Abstract / Summary
Background: Traumatic brain injury (TBI) is a leading cause of disability in Brazil and worldwide. National and multinational clinical trials in TBI require global standardization of outcome measures. The original English version of the Neurological Outcome Scale for TBI (NOS-TBI) is a valid and valuable neurological assessment tool. However, NOS-TBI has not yet been validated in Brazilian Portuguese.
Objective: To perform the translation, cultural adaptation, and validation of the NOS-TBI in a Brazilian cohort of individuals with TBI.
Methods: We conducted the translation and cultural adaptation of the NOS-TBI scale to Brazilian Portuguese, followed by an analysis of psychometric properties: internal consistency; interrater reliability; concurrent validity in relation to Revised Trauma Score (RTS) and Glasgow Coma Scale (GCS); and convergent validity in relation to Functional Independence Measure (FIM), and Extended Glasgow Outcome Scale (GOS-E). We assessed 255 subjects with TBI, age 42 ± 17.9 years, male-to-female ratio of 4.2:1. The interrater reliability analysis was conducted in a subcohort of 136 subjects, 85.3% male, aged 40.3 ± 17.5 years.
Results: The Brazilian Portuguese NOS-TBI showed excellent consistency and interrater reliability. The intraclass correlation coefficient (ICC) revealed excellent interrater agreement. The concurrent validity showed strong correlations of the NOS-TBI with both GCS and RTS at admission. For convergent validity, moderate correlations were observed for both GOS-E and FIM.
Conclusion: The Brazilian Portuguese NOS-TBI is valid, reliable, and can be used in clinical practice and scientific studies. Globally, developing relevant and reliable clinical scales in different languages, such as the NOS-TBI, can facilitate multinational studies in the field.