Traumatic
Brain
Injury
Assessment
Conceptualization
Therapeutic
Intervention
Options
Narrative
TBI ACTION Version 1.2 - NEW WEBSITE
TBI ACTION is a web-based resource that is intended to aid clinicians working with persons with TBI with developing case conceptualizations and considering treatment options. Development of TBI ACTION was funded by a Rehabilitation Research Training Center grant (H133B090023) from the National Institute on Disability and Rehabilitation Research (NIDRR) to TIRR Memorial Hermann.
TIRR Memorial Hermann, Baylor College of Medicine, and Harris Health System, Houston, Texas
Mark Sherer, Ph.D., Project Principal Investigator
Angelle Sander, Ph.D., Grant Principal Investigator
Wayne State University Medical School and Rehabilitation Institute of Michigan, Detroit, Michigan
Robin Hanks, Ph.D., Local Site Principal Investigator
University of Alabama – Birmingham, Birmingham, Alabama
Thomas A. Novack, Ph.D. Local Site Principal Investigator
University of Delaware College of Health Sciences in Newark, Delaware
David S. Tulsky, Ph.D. Consultant
Pamela Kisala, M.A.
University of Arkansas for Medical Sciences in Little Rock, Arkansas
Todd G. Nick, Ph.D., Project Biostatistician
Maria Melguizo, M.S.
Development of the TBI ACTION system was based on data collected from 504 persons with medically documented TBI who were given an extensive battery of cognitive tests and questionnaires. Study participants were community dwelling and all had capacity to give their own consent for this investigation. The initial analysis of data from this group resulted in identification of 12 dimensions of the experience of persons in the post-hospital period of recovery. Further analysis of dimension scores for the 504 participants resulted in 5 clusters of persons with TBI that differed on dimensions scores as well as on participation (community integration) status. Finally, an expert consensus conference attended by nationally recognized experts in TBI rehabilitation was held in Galveston, Texas in May, 2014. The expert panel developed case conceptualizations as well as possible treatment options for each cluster.
The original cluster analysis of the 504 person cohort did not result in all persons with poor performance validity being assigned to Cluster 5. Based on analysis of data from a new cohort of persons with TBI, we determined that this might result in suboptimal findings. To remedy this problem, we changed the website programming so that all persons who showed poor performance validity on the Word Memory Test using the standard criteria were assigned to Group 5. We excluded 13 persons who did have full Word Memory Test data whose missing data had been imputed for the original cluster analysis. This new analysis had a substantial effect on the mean profile for persons in Group 5. We next recomputed the cluster analysis for the first four clusters. The profiles of these four clusters showed essentially no change from the original cluster analysis. As a result, we have substantially modified the report for Group 5, but no more that very minor changes were made to the reports for Groups 1 to 4. More recently, changes were made to formulae for calculating and displaying respondents’ profiles and scores to ensure that these scores are easily interpreted. If you have any questions regarding the differences between the original TBI ACTION website and TBI ACTION version 1.2, please contact Mark Sherer at Mark.Sherer@memorialhermann.org.
Tests/Questionnaires that Determine the 12 Dimensions
Dimension
Measures
Memory
WAIS-IV Letter Number Sequencing
Rey Auditory Verbal Learning Test Trials I-V Total
Cognitive Process Speed
Trailmaking Test Part A
WAIS-IV Coding
Verbal Fluency
FAS Letter Fluency Test
Self-reported Cognitive Impairment
TBI-QOL Cognition – General Concerns
Independence and Self-esteem
TBI-QOL Self-esteem
TBI-QOL Independence
Resilience
TBI-QOL Resilience
Emotional Distress
TBI-QOL Anxiety
TBI-QOL Emotional and Behavioral Dyscontrol
Postconcussive Symptoms
Neurobehavioral Symptoms Inventory
Physical Symptoms
TBI-QOL Headache
TBI-QOL Pain Interference
Physical Functioning
TBI-QOL Upper Extremity
Economic and Family Support
Economic Quality of Life, Family Assessment
Device General Functioning Scale
Performance Validity
Word Memory Test
Clinicians working with persons with TBI can administer (or have administered) the 5 cognitive tests and the Word Memory Test and then have their client complete the 12 questionnaires on line. The clinician will then be provided a case conceptualization and treatment options for the cluster group to which the client is most similar. These materials are intended to be used as an aid to clinical reasoning and planning when combined with clinician judgment and other sources of information. No personal health information or identifying information is entered. Users are not tracked in anyway so use of this website is completely confidential and both client and clinician privacy are protected. There is no charge for using the TBI ACTION website.
Case conceptualizations and treatment options provided by this website are meant to be an aid to clinical care for persons with TBI. They are meant to supplement rather than replace clinician judgment and they are not intended for use in disability determination, litigation, or other contexts.
The contents of this website were developed under grants from the National Institute on Disability, Independent Living, and Rehabilitation Research (NIDILRR grant numbers 90RT5007 and 90DP0028). NIDILRR is a Center within the Administration for Community Living (ACL), Department of Health and Human Services (HHS). The contents of this website do not necessarily represent the policy of NIDILRR, ACL, HHS, and you should not assume endorsement by the Federal Government.
