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Measuring Change in Symptoms of Neurobehavioural Disability: Responsiveness of the St Andrew's-Swansea Neurobehavioural Outcome Scale

Nick Alderman, Claire Williams Orcid Logo, Caroline Knight, Rodger Ll. Wood

Archives of Clinical Neuropsychology, Volume: 32, Issue: 8, Pages: 951 - 962

Swansea University Author: Claire Williams Orcid Logo

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DOI (Published version): 10.1093/arclin/acx026

Abstract

Introduction: Neurobehavioural disability (NBD) after acquired brain injury (ABI) is often associated with poor outcome. The “St Andrew's-Swansea Neurobehavioural Outcome Scale” (SASNOS) was developed to measure NBD in a range of applications. Two of the “holy trinity” of psychometric propertie...

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Published in: Archives of Clinical Neuropsychology
ISSN: 0887-6177 1873-5843
Published: Oxford University Press 2017
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URI: https://cronfa.swan.ac.uk/Record/cronfa32995
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fullrecord <?xml version="1.0"?><rfc1807><datestamp>2018-11-06T16:06:18.1455627</datestamp><bib-version>v2</bib-version><id>32995</id><entry>2017-04-13</entry><title>Measuring Change in Symptoms of Neurobehavioural Disability: Responsiveness of the St Andrew's-Swansea Neurobehavioural Outcome Scale</title><swanseaauthors><author><sid>21dc2ebf100cf324becc27e8db6fde8d</sid><ORCID>0000-0002-0791-744X</ORCID><firstname>Claire</firstname><surname>Williams</surname><name>Claire Williams</name><active>true</active><ethesisStudent>false</ethesisStudent></author></swanseaauthors><date>2017-04-13</date><deptcode>HPS</deptcode><abstract>Introduction: Neurobehavioural disability (NBD) after acquired brain injury (ABI) is often associated with poor outcome. The &#x201C;St Andrew's-Swansea Neurobehavioural Outcome Scale&#x201D; (SASNOS) was developed to measure NBD in a range of applications. Two of the &#x201C;holy trinity&#x201D; of psychometric properties, reliability and validity, have been comprehensively mapped, but the extent to which SASNOS meets the third, responsiveness, has not been investigated. Demonstrating responsiveness is essential in instruments employed in repeated measurement scenarios to confirm their ability to discriminate real change from error. However, there is no single agreed method for determining responsiveness. For some instruments, this property remains unexplored. A difference in scores attaining statistical significance for aggregate data is frequently cited as support for this construct, but this approach remains heavily criticized. This study explores responsiveness of SASNOS.Method: Consecutive SASNOS assessments completed over varying times for 145 individuals participating in neurobehavioural rehabilitation, drawn from multiple services, were compiled into a retrospective sample of convenience. Multiple methods were employed to confirm internal responsiveness, including those identifying statistically significant change, minimally detectable change and minimally important change.Results: All methods confirmed responsiveness as a psychometric property of SASNOS; the extent depended on method used and NBD domain investigated. A number of indicators are presented, which equip clinicians and researchers with options to interpret results from repeated assessments, including the individual level in the context of rehabilitation.Conclusions: SASNOS reliably measures change over time in NBD symptoms, further confirming its suitability as an instrument for investigating multidimensional outcomes of ABI.