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Auteur John Whyte |
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Brain Injury Functional Outcome Measure (BI-FOM): A Single Instrument Capturing the Range of Recovery in Moderate-Severe Traumatic Brain Injury / John Whyte in Archives of Physical Medicine and Rehabilitation, Vol. 102, n° 1 (2021)
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Titre : Brain Injury Functional Outcome Measure (BI-FOM): A Single Instrument Capturing the Range of Recovery in Moderate-Severe Traumatic Brain Injury Type de document : Article Auteurs : John Whyte ; Joseph T. Giacino ; Allen W. Heinemann ; Yelena G. Bodien ; Tessa Hart ; Mark Sherer ; Gale G. Whiteneck ; David Mellick ; Flora M. Hammond ; Patrick Semik ; Amy Rosenbaum ; Risa Nakase-Richardson Année de publication : 2021 Article en page(s) : p. 87-96 Note générale : https://doi.org/10.1016/j.apmr.2020.09.377 Langues : Anglais (eng) Descripteurs : HE Vinci
Évaluation des résultats des patients ; Lésions encéphaliques ; RéadaptationRésumé : Objective
To develop a measure of global functioning after moderate-severe TBI with similar measurement precision but a longer measurement range than the FIM.
Design
Phase 1: retrospective analysis of 5 data sets containing FIM, Disability Rating Scale, and other assessment items to identify candidate items for extending the measurement range of the FIM; Phase 2: prospective administration of 49 candidate items from phase 1, with Rasch analysis to identify a unidimensional scale with an extended range.
Setting
Six TBI Model System rehabilitation hospitals.
Participants
Individuals (N=184) with moderate-severe injury recruited during inpatient rehabilitation or at 1-year telephone follow-up.
Interventions
Participants were administered the 49 assessment items in person or via telephone.
Main Outcome Measures
Item response theory parameters: item monotonicity, infit/outfit statistics, and Factor 1 variance.
Results
After collapsing misordered rating categories and removing misfitting items, we derived the Brain Injury Functional Outcome Measure (BI-FOM), a 31-item assessment instrument with high reliability, greatly extended measurement range, and improved unidimensionality compared with the FIM.
Conclusions
The BI-FOM improves global measurement of function after moderate-severe brain injury. Its high precision, relative lack of floor and ceiling effects, and feasibility for telephone follow-up, if replicated in an independent sample, are substantial advantages.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=264117
in Archives of Physical Medicine and Rehabilitation > Vol. 102, n° 1 (2021) . - p. 87-96[article]Cost-Benefit Analysis From the Payors Perspective for Screening and Diagnosing Obstructive Sleep Apnea During Inpatient Rehabilitation for Moderate to Severe TBI / Risa Nakase-Richardson in Archives of Physical Medicine and Rehabilitation, Vol. 101, n° 9 (2020)
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Titre : Cost-Benefit Analysis From the Payors Perspective for Screening and Diagnosing Obstructive Sleep Apnea During Inpatient Rehabilitation for Moderate to Severe TBI Type de document : Périodique Auteurs : Risa Nakase-Richardson ; Jeanne M. Hoffman ; Ulysses J. Magalang ; Emily Almeida ; Daniel J. Schwartz ; Leah Drasher-Phillips ; Jessica M. Ketchum ; John Whyte ; Jennifer A. Bogner ; Clara E. Dismuke-Greer Année de publication : 2020 Article en page(s) : p. 1497-1508 Note générale : https://doi.org/10.1016/j.apmr.2020.03.020 Langues : Anglais (eng) Descripteurs : HE Vinci
Analyse coût-bénéfice ; Encephale ; Plaies et blessures ; Polysomnographie ; Réadaptation ; Syndromes d'apnées du sommeilRésumé : Objective
To describe the cost benefit of 4 different approaches to screening for sleep apnea in a cohort of participants with moderate to severe traumatic brain injury (TBI) receiving inpatient rehabilitation from the payors perspective.
Design
A cost-benefit analysis of phased approaches to sleep apnea diagnosis.
Setting
Six TBI Model System Inpatient Rehabilitation Centers.
Participants
Trial data from participants (N=214) were used in analyses (mean age 44±18y, 82% male, 75% white, with primarily motor vehiclerelated injury [44%] and falls [33%] with a sample mean emergency department Glasgow Coma Scale of 8±5).
Intervention
Not applicable.
Main Outcome
Cost benefit.
