About
245
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Introduction
Additional affiliations
September 2014 - present
Position
- Professor and Director of the Center on Assessment Research and Translation
September 2014 - present
Position
- Professor and Director of the Center on Assessment Research and Translation
September 2014 - present
Position
- Professor and Director of the Center on Assessment Research and Translation
Publications
Publications (245)
A series of recent reports have shed light on the pervasive nature of motor impairments in children with ASD (Bhat, 2020, 2021, Bhat et al., 2022), underscoring the importance of providing ASD clinicians efficient and accurate tools for motor screening. The Developmental Coordination Disorder-Questionnaire (DCD-Q) is a widely used motor screening t...
Upper extremity transplantation offers the promise of restored function and regained quality of life (QOL) for individuals who have sustained hand or arm amputation. However, a major challenge for this procedure becoming an accessible treatment option for patients is the lack of standard measures to document benefits to QOL. Patient-reported outcom...
Objective
To identify the most important health-related quality of life (HRQOL) domains and patient-reported outcomes following upper extremity transplantation (UET) in individuals with upper extremity amputation.
Design
Verbatim audio-recordings of individual interviews and focus groups were analyzed using qualitative, grounded theory-based metho...
Purpose
To empirically assign severity levels (e.g., mild , moderate ) to four relatively new patient-reported outcome measures (PROMs) for adults with acquired cognitive/language disorders. They include the Communicative Participation Item Bank, the Aphasia Communication Outcome Measure, and Neuro-QoL’s item banks of Cognitive Function (v2.0) and...
Objective
To provide reliability and validity data to support the clinical utility of Econ-QOL scores in caregivers of civilians and service members/veterans (SMVs) with TBI.
Design
Cross-sectional survey study.
Setting
Three academic medical centers and a VA treatment facility.
Participants
376 caregivers of civilians (n=213) and SMVs (n=163) w...
Purpose
The present study tested the fit and comparability of the tripartite model of health (Physical Health, Mental Health, and Social Health) proposed by the NIH PROMIS for adults with SCI and TBI.
Methods
Participants were 630 adults with spinal cord injury (SCI; n = 336) and traumatic brain injury (TBI; n = 294) who completed 8 PROMIS short f...
Patient report of functioning is one component of the neurocognitive exam following traumatic brain injury, and standardized patient-reported outcomes measures are useful to track outcomes during rehabilitation. The Traumatic Brain Injury Quality of Life measurement system (TBI-QOL) is a TBI-specific extension of the PROMIS and Neuro-QoL measuremen...
Motor impairments are pervasive and persistent in children with autism spectrum disorder (ASD) throughout childhood and adolescence. Based on recent studies examining motor impairments in children with ASD between 5 and 15 years (i.e., SPARK study sample), 87–88% of this population is at‐risk for a motor impairment, these problems persisted until 1...
Secondary analysis of cross-sectional data from a multisite survey study.
To describe associations between residential greenspace and psychological well-being among adults living with chronic spinal cord injury (SCI).
Community.
Participants were from the Spinal Cord Injury-Quality of Life (SCI-QOL) Calibration Study (N = 313). Geographic Informati...
Background
Patient-reported outcome (PRO) measures produce scores that do not always have obvious clinical meaning. The PRO-bookmarking procedure is a new and promising way to make PRO measures more meaningful and interpretable. However, the materials and procedures of the task may benefit from adaptations to be more accessible to individuals with...
Objective
Explore trajectories of functional recovery that occur during the first two years after spinal cord injury (SCI).
Design
Observational cohort study.
Setting
Eight SCI Model System sites.
Participants
479 adults with SCI completed four Spinal Cord Injury-Functional Index (SCI-FI) item banks within 4 months of injury and again at 2 weeks...
Objective
To establish responsiveness of 3 Spinal Cord Injury – Functional Index/Capacity (SCI-FI/C) item banks in the first year following SCI.
Design
Longitudinal patient-reported outcomes assessment replicated through secondary analysis of an independent data set.
Setting
8 SCI Model Systems rehabilitation hospitals in the US.
Participants
St...
