Cognitive-Communication Performance Following Mild Traumatic Brain injury : Acute Outcome Prediction
Bibliographic record
Abstract
Objective : Although several studies have investigated outcomes post mild traumatic brain injury (mTBI), little information is available in the literature regarding the effects and consequences of language and communication deficits, particularly in the acute stage. The goal of our study was to determine how performance on measures of auditory comprehension, verbal reasoning, oral expression and reading comprehension obtained during acute care hospital admission in patients with complicated mTBI contribute to acute care discharge outcomes. Method: Speech-language pathologists administered the Boston Naming Test (short form), the conversational discourse subtest of the Montreal Protocol for the Evaluation of Communication, verbal fluency tasks, the verbal absurdity subtest of the Detroit Test of Learning Aptitude, the complex ideational material subtest of the Boston Diagnostic Aphasia Examination and the reading comprehension subtest of the Canadian Adult Achievement Test to 128 patients with a diagnosis of complicated mTBI admitted to the TBI program of the McGill University Health Center-Montreal General Hospital, a supra-regional Level I trauma hospital. Medical charts of participants were retrospectively reviewed to gather demographical data, language test results and accident-related information. Outcome measures obtained from the TBI program database included length of stay (LOS), discharge destination and scores on the extended Glasgow Outcome Scale (GOSE). Results: Over half of the patients with complicated mTBI (56.3%) required rehabilitation services post discharge from acute care. Of this group, 39.1% were transferred to an in-patient rehabilitation center whereas 17.2% were discharged home and obtained services in an out-patient facility. Performances on tasks of auditory comprehension, verbal reasoning, confrontation naming, and verbal fluency as well as conversational discourse skills predicted transfer to an in-patient rehabilitation facility at discharge (p<.05). Thus, those patients who had more difficulty naming, understanding oral information, organizing spontaneous discourse and those with poorer verbal reasoning and verbal fluency skills were more likely to require specialized in-patient rehabilitation services versus being discharged home with no services. Those patients with worse skills in naming, conversational discourse and letter-category verbal fluency also had a greater chance of requiring out-patient rehabilitation services (p<.05). In addition, LOS was more likely to be longer in patients with poorer letter-category naming (p<.05) and the probability of greater disability as measured with the GOSE was linked to worse conversational discourse skills and semantic category naming (p<.05). Conclusion: Rehabilitation services are often required after complicated mTBI. In this study, the likelihood of patients needing such services was related to performance on several oral expression and auditory comprehension tests. It is therefore important to evaluate these skills in acute care post mTBI. The results of this study add to the information available to healthcare professionals in predicting overall acute outcomes following complicated mTBI.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".