Results
At apnea-hypopnea index (AHI) ≥15 (34%), phased modeling approaches using screening measures (Snoring, Tired, Observed, Blood Pressure, Body Mass Index, Age, Neck Circumference, and Gender [STOPBANG] [$5291], Multivariable Apnea Prediction Index MAPI [$5262]) resulted in greater cost savings and benefit relative to the portable diagnostic approach ($5210) and initial use of laboratory-quality polysomnography ($5,011). Analyses at AHI≥5 (70%) revealed the initial use of portable testing ($6323) relative to the screening models (MAPI [$6250], STOPBANG [$6237) and initial assessment with polysomnography ($5977) resulted in greater savings and cost-effectiveness.
Conclusions
The high rates of sleep apnea after TBI highlight the importance of accurate diagnosis and treatment of this comorbid disorder. However, financial and practical barriers exist to obtaining an earlier diagnosis during inpatient rehabilitation hospitalization. Diagnostic cost savings are demonstrated across all phased approaches and OSA severity levels with the most cost-beneficial approach varying by incidence of OSA.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=259799
in Archives of Physical Medicine and Rehabilitation > Vol. 101, n° 9 (2020) . - p. 1497-1508[article]Disorders of Consciousness: Outcomes, Comorbidities, and Care Needs / John Whyte in Archives of Physical Medicine and Rehabilitation, 2013/10 (2013)
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Titre : Disorders of Consciousness: Outcomes, Comorbidities, and Care Needs Type de document : Article Auteurs : John Whyte ; Risa Nakase-Richardson Article en page(s) : pp. 1851-1854 Langues : Anglais (eng) Descripteurs : HE Vinci
Prestations des soins de santé ; Pronostic ; Rééducation et réadaptationMots-clés : Brain Injuries Lésions encéphaliques Consciousness Disorders Troubles de la conscience Delivery of Health Care Persistent Vegetative State État végétatif persistant Prognosis Résumé : Over the last decade, research on patients with disorders of consciousness (DOC) has suggested that their prognosis for functional recovery early after injury is surprisingly positive, particularly for those with traumatic etiologies; that meaningful recovery proceeds for longer intervals than previously appreciated; and that such individuals are often medically complex and challenging to manage. However, access to intensive specialty rehabilitation is limited for most individuals with DOC in the United States. The evolving understanding of DOC calls for a reconsideration of appropriate models of care. This collection of articles provides insight into the functional recovery of individuals with DOC, new tools for assessing prognosis, and the patterns of comorbidity that complicate the recovery process. In addition, models of care from the United States and Europe that attempt to address the needs of patients as well as their caregivers are presented. Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117598
in Archives of Physical Medicine and Rehabilitation > 2013/10 (2013) . - pp. 1851-1854[article]Functional Outcomes in Traumatic Disorders of Consciousness: 5-Year Outcomes From the National Institute on Disability and Rehabilitation Research Traumatic Brain Injury Model Systems / John Whyte in Archives of Physical Medicine and Rehabilitation, 2013/10 (2013)
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Titre : Functional Outcomes in Traumatic Disorders of Consciousness: 5-Year Outcomes From the National Institute on Disability and Rehabilitation Research Traumatic Brain Injury Model Systems Type de document : Article Auteurs : John Whyte ; Risa Nakase-Richardson ; Flora Hammond ; [et al.] Article en page(s) : pp. 1855-1860 Langues : Anglais (eng) Descripteurs : HE Vinci
Cognition ; Pronostic ; Rééducation et réadaptationMots-clés : Consciousness Disorders Troubles de la conscience Persistent Vegetative State État végétatif persistant Prognosis Treatment Outcome Résultat thérapeutique Brain Injuries Lésions encéphaliques Résumé : Objective
To characterize the 5-year outcomes of patients with traumatic brain injury (TBI) not following commands when admitted to acute inpatient rehabilitation.
Design
Secondary analysis of prospectively collected data from the National Institute on Disability and Rehabilitation Researchfunded Traumatic Brain Injury Model Systems (TBIMS).
Setting
Inpatient rehabilitation hospitals participating in the TBIMS program.
Participants
Patients (N=108) with TBI not following commands at admission to acute inpatient rehabilitation were divided into 2 groups (early recovery: followed commands before discharge [n=72]; late recovery: did not follow commands before discharge [n=36]).
Interventions
Not applicable.
Main Outcome Measures
FIM items.