The Spinal Cord Injury – Functional Index is a system of patient reported outcomes (PRO) measures of functional activities developed specifically with and for individuals with spinal cord injury (SCI). The SCI-FI was designed to overcome limitations in measurement of the full range of activities and breadth of content of physical functioning common...
Objective
While prior studies have found parental socioeconomic status (SES) affects the outcomes of pediatric traumatic brain injury (TBI), the longitudinal trajectory of this effect is not well understood.
Methods
This prospective cohort study included children 8–18 years of age admitted to six sites with a complicated mild (n = 123) or moderate...
Objective
To link three Spinal Cord Injury – Functional Index (SCI-FI) item banks (Basic Mobility, Fine Motor Function, Self-Care) to the PROMIS® Physical Function (PF) metric.
Design
Observational study
Setting
6 SCI Model Systems rehabilitation hospitals in the U.S.
Participants
855 adults with SCI and 730 healthy individuals.
Interventions
N...
Objective
To evaluate the psychometric properties of the Spinal Cord Injury Functional Index (SCI-FI) instruments in a community-dwelling sample.
Design
Cross-sectional study.
Setting
Community setting.
Participants
269 individuals recruited from six SCI Model Systems sites.
Interventions
n/a
Main Outcome Measures
Participants completed comput...
Objective
To develop clinically relevant interpretive standards for the Spinal Cord Injury – Functional Index/Capacity (SCI-FI/C) Basic Mobility and Self-Care item bank scores.
Design
Modified “bookmarking” standard-setting methodology, including two stakeholder consensus meetings with individuals with SCI and SCI clinicians, respectively, and a f...
Background:
Barriers in the built environment, enduring stereotypes and biases, and limited disability competency of health care providers compromise access to and quality of reproductive health care for women with physical disabilities. One way to improve our understanding of critical factors that drive reproductive health inequity and its impact...
Objective
To understand the factor structure of Health-Related Quality of Life (HRQOL) specific to caregivers of people living with Traumatic Brain Injury (TBI).
Design
Prospective, cross-sectional data collection.
Setting
Three TBI Model Systems rehabilitation hospitals, an academic medical center, and a military medical treatment facility.
Par...
Objective: To provide an overview of clinical assessments and diagnostic tools, self-report measures (SRMs) and data sets used in neurogenic bladder and bowel (NBB) dysfunction and recommendations for their use with persons with spinal cord injury /disease (SCI/D).
Methods: Experts in SCI/D conducted literature reviews, compiled a list of NBB relat...
Objective:
Caregivers of individuals with traumatic brain injury (TBI) frequently experience anxiety related to the caregiver role. Often this is due to a caregiver's perceived need to avoid people and situations that might upset or "trigger" the care recipient. There are currently no self-report measures that capture these feelings; thus, this ar...
Purpose:
Family disruption is often an indirect consequence of providing care for a person with traumatic brain injury (TBI). This article describes the development and preliminary validation of a Family Disruption scale designed for inclusion within the TBI-CareQOL measurement system.
Method/design:
Five hundred thirty-four caregivers of person...
Objective:
The Traumatic Brain Injury Caregiver Quality of Life (TBI-CareQOL) is a patient-reported outcome measurement system that is specific to caregivers of civilians and service members/veterans (SMVs) with traumatic brain injury (TBI). This measurement system includes 26 item banks that represent both generic (i.e., borrowed from existing me...
Objective:
Caregivers of individuals with traumatic brain injury (TBI) often feel pressure to maintain the appearance that they are emotionally well adjusted, despite feelings to the contrary. Because there are currently no measures examining this construct, this article focuses on the development of a new measure that is specific to caregivers of...
BACKGROUND
Ensuring care is patient-centered can be particularly challenging in spinal cord injury (SCI). Due to the sudden onset and variable severity, people with SCI often experience a wide range of limitations and secondary complications that evolve over time. Patient-Reported Outcomes (PROs) offer a primary way of monitoring secondary complica...
