Analyzing outcome of treatment of severe head injury: A review and update on advancing the use of the Glasgow Outcome Scale

GM Teasdale*, LEL Pettigrew, JTL Wilson, G Murray, B Jennett

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

The Glasgow Outcome Scale (GOS), two decades after its description, remains the most widely used method of analyzing outcome in series of severely head-injured patients. This review considers limitations recognized in the use of the GOS and discusses a new approach to assessment, using a structured questionnaire-based interview, Assignments can be made to an extended eight-point scale (GOSE) as well as the original five-point approach-in each case, with a high degree of interobserver consistency. The assignments are coherent with the principles of the World Health Organization classification of impairments, disabilities, and handicaps, and their validity is supported by strong associations with the results of neuropsychological testing and assessment of general health status. The need to allow for disability existing before injury, issues concerning the time of assessment after injury, and subdivisions of the scale into "favorable" and "unfavorable" categories are discussed. It is concluded that, in its improved structured format, the Glasgow Outcome Scale should remain the primary method of assessing outcome in trials of the management of severe head injury.

Original languageEnglish
Pages (from-to)587-597
Number of pages11
JournalJournal of Neurotrauma
Volume15
Issue number8
Publication statusPublished - Aug 1998
EventMeeting on Outcome in Clinical Trials in Severe Head Injury - NEW ORLEANS, United Kingdom
Duration: 1 Sep 1997 → …

Keywords

  • clinical trials
  • Glasgow Outcome Scale
  • head injury
  • neuropsychological tests
  • observer variability
  • outcome
  • quality of life
  • BRAIN INJURY
  • DISABILITY

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