Concordance between the Awareness Questionnaire and Self-Awareness of Deficits Interview for identifying impaired self-awareness in individuals with traumatic brain injury in the community.

Abstract

To investigate concordance between the Awareness Questionnaire (AQ) and Self-Awareness of Deficits Interview (SADI) for identifying impaired self-awareness in the community after traumatic brain injury. A retrospective file audit was conducted to retrieve data on the AQ and SADI for participants with traumatic brain injury involved in previous studies on community-based outcomes. Concordance between the AQ and SADI was examined using receiver operating characteristic curves for different scores on each measure. A total of 80 individuals with moderate-to-severe traumatic brain injury (81% male, mean age 2.25 years, standard deviation (SD) 11.5 years) living in the community. Participants were administered the AQ and SADI and their significant other completed the AQ and SADI checklist. Consistency of classification of impaired self-awareness between the AQ and SADI was high (i.e. 80-84%) based on scores reflecting good sensitivity and specificity. Corresponding scores on the 2 measures and rates of impaired self-awareness were as follows: SADI > 3~AQ discrepancy > 4 (45-48% with impaired self-awareness); SADI > 4~AQ discrepancy > 9 (26-34% with impaired self-awareness); SADI > 5~AQ discrepancy >12 (13-26% with impaired self-awareness). The AQ and SADI yielded consistent information regarding the presence of impaired self-awareness in community-based individuals with traumatic brain injury. The choice of measure may depend on how the tool is being used to guide rehabilitation planning.