Objective:
To link scores on commonly used measures of anxiety (7-item Generalized Anxiety Disorder Scale; GAD-7) and depression (9-item Patient Health Questionnaire; PHQ-9) to the Traumatic Brain Injury Quality of Life (TBI-QOL) measurement system.
Setting:
5 Traumatic Brain Injury Model Systems.
Participants:
A total of 385 individuals with...
Objectives:
To describe the development and field testing of the patient-reported outcome measures of Mobility and Upper Extremity function from the Traumatic Brain Injury Quality of Life (TBI-QOL) measurement system, and to evaluate the use of computer adaptive testing.
Setting:
Five rehabilitation facilities funded as part of the TBI Model Sys...
Objective:
To develop, calibrate, and evaluate the test-retest reliability of a new patient-reported outcome measure of headache pain relevant for individuals with traumatic brain injury (TBI).
Setting:
Six TBI Model Systems rehabilitation centers in the United States.
Participants:
Adults with medically confirmed documentation of TBI.
Design...
Objective:
To develop a traumatic brain injury (TBI)-specific, item response theory (IRT)-calibrated Fatigue item bank, short form, and computer adaptive test (CAT) as part of the Traumatic Brain Injury-Quality of Life (TBI-QOL) measurement system.
Setting:
Five TBI Model Systems rehabilitation centers in the US PARTICIPANTS:: Adults with compli...
Objective:
To develop and calibrate new patient-reported outcome measures of cognitive concerns for individuals with traumatic brain injury (TBI).
Setting:
Five TBI model systems rehabilitation centers in the United States.
Participants:
Adults with medically confirmed history of TBI.
Design:
Cross-sectional survey in interview format.
Main...
Objective:
To develop a pain interference item bank, computer adaptive test (CAT), and short form for use by individuals with traumatic brain injury (TBI).
Design:
Cross-sectional survey study.
Setting:
Five TBI Model Systems rehabilitation hospitals.
Participants:
Five hundred ninety individuals with TBI.
Interventions:
Not Applicable.
O...
Objective:
To develop traumatic brain injury (TBI)-optimized versions of the Quality of Life in Neurological Disorders (Neuro-QoL) Ability to Participate in Social Roles and Activities and Satisfaction with Social Roles and Activities item banks, evaluate the psychometric properties of the item banks developed for adults with TBI, develop short fo...
Objective:
To develop an item response theory (IRT)-calibrated, patient-reported outcome measure of subjective independence for individuals with traumatic brain injury (TBI).
Design:
Large-scale item calibration field testing; confirmatory factor analysis (CFA) and graded response model IRT analyses.
Setting:
Five TBI Model System centers acro...
Objective:
To investigate the relationship of 2 health-related quality-of-life (QOL) item banks (Emotional Suppression and Caregiver Vigilance), developed for caregivers of service members/veterans with traumatic brain injury (TBI), to caregivers' positive and negative affect.
Setting:
Community.
Participants:
One hundred sixty-five caregivers...
Purpose
Having independent versions of the PROMIS® scales (for Pediatric and Adults) is problematic as scores cannot be evaluated longitudinally as individuals move from childhood into adulthood. The primary aim of this research project is to use item response theory (IRT) to develop a transitional scoring link (or “crosswalk”) between the PROMIS a...
Objective:
To assess differential item functioning and observed mean differences across two modes of administration for PROMIS® measure scores in a sample of adults with traumatic injury.
Method:
Items from 7 PROMIS® adult measures (v1.0 Physical Function, Fatigue, Pain Interference, Anger, Anxiety, and Depression and v2.0 Social Health-Emotiona...
Purpose
The purpose of this study was to evaluate the internal consistency and construct validity of the Traumatic Brain Injury Quality of Life Communication Item Bank (TBI-QOL COM) short form as a parent-proxy report measure. The TBI-QOL COM is a patient-reported outcome measure of functional communication originally developed as a self-report mea...
Objective:
To examine group differences among caregivers of service members or veterans (SMVs) and civilians with traumatic brain injury (TBI).
Design:
An observational research study examining the group differences between caregivers of SMVs and civilians with TBI. The data presented was collected as part of a larger study that calibrated and v...