</abstract><type>Journal Article</type><journal>Archives of Clinical Neuropsychology</journal><volume>32</volume><journalNumber>8</journalNumber><paginationStart>951</paginationStart><paginationEnd>962</paginationEnd><publisher>Oxford University Press</publisher><issnPrint>0887-6177</issnPrint><issnElectronic>1873-5843</issnElectronic><keywords>Head injury, traumatic brain injury, Assessment, Norms/normative studies, Rehabilitation, Practice effects/reliable change, Statistical methods, Neurobehavioural Rehabilitation</keywords><publishedDay>5</publishedDay><publishedMonth>4</publishedMonth><publishedYear>2017</publishedYear><publishedDate>2017-04-05</publishedDate><doi>10.1093/arclin/acx026</doi><url>https://academic.oup.com/acn/article-abstract/doi/10.1093/arclin/acx026/3102931/Measuring-Change-in-Symptoms-of-Neurobehavioural?redirectedFrom=fulltext</url><notes/><college>COLLEGE NANME</college><department>Psychology</department><CollegeCode>COLLEGE CODE</CollegeCode><DepartmentCode>HPS</DepartmentCode><institution>Swansea University</institution><apcterm/><lastEdited>2018-11-06T16:06:18.1455627</lastEdited><Created>2017-04-13T11:01:18.3639899</Created><path><level id="1">College of Human and Health Sciences</level><level id="2">Psychology</level></path><authors><author><firstname>Nick</firstname><surname>Alderman</surname><order>1</order></author><author><firstname>Claire</firstname><surname>Williams</surname><orcid>0000-0002-0791-744X</orcid><order>2</order></author><author><firstname>Caroline</firstname><surname>Knight</surname><order>3</order></author><author><firstname>Rodger Ll.</firstname><surname>Wood</surname><order>4</order></author></authors><documents><document><filename>0032995-11052017092539.pdf</filename><originalFilename>ACNSASNOS.pdf</originalFilename><uploaded>2017-05-11T09:25:39.3100000</uploaded><type>Output</type><contentLength>763765</contentLength><contentType>application/pdf</contentType><version>Accepted Manuscript</version><cronfaStatus>true</cronfaStatus><embargoDate>2018-04-05T00:00:00.0000000</embargoDate><documentNotes>12 month embargo.</documentNotes><copyrightCorrect>true</copyrightCorrect><language>eng</language></document></documents><OutputDurs/></rfc1807>
spelling 2018-11-06T16:06:18.1455627 v2 32995 2017-04-13 Measuring Change in Symptoms of Neurobehavioural Disability: Responsiveness of the St Andrew's-Swansea Neurobehavioural Outcome Scale 21dc2ebf100cf324becc27e8db6fde8d 0000-0002-0791-744X Claire Williams Claire Williams true false 2017-04-13 HPS Introduction: Neurobehavioural disability (NBD) after acquired brain injury (ABI) is often associated with poor outcome. The “St Andrew's-Swansea Neurobehavioural Outcome Scale” (SASNOS) was developed to measure NBD in a range of applications. Two of the “holy trinity” of psychometric properties, reliability and validity, have been comprehensively mapped, but the extent to which SASNOS meets the third, responsiveness, has not been investigated. Demonstrating responsiveness is essential in instruments employed in repeated measurement scenarios to confirm their ability to discriminate real change from error. However, there is no single agreed method for determining responsiveness. For some instruments, this property remains unexplored. A difference in scores attaining statistical significance for aggregate data is frequently cited as support for this construct, but this approach remains heavily criticized. This study explores responsiveness of SASNOS.Method: Consecutive SASNOS assessments completed over varying times for 145 individuals participating in neurobehavioural rehabilitation, drawn from multiple services, were compiled into a retrospective sample of convenience. Multiple methods were employed to confirm internal responsiveness, including those identifying statistically significant change, minimally detectable change and minimally important change.Results: All methods confirmed responsiveness as a psychometric property of SASNOS; the extent depended on method used and NBD domain investigated. A number of indicators are presented, which equip clinicians and researchers with options to interpret results from repeated assessments, including the individual level in the context of rehabilitation.Conclusions: SASNOS reliably measures change over time in NBD symptoms, further confirming its suitability as an instrument for investigating multidimensional outcomes of ABI. Journal Article Archives of Clinical Neuropsychology 32 8 951 962 Oxford University Press 0887-6177 1873-5843 Head injury, traumatic brain injury, Assessment, Norms/normative studies, Rehabilitation, Practice effects/reliable change, Statistical methods, Neurobehavioural Rehabilitation 5 4 2017 2017-04-05 10.1093/arclin/acx026 https://academic.oup.com/acn/article-abstract/doi/10.1093/arclin/acx026/3102931/Measuring-Change-in-Symptoms-of-Neurobehavioural?redirectedFrom=fulltext COLLEGE NANME Psychology COLLEGE CODE HPS Swansea University 2018-11-06T16:06:18.1455627 2017-04-13T11:01:18.3639899 College of Human and Health Sciences Psychology Nick Alderman 1 Claire Williams 0000-0002-0791-744X 2 Caroline Knight 3 Rodger Ll. Wood 4 0032995-11052017092539.pdf ACNSASNOS.pdf 2017-05-11T09:25:39.3100000 Output 763765 application/pdf Accepted Manuscript true 2018-04-05T00:00:00.0000000 12 month embargo. true eng
