TBI HISTORY

See subdomain notes

OSU TBI-ID

Definition

The OSU TBI Identification Method-Short Form is a structured interview developed using recommendations from the CDC for the detection of and history of exposure to TBI. It was designed to elicit self- or proxy-reports of TBI occurring over a person’s lifetime. The OSU TBI-ID-SF uses an interview methodology based on the original longer version, but only measures selected summary indices.

The OSU-TBI-ID method is a means of identifying possible TBIs that may have been previously undiagnosed.

To avoid biases created by terminology used, the interview first elicits recall of all possible head or neck injuries through a series of queries tapping possible causes of TBI. This first step is critical for obtaining a complete history, and should not be interrupted by probing for more details at this stage. After all possible injuries have been elicited, the interviewer goes back to obtain more information about the injuries. For these injuries, the occurrence and length of loss of consciousness is probed. If there is no loss of consciousness, the presence of altered consciousness is probed. Age is also determined for any injuries reported. The final step involves identifying individuals who have experienced a period of time in which they have sustained multiple blows to the head.

Using the structured elicitation method of the OSU TBI-ID-SF, multiple dimensions of history are available, including number of injuries with LOC, number of injuries with LOC>30 minutes, age at first TBI, whether there was an injury with LOC before the age of 15, worst injury and repeated impacts to the head.

The following steps are performed to obtain input information used in each of the TBI ID variables.

First, the length of loss of consciousness as well as whether a person was dazed are classified into the following categories. This is done for each injury listed, excluding the index injury.

  • No LOC
  • Unknown Duration
  • Dazed
  • Less than 30 minutes
  • 30 minutes to 24 hours
  • More than 24 hours

Next, using a person’s age, it is determined whether each injury occurred before, concurrent with, or after a person’s index injury.

Finally, using the combination of length of loss of consciousness and injury timing, aggregate counts of the TBI ID variables are calculated.

Form

[X] Form 1
[X] Form 2

Source

Interview (participant or proxy)

Details

This is a structured interview to detect lifetime history of TBI. It is not designed to be administered as a paper/pencil questionnaire.

Individuals are not directly asked about whether they had a traumatic brain injury, because of a tendency for misinterpretation of this and similar terms.

Many people have had multiple brain injuries in their life. We want to make sure we capture all injuries. For this reason, the first part of the interview is critical to obtaining information on all possible injuries. It should not be interrupted by probing for details, because that would disrupt the flow of recall.

Step 1: Any injuries to head or neck
The first time the OSU TBI-ID is administered, the five questions about head or neck injuries should be prefaced with “In your lifetime, have you ever…”. During subsequent administrations, the five questions about head or neck injuries should be prefaced with “Since we last spoke with you on ‘last successful follow-up date’, have you…”. When asking about head or neck injuries since the last follow-up, do not disregard any new ‘lifetime’ injuries if reported.

Injuries do not have to have been diagnosed or treated by a physician or other health professional.

Do NOT include the index injury (the TBI that brought them to your facility).

Step 2: Additional Details
When asking about the duration of LOC, participants should be encouraged to use their best guess and only code ‘5 - Positive Loss of Consciousness, Duration Unknown’ when participant is truly unable to estimate the duration of LOC.

If a participant reports a TBI with loss of consciousness of an unknown duration, data collector should do some additional probing to assist the participant with narrowing down the time frame. For example, if the person awakened at the scene, then it is likely that LOC was less than 30 minutes. If the person awakened while already hospitalized, but it was still the day of the injury, then LOC is likely 30 minutes to 24 hours, etc. After probing using various anchors, then the next step would be to offer the individual the choice regarding the three time periods. If the person still does not know, then the time frame should be coded as “5-Positive Loss of Consciousness, Duration Unknown”.

If a range is given for age, record the midpoint of the range given.

Passing out from alcohol or marijuana use should not be considered a LOC. Most people will pass out before they are able to drink enough alcohol to lose consciousness. However, someone with severe alcoholism may be able to drink enough alcohol to lose consciousness. Additional probing may be necessary to differentiate between an episode of passing out, and a true LOC.

