Discriminatory Capacity of the Physical Domain versus the Full-Scale Pediatric Quality of Life Inventory with Traumatic Brain Injury Severity in Children.

ABSTRACT A previous study demonstrated that the Pediatric Quality of Life Inventory (PedsQL), a health-related quality-of-life instrument consisting of physical and psychosocial domain scores, reliably differentiates between children with varying severities of traumatic brain injuries (TBI) (N = 729) at 3, 12, and 24 months after injury. However, the PedsQL physical domain score alone may simplify evaluation outcomes in physical rehabilitation and clinical research when comparing different trauma interventions. Therefore, we performed a secondary analysis to evaluate and compare the discriminative capacity of TBI injury severity for changes in the overall PedsQL or the PedsQL physical domain score alone. We used linear mixed models to assess the change of outcome scores from baseline compared to arm injury controls. Somers' D was calculated to compare discriminatory capacity with injury severity as a predictor of change in PedsQL outcome scores. We found that TBI severity in children can be differentiated by the PedsQL physical domain score alone. However, at all follow-up timepoints, TBI severity had higher discriminatory capacity for changes in the overall PedsQL. Our results suggest that the overall PedsQL should be used preferentially in children with TBIs, though further investigation of the physical domain is warranted in conditions where physical injuries may predominate.