title Measuring Change in Symptoms of Neurobehavioural Disability: Responsiveness of the St Andrew's-Swansea Neurobehavioural Outcome Scale
spellingShingle Measuring Change in Symptoms of Neurobehavioural Disability: Responsiveness of the St Andrew's-Swansea Neurobehavioural Outcome Scale
Claire Williams
title_short Measuring Change in Symptoms of Neurobehavioural Disability: Responsiveness of the St Andrew's-Swansea Neurobehavioural Outcome Scale
title_full Measuring Change in Symptoms of Neurobehavioural Disability: Responsiveness of the St Andrew's-Swansea Neurobehavioural Outcome Scale
title_fullStr Measuring Change in Symptoms of Neurobehavioural Disability: Responsiveness of the St Andrew's-Swansea Neurobehavioural Outcome Scale
title_full_unstemmed Measuring Change in Symptoms of Neurobehavioural Disability: Responsiveness of the St Andrew's-Swansea Neurobehavioural Outcome Scale
title_sort Measuring Change in Symptoms of Neurobehavioural Disability: Responsiveness of the St Andrew's-Swansea Neurobehavioural Outcome Scale
author_id_str_mv 21dc2ebf100cf324becc27e8db6fde8d
author_id_fullname_str_mv 21dc2ebf100cf324becc27e8db6fde8d_***_Claire Williams
author Claire Williams
author2 Nick Alderman
Claire Williams
Caroline Knight
Rodger Ll. Wood
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container_title Archives of Clinical Neuropsychology
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publishDate 2017
institution Swansea University
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publisher Oxford University Press
college_str College of Human and Health Sciences
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description Introduction: Neurobehavioural disability (NBD) after acquired brain injury (ABI) is often associated with poor outcome. The “St Andrew's-Swansea Neurobehavioural Outcome Scale” (SASNOS) was developed to measure NBD in a range of applications. Two of the “holy trinity” of psychometric properties, reliability and validity, have been comprehensively mapped, but the extent to which SASNOS meets the third, responsiveness, has not been investigated. Demonstrating responsiveness is essential in instruments employed in repeated measurement scenarios to confirm their ability to discriminate real change from error. However, there is no single agreed method for determining responsiveness. For some instruments, this property remains unexplored. A difference in scores attaining statistical significance for aggregate data is frequently cited as support for this construct, but this approach remains heavily criticized. This study explores responsiveness of SASNOS.Method: Consecutive SASNOS assessments completed over varying times for 145 individuals participating in neurobehavioural rehabilitation, drawn from multiple services, were compiled into a retrospective sample of convenience. Multiple methods were employed to confirm internal responsiveness, including those identifying statistically significant change, minimally detectable change and minimally important change.Results: All methods confirmed responsiveness as a psychometric property of SASNOS; the extent depended on method used and NBD domain investigated. A number of indicators are presented, which equip clinicians and researchers with options to interpret results from repeated assessments, including the individual level in the context of rehabilitation.Conclusions: SASNOS reliably measures change over time in NBD symptoms, further confirming its suitability as an instrument for investigating multidimensional outcomes of ABI.
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