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Research paper
QOLIBRI Overall Scale: a brief index of health-related quality of life after traumatic brain injury
  1. Nicole von Steinbuechel1,
  2. Lindsay Wilson2,
  3. Henning Gibbons1,
  4. Holger Muehlan3,
  5. Holger Schmidt4,
  6. Silke Schmidt4,
  7. Nadine Sasse1,
  8. Sanna Koskinen5,
  9. Jaana Sarajuuri5,
  10. Stefan Höfer6,
  11. Monika Bullinger7,
  12. Andrew Maas8,
  13. Edmund Neugebauer9,
  14. Jane Powell10,
  15. Klaus von Wild11,
  16. George Zitnay12,
  17. Wilbert Bakx13,
  18. Anne-Lise Christensen14,
  19. Rita Formisano15,
  20. Graeme Hawthorne16,
  21. Jean-Luc Truelle17
  1. 1Department of Medical Psychology and Medical Sociology, Georg-August-University, Göttingen, Germany
  2. 2Division of Psychology, University of Stirling, Stirling, UK
  3. 3Department of Health and Prevention, University of Greifswald, Greifswald, Germany
  4. 4Department of Neurology, University Medical Center, Göttingen, Germany
  5. 5Unit of Clinical Neuropsychology and Psychology, Käpylä Rehabilitation Centre, Helsinki, Finland
  6. 6Department of Medical Psychology, Innsbruck Medical University, Innsbruck, Austria
  7. 7Institut und Poliklinik für Medizinische Psychologie, University of Hamburg, Hamburg, Germany
  8. 8Department of Neurosurgery, University Hospital Antwerp, Antwerp, Belgium
  9. 9Institute for Research in Operative Medicine, University of Witten/Herdecke, Cologne, Germany
  10. 10Department of Psychology, Goldsmiths, University of London, London, UK
  11. 11Westfälische Wilhelms-University, Münster, Germany
  12. 12University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
  13. 13Adelante Adult Rehabilitation Centre, Maastricht University, Maastricht, The Netherlands
  14. 14Centre for Rehabilitation of Brain Injury and Centre for Cognition and Memory, University of Copenhagen, Copenhagen, Denmark
  15. 15IRCCS Fondazione ‘Santa Lucia’, Rome, Italy
  16. 16Department of Psychiatry, University of Melbourne, Victoria, Australia
  17. 17Rehabilitation Department, University Hospital Garches, Garches, France
  1. Correspondence to Professor Lindsay Wilson, Department of Psychology, University of Stirling, Stirling FK9 4LA, UK; jtlw1{at}


Background The Quality of Life after Brain Injury (QOLIBRI) scale is a recently developed instrument that provides a profile of health-related quality of life (HRQoL) in domains typically affected by brain injury. However, for global assessment it is desirable to have a brief summary measure. This study examined a 6-item QOLIBRI Overall Scale (QOLIBRI-OS), and considered whether it could provide an index of HRQoL after traumatic brain injury (TBI).

Methods The properties of the QOLIBRI-OS were studied in a sample of 792 participants with TBI recruited from centres in nine countries covering six languages. An examination of construct validity was undertaken on a subsample of 153 participants recruited in Germany who had been assessed on two relevant brief quality of life measures, the Satisfaction With Life Scale and the Quality of Life Visual Analogue Scale.

Results The reliability of the QOLIBRI-OS was good (Cronbach's α=0.86, test–retest reliability =0.81) and similar in participants with higher and lower cognitive performance. Factor analysis indicated that the scale is unidimensional. Rasch analysis also showed a satisfactory fit with this model. The QOLIBRI-OS correlates highly with the total score from the full QOLIBRI scale (r=0.87). Moderate to strong relationships were found among the QOLIBRI-OS and the Extended Glasgow Outcome Scale, Short-Form-36, and Hospital Anxiety and Depression scale (r=0.54 to -0.76). The QOLIBRI-OS showed good construct validity in the TBI group.

Conclusions The QOLIBRI-OS assesses a similar construct to the QOLIBRI total score and can be used as a brief index of HRQoL for TBI.

  • Traumatic brain injury
  • outcome
  • health-related
  • quality of life
  • head injury
  • exptl
  • cognitive neuropsych
  • applied
  • psychology
  • rehabilitation
  • trauma
  • psychol seque
  • neurosurgery
  • behavioural disorder
  • subarachnoid haemorrhage
  • frontal lobe
  • psychopharmacology
  • epidemiology
  • depression
  • statistics

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  • An additional appendix is published online only. To view this file please visit the journal online (

  • NvS and LW are joint first authors.

  • Funding This work was supported by research grant 2008014 from the ZNS—Hannelore Kohl Foundation, Germany. The Australian data were collected under grant D114 from the Victorian Transport Accident Commission. Italian data were collected under grant RF08.31 from the Italian Ministry of Health.

  • Competing interests None.

  • Ethics approval Ethics approval was provided by the South Glasgow and Clyde Local Research Ethics Committee and other local RECs.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The database is under the management of the QOLIBRI Steering Committee, and researchers who contributed to the data set can request access. Use of the data is monitored by the QOLIBRI Methodological Centre.