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Abstract：
The Glasgow Outcome Scale-Extended (GOSE) is one of the most widely used measures of functional limitations after traumatic brain injury (TBI), and is the primary outcome measure used in clinical trials of acute TBI treatment. However, the GOSE appears insensitive to the full spectrum of TBI-related functional limitations, which may limit its potential to capture treatment effects or correlate with other variables that impact outcome. The Functional Status Examination (FSE) was designed to improve on the assessment of injury-related functional limitations using a standardized assessment and wider possible score range. The aim of this pilot study was to employ item response theory (IRT) to test the hypothesis that the FSE yields more precise estimation of functional outcome than the GOSE. Traumatically injured patients (n = 100, 77 TBI, 23 orthopedic injuries) were interviewed at 3 months post-injury using both the GOSE and FSE structured interviews. IRT was used to quantify and compare the tests\' information functions, which reflect the degree to which each instrument precisely measures functional limitations across the severity spectrum. Findings were consistent with predictions: the FSE yielded stronger measurement of functional limitations (i.e., higher test information) across a wider range of severity than the GOSE, whether scoring the GOSE from all interview items or using the traditional GOSE overall score. Although the FSE appears to be a promising alternative measure to the GOSE, further research is needed to cross-validate these findings in a larger sample and understand how to best deploy it in clinical and translational research.
摘要：
格拉斯哥结果扩展量表（GOSE）是创伤性脑损伤（TBI）后最广泛使用的功能限制指标之一，并且是急性TBI治疗临床试验中使用的主要结果指标。然而,GOSE似乎对TBI相关的全部功能限制不敏感，这可能会限制其捕获治疗效果或与影响结果的其他变量相关的潜力。功能状态检查（FSE）旨在使用标准化评估和更广泛的评分范围来改善与损伤相关的功能限制的评估。这项初步研究的目的是采用项目响应理论（IRT）来检验以下假设：FSE比GOSE对功能结果的估计更精确。创伤患者（n=100，77TBI，使用GOSE和FSE结构化访谈在受伤后3个月对23例骨科损伤进行了访谈。IRT用于量化和比较测试信息函数，这反映了每个仪器在严重性范围内精确测量功能限制的程度。研究结果与预测一致：FSE对功能限制产生了更强的测量(即，更高的测试信息)比GOSE更广泛的严重性范围，无论是从所有面试项目中评分GOSE，还是使用传统的GOSE总分。尽管FSE似乎是GOSE的有希望的替代措施，需要进一步的研究在更大的样本中交叉验证这些发现,并了解如何在临床和转化研究中最好地应用这些发现.
