Validation of an Ecological Organization and Problem Solving Test (TEM-PRO) in Vocational Rehabilitation

Study Overview
=================
Brief Summary
-----------------
Standard neuropsychological evaluations after severe TBI (traumatic brain injury) often minimizes the executive deficits, these latter are known to seriously impair return to work. Therefore, we developed an ecological organization and problem-solving test in a vocational setting called the TEM-PRO. The test consists of 4 activities of variable complexity, collection and redaction of information and demands to follow well defined rules.

Detailed Description
-----------------
While there may be many reasons for obtaining neuropsychological assessement after TBI, predication of the real world functioning is generally the final goal. Among the cognitive deficits, the dysexecutive syndrome is certainly the most disabling in impeding to return to work. The classical neuropsychological tests often fail to asses theses deficits adequately. Several more ecological tests have been previously developed. Based on the multiple errands test and the six elements test, we built up first an ecological test over 60 minutes for activities of the daily living (test des errances multiples,  TEM, version CRR ). Used regularly in the clinical setting, it was able to evaluate the functional aptitudes of the patients and was useful to complete the classical neuropsychological tests. However test duration is too short and activities are far away from real work scenarios to test working aptitudes. Therefore we developed a new executive-ecological test in a vocational setting (TEM-PRO). The adaptation of the original test in a vocational setting induces the addition of 4 activities of variable complexity, research and redaction of information and demands to follow well defined rules. Skills that are solicited are planning, selective and sustained attention, prospective memory, organization, problems solving and behavior adaption over a long period of time. Based on a pilot study with patients without neurological deficit we assessed that our test displayed good sensitivity without ceiling effect. It allowed a quantitative and differentiated evaluation, a classification of various error types (interpretation and judgment failure, rule breaks, task failures and inefficiencies) and provided a qualitative behavioral analysis.

Official Title
-----------------
Validation of an Ecological Organization and Problem Solving Test (TEM-PRO)

Conditions
-----------------
TBI (Traumatic Brain Injury)

Intervention / Treatment
-----------------
* Diagnostic Test: Implementation of a behavioural test for patients with TBI


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: French speaking patients, older than 18 years, able to understand and sign the study informed consent, able to answer questionnaires used in the study, suffering from moderate to severe TBI, without invalidate psychiatric comorbidities, without severe memory impairment, capable to participate for 4h in a vocational activity, planning to return to work. Patients still receiving compensation and patients returned to work will be included Exclusion Criteria: alcohol or drug abuse, severe physical disability interfering with the test (modified Ranking score >1), under legal custody.

Ages Eligible for Study
-----------------
Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Intervention/Treatment |
| --- |
|Diagnostic Test: Implementation of a behavioural test for patients with TBI|The following data will be collected: (1) sociodemographic variables (2); clinical and psychological data; (3) functional tests (neuropsychological testing, TEM version CRR and TEM-PRO). On day one, patients will undergo standard neuropsychological tests and questionnaires listed hereafter, which are commonly used in the clinical practice at the CRR. The Patient Competency Rating Scale (PCRS) TEM (Multiple errands test) GREFEX 5 POINTS TEST TAP 2.3 Behavioral Assessment of the Dysexecutives Syndrome (BADS) On day two, the patients will perform the TEM-PRO test ambulatory in our vocation rehabilitation unit. Predictors variables will be collected before testing: Sociodemographic: age, sex, education, marital status, mother language, time since TBI, severity of the TBI (moderate or severe), type of lesion (contusion, diffuse axonal injury grade 1-3, ischemic or other complications), history of TBI, stroke or meningitis.|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluation of the feasibility of the test. | Is it suitable for TBI patients? | 2020 | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Evaluation of the criterion validity of the TEM-PRO | Evaluation of the reproducibility of the test | 2020 | 
| Comparaison of the diagnostic value of the TEM-PRO with the classical Neuropsychological test and the TEM. | Comparison with existing tests | 2020 | 
| Evaluation of the association between RTW and TEM-PRO | Can the test be a predictor of RTW? | 2022 | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
Multiple errands tests