Related Experiment Video
Updated: Jun 20, 2026
Controlled Cortical Impact Model for Traumatic Brain Injury
Published on: August 5, 2014
Cross-Validation of a Classification System for Persons With Traumatic Brain Injury in the Posthospital Period
Mark Sherer1, Jennie Ponsford, Amelia Hicks
1TIRR Memorial Hermann, Houston, Texas (Drs Sherer and Sander); Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, Texas (Drs Sherer and Sander); School of Psychological Sciences, Monash University and Epworth Hospital, Melbourne, Australia (Dr Ponsford and Ms Hicks); School of Public Health, University of Texas Health Science Center at Houston, Texas (Dr Leon-Novelo and Ms Ngan); Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Department of Psychiatry, Baylor College of Medicine, Houston, Texas (Dr Sander); and Physical Medicine and Rehabilitation, Harris Health System, Houston, Texas (Dr Sander).
Objective:
To (1) identify groupings of persons with traumatic brain injury (TBI) in the posthospital period in a cohort recruited in Australia; (2) compare groupings from the Australian cohort to groupings previously developed for a US cohort.
Setting:
Rehabilitation centers in the US and Australia.
Participants:
A total of 170 persons with TBI from Australia and 504 persons with TBI from the United States. Participants were aged 18 to 64 years, greater than 6 months postinjury, had capacity to give consent, and had definitive contemporaneous medical evidence of TBI.
Design:
Observational study.
Main Measures:
Cognitive tests-Wechsler Letter-Number Sequencing and Coding, Rey Auditory Verbal Learning Test, Trail Making Test, Verbal Fluency. Questionnaires-9 scales from the Traumatic Brain Injury Quality-of-Life system; Neurobehavioral Symptom Inventory; Economic Quality of Life, Family Assessment Device-General Functioning. Performance validity-Word Memory Test.
Results:
Agreement in classification for the 2 samples was only moderate with 63.5% correctly classified and Cohen's κ = 0.53. A post hoc analysis placing all persons showing poor performance validity in the same group improved classification to 73% and Cohen's κ = 0.65 indicating substantial agreement.
Conclusion:
Results provided support for the patient groups developed for the US sample and indicate that these groupings largely replicated in a new cohort.
