Table 3. Functional outcome scales that can be applied in tuberculous meningitis (TBM).
| Description and purpose | Validity, reliability & responsiveness
to change * |
Feasibility | Examples of use
in TBM studies |
|---|---|---|---|
|
Modified Rankin Scale
Designed for stroke trials using six-point scale (0 = asymptomatic, 6 = dead). Most commonly used functional assessment. |
• High validity (with other stroke scales)
• Moderate reliability (stroke trials), which can be improved with use of structured questionnaire 66 • Limited responsiveness to change because of limited possible scores (five in survivors) |
Brief yet global measure of
functional recovery. |
8, 67 |
|
Barthel Index
Primarily measures independence and assists in long-term care planning in non- stroke settings. Ten-item scale delivered through a questionnaire (total score of 100) assessing ability to perform activities of daily living. |
• Moderate validity
• Moderate reliability • High responsiveness to change though limited by ‘ceiling’ effect 64 |
Best if based on direct
observation of task but can also be done with proxy-based or telephone assessment. |
68– 71 |
|
WHO Disability Assessment Schedule
(WHODAS) 2.0 Designed for use in adults across cultures and diseases. Questionnaire assesses six domains: cognition, mobility, self- care, interaction with others, life activities, participation. Directly linked at the level of the concepts to the International Classification of Functioning, Disability and Health (ICF). |
• Moderate to satisfactory validity
and reliability in European rehabilitation patients with a variety of brain disorders • Limited to moderate responsiveness to change 72, 73 |
Brief (12-item) questionnaire
takes five minutes, long version (36-item) takes 20 minutes. Can be administered by telephone or proxy. Two scoring systems: simple (simple arithmetic), or a complex (domain-weighted with statistical algorithm). |
Not yet used in
TBM studies |
|
Liverpool Outcome Scale
Designed for paediatric outcomes at hospital discharge following viral encephalitis. Fifteen-item scale giving a total score of up to 75. The outcome score (range 2–5) is the lowest score for any single question. |
• Moderate validity
• Good inter-observer reliability 65 • Responsiveness to change not tested |
Deemed feasible in children.
Not assessed in adults yet. |
To date only used
in paediatric brain infection studies 65 |
|
Glasgow outcome scale extended
version for adults and paediatrics (GOS-E & GOS-E-peds) Widely used in traumatic brain injury research and practice. Scale exists in adult and paediatric versions. Eight-item scale. |
• Good validity in paediatric patients
after severe traumatic brain injuries 74 • Good reliability and validity 75 |
Simple, short administration
time, flexibility of administration (face-to-face, over the telephone and by post) 76, 77. |
Not yet used in
TBM studies |
* ‘Validity’ describes the correlation with other assessment tools, ‘reliability’ describes the consistency of scoring between assessors (inter-assessor) and within assessors (intra-assessor), ‘responsiveness to change’ describes the ability of the tool to detect meaningful change over time 64. Please also refer to “Neurocognitive and functional impairment in adult and paediatric Tuberculous Meningitis” in this Tuberculous Meningitis International Research Consortium collection 78.