Exploring the measurement of pediatric cognitive-communication disorders in traumatic brain injury research: A scoping review

To synthesize information about the constructs measured, measurement instruments used, and the timing of assessment of cognitive-communication disorders (CCDs) in pediatric traumatic brain injury (TBI) research. Scoping review conducted in alignment with Arksey and O’Malley’s five-stage methodological framework and reported per the PRISMA extension for Scoping Reviews. Inclusion criteria: (a) cohort description, case–control, and treatment studies; (b) participants with TBI aged 5–18 years; (c) communication or psychosocial outcomes; and (d) English full-text journal articles. The first author reviewed all titles, abstracts, and full-text articles; 10% were independently reviewed. Following screening, a total of 687 articles were included and 919 measurement instruments, measuring 2134 unique constructs, were extracted. The Child Behavior Checklist was the most used measurement instrument and ‘Global Outcomes/Recovery’ was the construct most frequently measured. The length of longitudinal monitoring ranged between ≤3 months and 16 years. We found considerable heterogeneity in the constructs measured, the measurement instruments used, and the timing of CCD assessment in pediatric TBI research. A consistent approach to measurement may support clinical decision-making and the efficient use of data beyond individual studies in systematic reviews and meta-analyses.

本研究旨在梳理儿童创伤性脑损伤（pediatric traumatic brain injury, TBI）领域中，针对认知沟通障碍（cognitive-communication disorders, CCDs）的相关研究所涉及的测量构念、所用测量工具及评估时机等信息。本研究采用Arksey与O’Malley提出的五阶段方法学框架开展范围综述（scoping review），并遵循《PRISMA范围综述扩展声明》（PRISMA extension for Scoping Reviews）进行报告。纳入标准如下：(a) 队列研究、病例对照研究与干预性研究；(b) 年龄为5-18岁的创伤性脑损伤受试者；(c) 包含沟通或社会心理结局指标；(d) 英文全文期刊论文。第一作者审阅了所有文献的标题、摘要与全文，其中10%的文献由独立研究者进行复评。经筛选后共纳入687篇文献，提取得到919种测量工具，共覆盖2134个独特测量构念。使用频次最高的测量工具为《儿童行为量表（Child Behavior Checklist）》，最常被测量的构念为‘整体结局/恢复情况’。纵向监测的时长范围介于≤3个月至16年之间。本研究发现，儿童创伤性脑损伤领域中认知沟通障碍相关研究的测量构念、所用测量工具及评估时机均存在显著异质性。采用统一的测量方法或可助力临床决策制定，并提升系统综述与荟萃分析中跨单个研究的数据利用效率。