Objective: To investigate the association of the sociocultural variables race/ethnicity, education, and poverty level to caregivers’ positive and negative appraisals following traumatic brain injury.
Design: Survey. Setting: Community. Participants: 344 caregivers (216 White; 69 Black; 39 Hispanic) of persons with complicated mild to severe TBI a...
Objective:
To develop a new measurement system, the TBI-CareQOL, that can evaluate both general and caregiving-specific aspects of health-related quality of life (HRQOL) in caregivers of persons with traumatic brain injury (TBI).
Design:
New item pools were developed and refined using literature reviews, qualitative data from focus groups, and c...
Study design:
Secondary analysis of cross-sectional data from a multisite cohort study.
Objectives:
To analyze the association between the built environment and physical functioning reported by adults living with chronic spinal cord injury (SCI).
Setting:
Four US Spinal Cord Injury Model Systems centers in New Jersey, Colorado, Illinois, and M...
Purpose/objective:
To compare and contrast how individuals with traumatic brain injury (TBI) are classified (positive or negative screen) by different cut-offs on two self-report measures of depressive symptoms: the PHQ-9, which assesses somatic symptoms, and the TBI-QOL Depression item bank, which does not. Research Method/Design: Three hundred e...
Objective
To develop a set of composite scores that can be used for interpreting quality of life (QOL) after traumatic brain injury (TBI) using 9 of the patient-reported outcomes measures from the Traumatic Brain Injury Quality of Life (TBI-QOL) measurement system.
Design
Participants completed 20 item banks from the TBI-QOL as part of a larger as...
Objective:
To examine the reliability and validity of the short form (SF) and computer adaptive test (CAT) versions of the Patient Reported Outcomes Measurement Information System (PROMIS) measures of social health of caregivers of civilians and service members/veterans (SMVs) with traumatic brain injury (TBI).
Design:
Self-report questionnaires...
Objective:
To examine the reliability and validity of Patient Reported Outcomes Measurement Information System (PROMIS) measures of sleep disturbance and fatigue in TBI caregivers and to determine the severity of fatigue and sleep disturbance in these caregivers.
Design:
Cross-sectional survey data collected through an online data capture platfo...
Objectives:
To establish the reliability and validity of the newly developed TBI-CareQOL patient reported outcomes measures in caregivers of civilians and service members/veterans (SMVs) with traumatic brain injury (TBI) so that they can be used with confidence in clinical research and practice.
Design:
Computer-based surveys delivered through a...
Objectives:
In this study, we describe unmet service needs of children hospitalized for traumatic brain injury (TBI) during the first 2 years after injury and examine associations between child, family, and injury-related characteristics and unmet needs in 6 domains (physical therapy, occupational therapy, speech therapy, mental health services, e...
Introduction
This study examines the validity and distribution characteristics of the PROMIS® pediatric upper limb measures in a sample of young people with cerebral palsy.
Method
Data are a cross-sectional subset of a larger prospective study of the responsiveness to change of PROMIS® pediatric measures following surgery to improve functioning in...
Objective:
To examine the ability of the Spinal Cord Injury Functional Index Assistive Technology (SCI-FI/AT) measure to detect change in persons with SCI.
Design:
Multi-site, longitudinal (12-month follow-up).
Setting:
9 SCI Model Systems programs.
Participants:
165 adults with SCI enrolled in the SCI Model Systems database.
Interventions:...
Objective:
To assess the responsiveness of the Traumatic Brain Injury - Quality of Life (TBI-QOL) measurement system.
Design:
Participants completed the 20 TBI-QOL item banks and the Participation Assessment with Recombined Tools - Objective (PART-O) Productivity Subscale at baseline and 6-month follow-up assessments. Participants were categoriz...
Study design:
This is a focused review article.
Objectives:
This review presents important features of clinical outcomes assessments (COAs) in human spinal cord injury research. Considerations for COAs by trial phase and International Classification of Functioning, Disability and Health are presented as well as strengths and recommendations for...
