Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 2 | GOSAssistAllF | 694 | 2a. Is the assistance of another person at home essential every day for some activities of daily living? | 1998-04-01 - Variable Added |
Form 2 | GOSAssistPriorF | 7630 | 2c. Was assistance at home essential before the injury? | 1998-04-01 - Variable Added |
Form 2 | GOSCommandsF | 695 | 1. Is the participant able to obey simple commands or say any words? | 1998-04-01 - Variable Added |
Form 2 | GOSDisruptExF | 696 | 7b. What has been the extent of disruption or strain? | 1998-04-01 - Variable Added |
Form 2 | GOSDisruptF | 7639 | 7a. Have there been psychological problems which have resulted in ongoing family disruption or disruption to friendships? | 1998-04-01 - Variable Added |
Form 2 | GOSFactorF | 698 | 10. You noted (reference last problematic item i.e. not being able to travel without assistance). Is that due to... | 2007-10-01 - Variable Added |
Form 2 | GOSFrqHlpF | 7629 | 2b. Do you need frequent help or someone to be around at home most of the time? | 1998-04-01 - Variable Added |
Form 2 | GOSPrbCurrentF | 7641 | 8a. Are there any other current problems relating to the injury which affect daily life? | 1998-04-01 - Variable Added |
Form 2 | GOSPrbFamF | 7640 | 7c. Were there problems with family or friends before the injury? | 1998-04-01 - Variable Added |
Form 2 | GOSPrbPriorF | 7642 | 8b. Were similar problems present before the injury? | 1998-04-01 - Variable Added |
Form 2 | GOSRestrictF | 699 | 5b. How restricted are you? | 1998-04-01 - Variable Added |
Form 2 | GOSShopF | 7631 | 3a. Are you able to shop without assistance? | 1998-04-01 - Variable Added |
Form 2 | GOSShopPriorF | 7632 | 3b. Were you able to shop without assistance before the injury? | 1998-04-01 - Variable Added |
Form 2 | GOSSocF | 7637 | 6a. Are you able to resume regular social and leisure activities outside home? | 1998-04-01 - Variable Added |
Form 2 | GOSSocPriorF | 7638 | 6c. Did you engage in regular social and leisure activities outside the home before the injury? | 1998-04-01 - Variable Added |
Form 2 | GOSSocRestrictF | 700 | 6b. What is the extent of restriction on your social and leisure activities? | 1998-04-01 - Variable Added |
Form 2 | GOSTotalF | 701 | 9. GOS-E score: | 1998-04-01 - Variable Added |
Form 2 | GOSTravelF | 7633 | 4a. Are you able to travel locally without assistance? | 1998-04-01 - Variable Added |
Form 2 | GOSTravelPriorF | 7634 | 4b. Were you able to travel without assistance before the injury? | 1998-04-01 - Variable Added |
Form 2 | GOSWorkF | 7635 | 5a. Are you currently able to work to your previous capacity? | 1998-04-01 - Variable Added |
Form 2 | GOSWorkPriorF | 7636 | 5c. Were you either working or seeking employment before the injury? | 1998-04-01 - Variable Added |
GOS-E (GLASGOW OUTCOME SCALE - EXTENDED)
For information about the GOS-E (Glasgow Outcome Scale-Extended), see External Links under GOS-E subdomain below.
GOS-E
Definition
For information about the GOS-E (Glasgow Outcome Scale-Extended), see External Links.
Form
[ ] Form 1
[X] Form 2
Source
Interview (participant or proxy)
Details
Background of Instrument
The Glasgow Outcome Scale (GOS) was originally developed by Jennett and Bond as an examiner-rated measure of outcome. It has most typically been used to assess outcome in neurosurgery studies and has been widely used for clinical drug trials in acute TBI. The original GOS did not have a structured interview to accompany it. Raters, who may have been neurosurgeons, research nurses, or neuropsychologists, would give a GOS outcome rating based on all available information, including interviews with patients and their families, evaluation and examination of the patient, and any factual evidence they were able to obtain. Wilson et al. developed a structured interview to improve reliability of ratings on the GOS, as well as to extend the rating categories so that they would better characterize patients at different levels.