Step 3: Multiple Mild Injuries:
Some individuals have gone through periods in their life when they have sustained multiple mild TBIs, and they cannot distinguish between them. They usually describe such a period as a ‘blur’. For example, they may have been victims of abuse, played football, etc. If the individual is unable to distinguish between these injuries, treat that period in the person’s life as one injury. Ask the person to indicate the longest period that he/she was knocked out. For age, first ask the age range of the time period, then see if you can help them determine where the longest LOC happened in that time frame. If not known, use the midpoint of the age range.

  • If participant reports engaging in an activity that they had repeated head impacts, but had only one event that they were knocked unconscious, record this event under Step 2, and record the ongoing activity under Step 3.
  • If a participant reports a period of repeated injuries at step 2 without a specific event, this should be included in Step 3.
  • If the participant is still engaged in an activity that they reported multiple repeated impacts to the head, use the age at the time of the interview as the “end” age.

For assistance in assigning a Cause category in step 3 (Multiple Mild Injuries), see the link below titled “RHI Step 3 Classification”.

Reference

Ohio State University

Characteristics

The OSU TBI-ID variables replaced the History of TBI variables.

On 1/1/2015 Step 3 was added which asks “(In your lifetime)… or (Since we last spoke with you on last successful follow-up date)… have you (ever) had a period of time in which you experienced multiple, repeated impacts to your head (e.g. history of abuse, contact sports, military duty)?”

On 7/1/2023 a coding option of “Yes” or “No” was added to Step 3 to capture a response in addition to the already existing fields that capture reasons of repeated injuries.

On 1/15/2024 the OSU-TBI-ID was added to Form 1 Data Collection. Coding categories were also added to Step 2 and 3 to replace open text fields.

The error for participants who reported having had a prior TBI (head or neck injury reported), but did not have an entry in the TBI ID table, and who died prior to clarifying this error was removed.

Variables

Form Type

Variable

ID

Question

History

Form 1

Mod2TBIMultiold

Please Enter Multiple TBI Incidents

Form 1

Mod2TBIold

Please enter TBI information

Form 1

TBIInjury

8978

Is there any head or neck injury reported?

2024-01-15 - Variable Added

Form 1

TBIRepInjury

7649

Have you ever had a period of time in which you experienced multiple, repeated impacts to your head (e.g. history of abuse, contact sports, military duty)?

2024-01-15 - Variable Added

Form 2

Mod2TBI

3755

Please Enter TBI information

Form 2

Mod2TBIMulti

3756

Please Enter Multiple TBI Incidents

Form 2

TBIInjuryF

781

Is there any head or neck injury reported?

2010-04-01 - Variable Added

Form 2

TBIRepInjuryF

7654

Have you ever had a period of time in which you experienced multiple, repeated impacts to your head (e.g. history of abuse, contact sports, military duty)?

2024-01-15 - Variable Added

Codes and Values

ID

Code

Description

781

0

No

781

1

Yes

781

66

Variable Did Not Exist

781

77

Refused

781

99

Unknown

7649

0

No

7649

1

Yes

7649

66

Variable Did Not Exist

7649

77

Refused

7649

88

Not Applicable

7649

99

Unknown

7654

0

No

7654

1

Yes

7654

66

Variable Did Not Exist

7654

77

Refused

7654

88

Not Applicable

7654

99

Unknown

8978

0

No

8978

1

Yes

8978

66

Variable Did Not Exist

8978

77

Refused

8978

99

Unknown

History

Date

Description

2010-09-17

Added NOTE : if a participant reports a TBI with loss of consciousness of an unknown duration, data collector should do some additional probing to assist the participant with narrowing down the time frame

2011-05-04

Added NOTE : regarding blacking out or passing out from drugs or alcohol

2013-10-01

Changed DEFINITION : regarding asking 'In your lifetime' during first administration of TBI-ID and 'Since we spoke with you' during subsequent follow-ups.