Objectives:
First, to evaluate the frequency with which individuals with neurological conditions require test administration accommodations for the NIH Toolbox-Cognition Battery (NIHTB-CB). Second, to evaluate the appropriateness of accommodations provided by administrators, including adherence to NIHTB-CB Reasonable Accommodations Guidelines.
Me...
Purpose/objective:
The National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) includes a group of brief measures (i.e., 30 min) designed to assess language, processing speed, working memory, episodic memory, and executive functioning. These subtests can be combined to create composite scores that reflect fluid and crystallized cognitio...
Purpose/objective:
To apply multivariate base rate analyses to the National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) to facilitate the identification of cognitive impairment in individuals with traumatic brain injury (TBI). Research Method/Design: In a multisite cross-sectional design, 158 participants who sustained a complicated...
Purpose/objective:
Metrics to estimate premorbid cognitive ability, such as word reading tests, are important for clinical determination of cognitive changes following brain injury. In the present study, reading adjusted scores for the National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) fluid tests were developed and validated with...
A State-of-the-Science conference on measurement with disability populations recommended “...the development of cognitive and psychosocial outcome measures, using computer-adaptive testing...that are low in respondent burden and valid across patient populations,” (Clohan et al., 2007, p. 1537). Following this recommendation, the National Institute...
Purpose/objective:
The NIH Toolbox for the Assessment of Neurological Behavior and Function Cognition Battery (NIHTB-CB) is a common data element for use in individuals with traumatic brain injury (TBI). This study evaluates its sensitivity and specificity in distinguishing individuals with complicated mild, moderate, or severe TBI, and provides s...
Objective:
The National Institutes of Health (NIH) Toolbox (NIHTB) for the Assessment of Behavior and Neurological Function Cognition Battery (NIHTB-CB) provides a brief assessment (approximately 30 min) of key components of cognition. This article examines construct validity to support the clinical utility of the NIHTB-CB in individuals with stro...
Purpose/objective:
To compare the cognitive profiles of a well-characterized sample of adults with and without spinal cord injury (SCI) using the NIH Toolbox Cognition Battery NIHTB-CB. Research Method/Design: Participants were 156 community-dwelling individuals with SCI recruited from 3 academic medical centers, and 156 individuals without SCI se...
Objective:
The association between demographic characteristics and neurocognitive performance is well established; however, clinicians may have difficulty selecting when to use uncorrected versus demographically corrected scores. We compared these score types in individuals with traumatic brain injury (TBI) and stroke, on the National Institutes o...
Objective:
The National Institutes of Health Toolbox Cognition Battery (NIHTB-CB) measures reading, vocabulary, episodic memory, working memory, executive functioning, and processing speed. While previous research has validated the factor structure in healthy adults, the factor structure has not been examined in adults with neurological impairment...
Purpose:
To develop and evaluate a model of environmental factors-participation relationships for persons with traumatic brain injury (TBI), stroke, and spinal cord injury (SCI), and test whether this model differed across three diagnostic groups, as well as other demographic and clinical characteristics.
Methods:
A cross-sectional observational...
Objective:
To test the effect that indicators of mobility device quality have on participation outcomes among community dwelling adults with spinal cord injuries (SCI), traumatic brain injuries (TBI) and stroke using structural equation modeling.
Design:
Survey, cross-sectional study, and model testing.
Setting:
Clinical research space at 2 ac...
PurposeThe primary objective is to provide evidence of convergent and discriminant validity for the pediatric and parent-proxy versions of the Patient-Reported Outcomes Measurement Information System (PROMIS) Anxiety, Depression, Anger, Peer Relations, Mobility, Pain Interference, and Fatigue item banks, the Neurology Quality of Life measurement sy...
Objective:
To determine the factor structure of the Traumatic Brain Injury - Quality of Life (TBI-QOL) measurement system.
Design:
Observational.
Setting:
3 TBI Model Systems rehabilitation centers in the US PARTICIPANTS: and Methods: 20 TBI-QOL item banks were administered to a sample of 504 community-dwelling adults with traumatic brain inju...
Background:
People with disabilities, who face multiple barriers to care, experience health disparities, yet few studies have measured health literacy in this population.