Instructions for Rating
The interview can be administered to either the patient or a family member or other informant. However, the GOS-E is not meant to be a self-perception instrument. Raters should rate each item based on the most accurate information they have, regardless of source. The following guidelines should help with the rating.
Although you are administering the interview to one person, you can obtain clarification from other sources if you feel that a particular item or items is inaccurate. For example, if the person with injury is the only person available to interview, you would administer the interview to him/her. However, if that person has limited insight into difficulties, and you know from another source that some of the answers are inaccurate, you can rate those particular items based on the most accurate information you have. For example, if someone who is in your post-acute program at the time of follow-up tells you they can travel without assistance, while their therapist says that they are medically restricted from driving and are currently receiving transportation training, you should assign the GOS-E score based on the information from the source that you feel to be most accurate. This does not mean that you are required to interview multiple sources. It just means that if you happen to have information from multiple sources, you can combine that information to increase the accuracy of your rating.
Many GOS-E questions overlap with other questions that you may have already asked as part of local or national database projects. It is not necessary to ask the question again for the GOS-E. If you already know the answer to a question, you can fill it in and move on to the next question. (Dr. Dikmen confirmed this with the authors of the GOS-E when we first began using it.)
Collect and record all subscale scores unless instructed to skip some of them by the skip instructions on the Form 2.
The intention of the GOS-E is to measure the person’s ABILITY to do things, whether or not they actually do them, so scoring should be based on what a person is able to do.
All raters should familiarize themselves with the original GOS-E article by Wilson and colleagues. Pay particular attention to the section on Assigning an Outcome Category (p. 576). This includes guidelines on how to account for pre-injury functioning.
Instructions for coding Unknown items
Every effort should be made to obtain the GOS-E assessment, however, if it can not be assessed, use code “99. Unknown.” Do not leave blanks.
There should not be many “unknown” answers from a respondent. If there are, then the respondent is probably not sufficiently informed about the person with TBI to be the basis for scoring the GOS-E. If there ARE many “unknown” responses and no better source of information is available, then the overall rating for the GOS-E should be “unknown”. Data collectors should use their judgment as to whether there are too many “unknown” responses to allow the GOS-E to accurately indicate the person’s level. Confer with your Model System’s data manager if uncertain.
For a GOS-E item that the respondent does not provide enough information to score other than “unknown”, the data collector should attempt to infer the score from alternative sources, such as the respondent’s answers to numerically higher GOS-E items, other items in the Form 2, and probes asked of the respondent and other persons informed about the person with TBI.
Additional Tips
Code deficits due to age as ‘Effects of Illness or Injury to Another Part of the Body’.
GOS-E is a “best source” variable. Not necessary to ask the two “supplemental” questions about seizures and source of disability (not present on data collection form).
The employment section can be based on education instead of employment if the participant was not working prior to injury. Evaluate whether the participant was attending school without difficulty (extra time, assistance, tutors, etc.). If the participant has returned to school part-time because she can not return to a full schedule due to the injury, then yes, code 5b as 1-Reduced work capacity. If you don’t have enough information to rate their schooling ability, you can skip the employment section and code as 88’s, and move onto the next GOS-E section.
If the person was unemployed and not seeking work before the injury, then they should be rated on the answers given to questions 6 and 7. For example, if the person is long-term unemployed or retired, then they should be rated on social and leisure activities and personal relationships. See external link, Wilson et al.- Frequently Asked Questions (p. 576).
The hierarchical nature of the GOS-E items causes lower items in the scale to not contribute to the overall score if the person is able to perform the task described by a higher item.
DATA ENTRY: Enter into the database all subscale scores that do not autofill. For each case that you enter, check to be sure that the auto-filled total score in the database is the same as the total score that has been recorded on the Form 2. Notify your Data Manager of any discrepancies.
