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Glasgow Outcome Scale
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Glasgow Outcome Scale
The Glasgow Outcome Scale (GOS) is an interview-based method used since the 1970's to assess a patient's level of recovery from brain injury. It considers several factors such as a patient's ability to communicate, to function independently in activities of daily living (ADLs), and ability to return to work or school. The basic scale has five broad categories: death, vegetative state, severe disability, moderate disability, or good recovery; an extended version (GOSE) of the original scale includes three sub-categories for a total of eight possible outcomes. Both versions of the scale have been widely adopted in clinical practice, as well as in research studies on brain injury.
The Glasgow Outcome Scale was first described by Bryan Jennett and Michael Bond in 1975 as a tool to characterize both survival and quality of life after brain injury. Soon after its publication, it was used in several different large clinical studies of brain injury throughout the 1970s and early 1980s. In 1981, Jennett and his colleagues expanded the 5-point original GOS by subdividing some of the original categories, resulting in the 8-point Extended Glasgow Outcome Scale (GOSE).
Throughout the 1980s and 1990s, studies assessing the reliability of both the original and extended version of the GOS found that there was significant inter-rater variation in how patients were ranked on the scales based on the differences in background of the assessor. To address this and achieve greater consistency among different assessors, a structured interview format with clearer guidelines was developed in 1998 for both the GOS and GOSE.
The GOSE-Pediatric Revision (GOSE-Peds), introduced in 2012, is the latest development of the GOS. It uses the same 8 outcome categories as the GOSE, but modifies aspects of the structured interview to consider age and developmental differences.
The Glasgow Outcome Scale aims to characterize the overall functional outcome and quality of life in patients after sustaining brain injury. Thus, the scale reflects disability and limitations in major areas of life instead of focusing on specific impairments.
The assessment is conducted in interview format, assessing a patient's level of communication, responsiveness, independence in activities of daily living (ADLs), independence outside the home, ability to work, ability to participate in social or leisure activities, and extent of adverse impact on relationships with others. The Extended Glasgow Outcome Scale further includes assessment of other problems caused by or related to the initial injury, such as headaches, migraines, fatigue, or memory difficulty.
The Glasgow Outcome Scale and Extended Glasgow Outcome Scale are intended for use after discharge from hospital. A derivative of the GOSE, the Glasgow Outcome at Discharge Scale (GODS), was developed in 2013 for use in the inpatient setting.
The GOS and GOSE is carried out as standardized interview assessment. In some cases, the assessor may need to obtain collateral information from a family member or close friend of the patient if the patient is unable to participate or respond reliably. Multiple sources of information can be combined to determine the final overall scoring. After the interview assessment is complete, the assessor categorizes the responses into one of the possible outcome categories outlined by the scale.
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Glasgow Outcome Scale
The Glasgow Outcome Scale (GOS) is an interview-based method used since the 1970's to assess a patient's level of recovery from brain injury. It considers several factors such as a patient's ability to communicate, to function independently in activities of daily living (ADLs), and ability to return to work or school. The basic scale has five broad categories: death, vegetative state, severe disability, moderate disability, or good recovery; an extended version (GOSE) of the original scale includes three sub-categories for a total of eight possible outcomes. Both versions of the scale have been widely adopted in clinical practice, as well as in research studies on brain injury.
The Glasgow Outcome Scale was first described by Bryan Jennett and Michael Bond in 1975 as a tool to characterize both survival and quality of life after brain injury. Soon after its publication, it was used in several different large clinical studies of brain injury throughout the 1970s and early 1980s. In 1981, Jennett and his colleagues expanded the 5-point original GOS by subdividing some of the original categories, resulting in the 8-point Extended Glasgow Outcome Scale (GOSE).
Throughout the 1980s and 1990s, studies assessing the reliability of both the original and extended version of the GOS found that there was significant inter-rater variation in how patients were ranked on the scales based on the differences in background of the assessor. To address this and achieve greater consistency among different assessors, a structured interview format with clearer guidelines was developed in 1998 for both the GOS and GOSE.
The GOSE-Pediatric Revision (GOSE-Peds), introduced in 2012, is the latest development of the GOS. It uses the same 8 outcome categories as the GOSE, but modifies aspects of the structured interview to consider age and developmental differences.
The Glasgow Outcome Scale aims to characterize the overall functional outcome and quality of life in patients after sustaining brain injury. Thus, the scale reflects disability and limitations in major areas of life instead of focusing on specific impairments.
The assessment is conducted in interview format, assessing a patient's level of communication, responsiveness, independence in activities of daily living (ADLs), independence outside the home, ability to work, ability to participate in social or leisure activities, and extent of adverse impact on relationships with others. The Extended Glasgow Outcome Scale further includes assessment of other problems caused by or related to the initial injury, such as headaches, migraines, fatigue, or memory difficulty.
The Glasgow Outcome Scale and Extended Glasgow Outcome Scale are intended for use after discharge from hospital. A derivative of the GOSE, the Glasgow Outcome at Discharge Scale (GODS), was developed in 2013 for use in the inpatient setting.
The GOS and GOSE is carried out as standardized interview assessment. In some cases, the assessor may need to obtain collateral information from a family member or close friend of the patient if the patient is unable to participate or respond reliably. Multiple sources of information can be combined to determine the final overall scoring. After the interview assessment is complete, the assessor categorizes the responses into one of the possible outcome categories outlined by the scale.