Measuring Pain in TBI: Development of the TBI-QOL Pain Interference Item Bank and Short Form

Noelle E Carlozzi; Pamela A Kisala; Aaron J Boulton; Elliot Roth; Anna L Kratz; Mark Sherer; Angelle M Sander; Allen W Heinemann; Nancy D Chiaravalloti; Tamara Bushnik; David S Tulsky

doi:10.1016/j.apmr.2019.07.019

Measuring Pain in TBI: Development of the TBI-QOL Pain Interference Item Bank and Short Form

Arch Phys Med Rehabil. 2020 Jan;101(1):11-19. doi: 10.1016/j.apmr.2019.07.019. Epub 2019 Sep 25.

Authors

Affiliations

¹ Department of Physical Medicine and Rehabilitation, University of Michigan, Ann Arbor, Michigan, United States.
² Center for Health Assessment Research and Translation, University of Delaware College of Health Sciences, Newark, Delaware, United States.
³ Shirley Ryan AbilityLab, Chicago, Illinois, United States; Northwestern University Feinberg School of Medicine, Department of Physical Medicine and Rehabilitation, Chicago, Illinois, United States.
⁴ Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas, United States.
⁵ Brain Injury Research Center, TIRR Memorial Hermann, Houston, Texas, United States; Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas, United States.
⁶ Kessler Foundation, East Hanover, New Jersey, United States.
⁷ Rusk Rehabilitation, NYU Langone, New York, New York, United States.
⁸ Center for Health Assessment Research and Translation, University of Delaware College of Health Sciences, Newark, Delaware, United States; Departments of Physical Therapy and Psychological & Brain Sciences, University of Delaware, Newark, Delaware, United States. Electronic address: dtulsky@udel.edu.

PMID: 31562878
DOI: 10.1016/j.apmr.2019.07.019

Abstract

Objective: To develop a pain interference item bank, computer adaptive test (CAT), and short form for use by individuals with traumatic brain injury (TBI).

Design: Cross-sectional survey study.

Setting: Five TBI Model Systems rehabilitation hospitals.

Participants: Individuals with TBI (N=590).

Interventions: Not applicable.

Outcome measures: Traumatic Brain Injury-Quality of Life (TBI-QOL) Pain Interference item bank.

Results: Confirmatory factor analysis provided evidence of a single underlying trait (χ² [740]=3254.030; P<.001; Comparative Fix Index=0.988; Tucker-Lewis Index=0.980; Root Mean Square Error of Approximation=0.076) and a graded response model (GRM) supported item fit of 40 Pain Interference items. Items did not exhibit differential item functioning or local item dependence. GRM calibration data were used to inform the selection of a 10-item static short form and to program a TBI-QOL Pain Interference CAT. Comparative analyses indicated excellent comparability and reliability across test administration formats.

Conclusion: The 40-item TBI-QOL Pain Interference item bank demonstrated strong psychometric properties. End users can administer this measure as either a 10-item short form or CAT.

Keywords: Brain injuries; Outcome assessment (health care); Pain; Quality of life; Rehabilitation; Surveys and questionnaires; traumatic.

Publication types

Research Support, N.I.H., Extramural
Research Support, U.S. Gov't, Non-P.H.S.
Validation Study

MeSH terms

Adult
Brain Injuries, Traumatic / complications
Brain Injuries, Traumatic / psychology*
Cross-Sectional Studies
Diagnosis, Computer-Assisted / standards*
Factor Analysis, Statistical
Female
Humans
Male
Middle Aged
Pain / diagnosis*
Pain / psychology
Pain Measurement / methods
Pain Measurement / standards*
Psychometrics
Quality of Life
Reproducibility of Results
Surveys and Questionnaires / standards*

Grants and funding

U01 AR057929/AR/NIAMS NIH HHS/United States