2015-01-15

Changed DEFINITION : to match the updated OSU-TBI ID Data Collection Form, which includes the addition of a new 'Step 3' to capture multiple mild TBI's, and the deletion of the question 'Have you ever lost consciousness due to a drug overdose or being choked?'

2015-01-15

Added NOTE : when asking about the duration of LOC, participants should be encouraged to use their best guess and only code "5 - Positive Loss of Consciousness, Duration Unknown" when participant is truly unable to estimate the duration of LOC.

2018-01-15

Added NOTE : do NOT include the index injury.

2018-04-01

Added NOTE : 'If a range is given for age, record the midpoint of the range given.'

2024-01-15

Added CHARACTERISTICS: On 1/15/2024 the OSU-TBI-ID was added to Form 1 Data Collection. Coding categories were also added to Step 2 and 3 to replace open text fields.

2025-07-01

Added to DETAILS:
oIf participant reports engaging in an activity that they had repeated head impacts, but had only one event that they were knocked unconscious, record this event under Step 2, and record the ongoing activity under Step 3.
oIf a participant reports a period of repeated injuries at step 2 without a specific event, this should be included in Step 3.
oIf the participant is still engaged in an activity that they reported multiple repeated impacts to the head, use the age at the time of the interview as the “end” age.

OSU TBI-ID - CALCULATED

Variables

Form Type

Variable

ID

Question

History

Form 1

MostSevere

530

Most severe injury reported (not including Index Injury)

2010-04-01 - Variable Added

Form 1

TBI_IDAsked

3557

Was TBI ID asked?

2010-04-01 - Variable Added

Form 1

YoungestAgeLOC

Youngest age that a person recalled having a loss of consciousness

Form 1

YoungestAgeTBI

3577

Age at earliest TBI reported:

2010-04-01 - Variable Added

Form 1

cntAnyAfterIndex

3361

Number of TBI reported after Index

2010-04-01 - Variable Added

Form 1

cntAnyBefore15yr

3362

Number of TBI reported before age 15

2010-04-01 - Variable Added

Form 1

cntAnyBeforeIndex

3363

Number of TBI prior to Index

2010-04-01 - Variable Added

Form 1

cntAnyInjuries

3364

Number of TBI Reported

2010-04-01 - Variable Added

Form 1

cntAnySameIndex

3365

Number of TBI reported same age as Index

2010-04-01 - Variable Added

Form 1

cntLOCAfterIndex

3366

Number of TBI w/LOC reported after Index Injury

2010-04-01 - Variable Added

Form 1

cntLOCBefore15yr

3367

Number of TBI w/LOC reported before age 15

2010-04-01 - Variable Added

Form 1

cntLOCBeforeIndex

3368

Number of TBI w/LOC reported before Index Injury

2010-04-01 - Variable Added

Form 1

cntLOCInjuries

3369

Number of TBI reported with LOC:

2010-04-01 - Variable Added

Form 1

cntLOCSameIndex

3370

Number of TBI w/LOC reported at same age as index TBI

2010-04-01 - Variable Added

Form 1

cntModSevAfterIndex

3371

Number of TBI Mod/Sev reported after Index injury

2010-04-01 - Variable Added

Form 1

cntModSevBefore15yr

3372

Number of TBI Mod/Sev reported before age 15

2010-04-01 - Variable Added

Form 1

cntModSevBeforeIndex

3373

Number of TBI Mod/Sev reported before index injury

2010-04-01 - Variable Added

Form 1

cntModSevInjuries

3374

Number of reported TBI Moderate/ Severe

2010-04-01 - Variable Added

Form 1

cntModSevSameIndex

3375

Number of TBI Mod/Sev reported same age as index injury

2010-04-01 - Variable Added

Codes and Values

ID

Code

Description

530

1

No LOC

530

2

Dazed

530

3

LOC Less than 30 min or unknown duration

530

4

LOC 30min to 24Hr

530

5

LOC more than 24Hr

3557

1

Yes

History

No history found for the Domain.