DATA MANAGERS: If errors in calculating the total score turn up on the Form 2, provide your data collector(s) with more training in scoring the GOS-E and in calculating the total score. Contact the TBIMS NDSC if you have questions.
Links
PubMed: JT Wilson, et. al. (1998) GOSE-Manual Frequently Asked Questions for GOS-E (COMBI) Properties of the GOS-E instrument (COMBI) GOS-E References (COMBI)
Reference
JT Wilson, L Pettigrew, G Teasdale. Structured Interviews for the Glasgow Outcome Scale and the Extended Glasgow Outcome Scale: Guidelines for their use. Journal of Neurotrauma, Vol. 15 No. 8, 1998. For an abstract of this article, see External Links.
For additional references, see External Links.
Characteristics
On 7/1/00 a field for data with the new scoring was created. The old field (data prior to 7/1/00) is also in the database. GOS-E data can be collapsed onto the GOS scale if analyses require.
Variables
Codes and Values
ID | Code | Description |
|---|---|---|
694 | 0 | No (3a) |
694 | 1 | Yes |
694 | 66 | Variable Did Not Exist |
694 | 88 | NA |
694 | 99 | Unknown |
695 | 0 | No (Stop! VS) |
695 | 1 | Yes (2a) |
695 | 66 | Variable Did Not Exist |
695 | 99 | Unknown |
696 | 1 | Occasionally: Less than weekly (LGR) |
696 | 2 | Frequent: Once per week or more but tolerable (UMD) |
696 | 3 | Constant: Daily and intolerable (LMD) |
696 | 66 | Variable Did Not Exist |
696 | 88 | NA |
696 | 99 | Unknown |
698 | 1 | Effects of Head Injury |
698 | 2 | Effects of Illness or Injury to Another Part of the Body |
698 | 3 | A Mixture of These |
698 | 66 | Variable Did Not Exist |
698 | 88 | Not Applicable |
698 | 99 | Unknown |
699 | 1 | Reduced Work Capacity (UMD) |
699 | 2 | Sheltered Workshop or Non-Competitive Job or Currently Unable to Work (LMD) |
699 | 66 | Variable Did Not Exist |
699 | 88 | NA |
699 | 99 | Unknown |
700 | 1 | Participate a Bit Less : At least half as often as before injury (LGR) |
700 | 2 | Participate Much Less: Less than half as often (UMD) |
700 | 3 | Unable to Participate: Rarely, if ever, take part (LMD) |
700 | 66 | Variable Did Not Exist |
700 | 88 | NA |
700 | 99 | Unknown |
701 | 1 | Dead |
701 | 2 | Vegetative State (VS) |
701 | 3 | Lower Severe Disability (LSD) |
701 | 4 | Upper Severe Disability (USD) |
701 | 5 | Lower Moderate Disability (LMD) |
701 | 6 | Upper Moderate Disability (UMD) |
701 | 7 | Lower Good Recovery (LGR) |
701 | 8 | Upper Good Recovery (UGR) |
701 | 66 | Variable Did Not Exist |
701 | 99 | Unknown |
7629 | 0 | No (USD) |
7629 | 1 | Yes (LSD) |
7629 | 66 | Variable Did Not Exist |
7629 | 88 | NA |
7629 | 99 | Unknown |
7630 | 0 | No (Stop!) |
7630 | 1 | Yes (Go to item 3a) |
7630 | 66 | Variable Did Not Exist |
7630 | 88 | NA |
7630 | 99 | Unknown |
7631 | 0 | No (USD) |
7631 | 1 | Yes (4a) |
7631 | 66 | Variable Did Not Exist |
7631 | 88 | NA |
7631 | 99 | Unknown |
7632 | 0 | No (4a) |
7632 | 1 | Yes (Stop!) |
7632 | 66 | Variable Did Not Exist |
7632 | 88 | NA |
7632 | 99 | Unknown |
7633 | 0 | No (USD) |
7633 | 1 | Yes (5a) |
7633 | 66 | Variable Did Not Exist |
7633 | 88 | NA |
