle, Nicole von Steinbuechel, Amra Covic, Suzanne Polinder, Thomas Kohlmann, Ugne Cepulyte, Herbert Poinstingl, Joy Backhaus, Wilbert Bakx, Monika Bullinger, Anne-Lise Christensen, Rita Formisano, Henning Gibbons, Stefan Höfer, Sanna Koskinen, Andrew Maas, Edmund Neugebauer, Jane Powell, Jaana Sarajuuri, Nadine Sasse, Silke Schmidt, Holger Mühlan, Klaus von Wild, George Zitnay, Jean-Luc Truelle

Abstract

Psychosocial, emotional, and physical problems can emerge after traumatic brain injury (TBI), potentially impacting health-related quality of life (HRQoL). Until now, however, neither the discriminatory power of disease-specific (QOLIBRI) and generic (SF-36) HRQoL nor their correlates have been compared in detail. These aspects as well as some psychometric item characteristics were studied in a sample of 795 TBI survivors. The Shannon H (') index absolute informativity, as an indicator of an instrument's power to differentiate between individuals within a specific group or health state, was investigated. Psychometric performance of the two instruments was predominantly good, generally higher, and more homogenous for the QOLIBRI than for the SF-36 subscales. Notably, the SF-36 "Role Physical," "Role Emotional," and "Social Functioning" subscales showed less satisfactory discriminatory power than all other dimensions or the sum scores of both instruments. The absolute informativity of disease-specific as well as generic HRQoL instruments concerning the different groups defined by different correlates differed significantly. When the focus is on how a certain subscale or sum score differentiates between individuals in one specific dimension/health state, the QOLIBRI can be recommended as the preferable instrument.

Figures

Figure 1
Figure 1
Shannon indices H′ (confidence intervals 95%) of all QOLIBRI and SF-36 subscales, QOLIBRI Total score and summary scores.
Figure 2
Figure 2
Shannon indices H′ (confidence intervals 95%) of all QOLIBRI and SF-36 subscales, QOLIBRI Total score and MCS and PCS for the correlates: Help Needed and Social Activities.
Figure 3
Figure 3
Shannon indices H′ (confidence intervals 95%) of all QOLIBRI and SF-36 subscales, QOLIBRI Total score and MCS and PCS for the correlates: Comorbidity, Sensory/Psychosomatic and Motor/Skeletal Complaints.
Figure 4
Figure 4
Shannon indices H′ (confidence intervals 95%) of all QOLIBRI and SF-36 subscales, QOLIBRI Total score and MCS and PCS for the correlate GOSE scores.
Figure 5
Figure 5
Shannon indices H′ (confidence intervals 95%) of all QOLIBRI and SF-36 subscales, QOLIBRI Total score and MCS and PCS for the correlate HADS Depression scores.
Figure 6
Figure 6
Shannon indices H′ (confidence intervals 95%) of all QOLIBRI and SF-36 subscales, QOLIBRI Total score and PCS and MCS for the correlate HADS Anxiety scores.

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