Objective:
This study evaluated functional literacy, health literacy, fluid cognitive function, and self-reported health in people who live in community dwellings with spinal c...
Introduction:
The National Institutes of Health Toolbox for Assessment of Neurological and Behavioral Function Cognition Battery is comprised of seven cognitive tests, including two tests measuring crystallized cognitive ability (i.e., vocabulary and reading) and five tests measuring fluid cognitive functioning (i.e., working memory, memory, speed...
Objective:
Individuals with spinal cord injury (SCI), traumatic brain injury (TBI), and stroke experience a variety of neurologically related deficits across multiple domains of function. The NIH Toolbox for the Assessment of Neurological and Behavioral Function (NIHTB) examines motor, sensation, cognition, and emotional functioning. The purpose o...
Objective: To develop modern patient-reported outcome measures that assess pain interference and pain behavior after spinal cord injury (SCI).
Design: Grounded-theory based qualitative item development; large-scale item calibration field-testing; confirmatory factor analyses; graded response model item response theory analyses; statistical linking...
Objective: To identify longitudinal trends in parent-reported language problems in children with traumatic brain injury (TBI). Participants and Methods: Parents of 170 children with TBI completed a battery of outcome measures soon after injury (reporting on premorbid functioning), and again 6 and 12 months post-injury. Of the total sample, 123 (72....
Objectives:
To describe the unique and overlapping content of the newly developed Environmental Factors Item Banks (EFIB) and 7 legacy environmental factor instruments, and to evaluate the EFIB's construct validity by examining associations with legacy instruments.
Design:
Cross-sectional, observational cohort.
Setting:
Community.
Participant...
This study examined the relationships between the Executive Function Performance Test (EFPT), the NIH Toolbox Cognitive Function tests, and neuropsychological executive function measures in 182 persons with traumatic brain injury (TBI) and 46 controls to evaluate construct, discriminant, and predictive validity. Construct validity: There were moder...
Aim:
The present study examined the Patient Reported Outcomes Measurement Information System (PROMIS) Mobility, Fatigue, and Pain Interference Short Forms (SFs) in children and adolescents with cerebral palsy (CP) for the presence of differential item functioning (DIF) relative to the original calibration sample.
Method:
Using the Graded Respons...
Purpose:
Research studies that measure health-related quality of life (HRQOL) in both children and adults and longitudinal studies that follow children into adulthood need measures that can be compared across these age groups. This study links the PROMIS pediatric and adult emotional distress measures using data from participants with diverse heal...
Objective:
Evaluate the psychometric properties of the Spinal Cord Injury Functional Index/Assistive Technology (SCI-FI/AT) short forms (SFs) in the domains of Basic Mobility, Self-Care, Fine Motor Function, and Ambulation based on: internal consistency; correlations between SFs and full item banks, and a 10-item computerized adaptive test (CAT) v...
Study design:
Cross-sectional, focus group.
Objectives:
To explore positive and negative issues reported by family caregivers of people with spinal cord injury (SCI) to develop a relevant and valid tool to assess caregiver distress and benefit for this unique population.
Methods:
Seventy-three family caregivers of people with SCI participated...
Objective:
To provide validation of functional ability levels for the Spinal Cord Injury - Functional Index (SCI-FI).
Design:
Cross-sectional.
Setting:
Inpatient rehabilitation hospital and community settings.
Participants:
A sample of 855 individuals with traumatic spinal cord injury enrolled in 6 rehabilitation centers participating in the...
The purpose of this study was to develop a conceptual framework that captures aspects of health-related quality of life (HRQOL) for caregivers of individuals with military-related traumatic brain injury (TBI). We analyzed qualitative data from nine focus groups composed of caregivers of wounded warriors with a medically documented TBI. Focus group...
Objective:
To examine the clinical utility and psychometric properties of the Traumatic Brain Injury Quality of Life (TBI-QOL) scale in a US military population.
Participants:
One hundred fifty-two US military service members (age: M = 34.3, SD = 9.4; 89.5% men) prospectively enrolled from the Walter Reed National Military Medical Center and oth...