7633 | 99 | Unknown |
7634 | 0 | No (5a) |
7634 | 1 | Yes (Stop!) |
7634 | 66 | Variable Did Not Exist |
7634 | 88 | NA |
7634 | 99 | Unknown |
7635 | 0 | No |
7635 | 1 | Yes (6a) |
7635 | 66 | Variable Did Not Exist |
7635 | 88 | NA |
7635 | 99 | Unknown |
7636 | 0 | No (6a) |
7636 | 1 | Yes (Stop!) |
7636 | 66 | Variable Did Not Exist |
7636 | 88 | NA |
7636 | 99 | Unknown |
7637 | 0 | No |
7637 | 1 | Yes (7a) |
7637 | 66 | Variable Did Not Exist |
7637 | 88 | NA |
7637 | 99 | Unknown |
7638 | 0 | No (7a) |
7638 | 1 | Yes (Stop!) |
7638 | 66 | Variable Did Not Exist |
7638 | 88 | NA |
7638 | 99 | Unknown |
7639 | 0 | No (8a) |
7639 | 1 | Yes |
7639 | 66 | Variable Did Not Exist |
7639 | 88 | NA |
7639 | 99 | Unknown |
7640 | 0 | No (Stop!) |
7640 | 1 | Yes (8a) |
7640 | 66 | Variable Did Not Exist |
7640 | 88 | NA |
7640 | 99 | Unknown |
7641 | 0 | No (Stop! UGR) |
7641 | 1 | Yes (8b) |
7641 | 66 | Variable Did Not Exist |
7641 | 88 | NA |
7641 | 99 | Unknown |
7642 | 0 | No (Stop! LGR) |
7642 | 1 | Yes (Stop! UGR) |
7642 | 66 | Variable Did Not Exist |
7642 | 88 | NA |
7642 | 99 | Unknown |
History
Date | Description |
|---|---|
2021-10-22 | Added NOTE : Incorporated links “28a Instructions for Rating GOS-E” and items 1 and 2 from “28b Instructions for scoring the GOS-E with Unknown Items.” to data dictionary Details. Removed both of these links. |
GOS-E - CALCULATED
Scoring the GOS-E with Unknown Items
If there is an “unknown” response in any part of a GOS-E item (e.g., 2a, 2b, or 2c) then that entire item (e.g., 2) is not used in determining the GOS-E overall score.
Because the TBIMS scoring instructions treat questions 1-8 as hierarchical (i.e., higher numbered questions indicate higher levels of functioning), if responses to a higher-numbered question indicate that the person is functioning at that level, then “unknown” responses to lower items should be disregarded in determining the overall score.
If all items above a given item are “unknown”, then the GOS-E overall score is “unknown”. (Because it is not possible to determine the person’s highest level of performance.)
If the person has difficulty with the first item above an item that is “unknown”, then the GOS-E overall score is “unknown”. (Because it is not possible to identify the lowest item with which the person has difficulty.)
Variables
Form Type | Variable | ID | Question | History |
|---|---|---|---|---|
Form 2 | GOSEF | 697 | GOS-E Incl. Expired | 1998-04-01 - Variable Added |
Codes and Values
ID | Code | Description |
|---|---|---|
697 | 1 | Dead |
697 | 2 | Vegetative State (VS) |
697 | 3 | Lower Severe Disability (LSD) |
697 | 4 | Upper Severe Disability (USD) |
697 | 5 | Lower Moderate Disability (LMD) |
697 | 6 | Upper Moderate Disability (UMD) |
697 | 7 | Lower Good Recovery (LGR) |
697 | 8 | Upper Good Recovery (UGR) |
697 | 66 | Variable Did Not Exist |
697 | 99 | Unknown |
History
Date | Description |
|---|---|
2021-10-22 | Added NOTE : Incorportated items 3-6 from link "28b Instructions for scoring the GOS-E with Unknown Items" to Details. Removed link to form 28b. |