Results
For the early recovery group, depending on the FIM item, 8% to 21% of patients were functioning independently at discharge, increasing to 56% to 85% by 5 years postinjury. The proportion functioning independently increased from discharge to 1 year, 1 to 2 years, and 2 to 5 years. In the late recovery group, depending on the FIM item, 19% to 36% of patients were functioning independently by 5 years postinjury. The proportion of independent patients increased significantly from discharge to 1 year and from 1 to 2 years, but not from 2 to 5 years.
Conclusions
Substantial proportions of patients admitted to acute inpatient rehabilitation before following commands recover independent functioning over as long as 5 years, particularly if they begin to follow commands before hospital discharge.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/journal/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=117599
in Archives of Physical Medicine and Rehabilitation > 2013/10 (2013) . - pp. 1855-1860[article]Functional Recovery After Severe Traumatic Brain Injury: An Individual Growth Curve Approach / Tessa Hart in Archives of Physical Medicine and Rehabilitation, 2014/11 (2014)
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Titre : Functional Recovery After Severe Traumatic Brain Injury: An Individual Growth Curve Approach Type de document : Article Auteurs : Tessa Hart ; Allan J. Kozlowski ; John Whyte Article en page(s) : p. 2103-2110 Langues : Anglais (eng) Descripteurs : HE Vinci
Rééducation et réadaptationMots-clés : Brain injuries Lésions encéphaliques Résumé : Objective
To examine person, injury, and treatment characteristics associated with recovery trajectories of people with severe traumatic brain injury (TBI) during inpatient rehabilitation.
Design
Observational prospective longitudinal study.
Setting
TBI rehabilitation units.
Participants
Adults (N=206) with severe nonpenetrating TBI admitted directly to inpatient rehabilitation from acute care. Participants were excluded for prior disability and intentional etiology of injury.
Interventions
Naturally occurring treatments delivered within comprehensive multidisciplinary teams were recorded daily in 15-minute units provided to patients and family members, separately.
Main Outcome Measures
Motor and cognitive FIM were measured on admission, discharge, and every 2 weeks in between and were analyzed with individual growth curve methodology.
Results
Inpatient recovery was best modeled with linear, cubic, and quadratic components: relatively steep recovery was followed by deceleration of improvement, which attenuated prior to discharge. Slower recovery was associated with older age, longer coma, and interruptions to rehabilitation. Patients admitted at lower functional levels received more treatment, and more treatment was associated with slower recovery, presumably because treatment was allocated according to need. Therefore, effects of treatment on outcome could not be disentangled from effects of case mix factors.
Conclusions
FIM gain during inpatient recovery from severe TBI is not a linear process. In observational studies, the specific effects of treatment on rehabilitation outcomes are difficult to separate from case mix factors that are associated with both outcome and allocation of treatment.Disponible en ligne : Oui En ligne : https://login.ezproxy.vinci.be/login?url=https://www.sciencedirect.com/science/a [...] Permalink : https://bib.vinci.be/opac_css/index.php?lvl=notice_display&id=118678
in Archives of Physical Medicine and Rehabilitation > 2014/11 (2014) . - p. 2103-2110[article]How Do Intensity and Duration of Rehabilitation Services Affect Outcomes From Severe Traumatic Brain Injury? A Natural Experiment Comparing Health Care Delivery Systems in 2 Developed Nations / Tessa Hart in Archives of Physical Medicine and Rehabilitation, 2016/12 (2016)
PermalinkMedical Complications During Inpatient Rehabilitation Among Patients With Traumatic Disorders of Consciousness / John Whyte in Archives of Physical Medicine and Rehabilitation, 2013/10 (2013)
PermalinkSpecifying What We Study and Implement in Rehabilitation: Comments on the Reporting of Clinical Research / John Whyte in Archives of Physical Medicine and Rehabilitation, Vol. 99, n° 7 (2018)
PermalinkThe Importance of Voluntary Behavior in Rehabilitation Treatment and Outcomes / John Whyte in Archives of Physical Medicine and Rehabilitation, Vol. 100, n° 1 (2019)
PermalinkThe Rehabilitation Treatment Specification System: Implications for Improvements in Research Design, Reporting, Replication, and Synthesis / Jarrad H. Van Stan in Archives of Physical Medicine and Rehabilitation, Vol. 100, n° 1 (2019)
PermalinkA Theory-Driven System for the Specification of Rehabilitation Treatments / Tessa Hart in Archives of Physical Medicine and Rehabilitation, Vol. 100, n° 1 (2019)
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