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26-560: The scale was first developed by Jennett and Bond in 1975. Later, in 1981, Jennett et al. introduced the Extended Glasgow Outcome Scale (GOSE), which subdivided the upper three categories of the original scale.  This resulted in the GOSE having eight outcome categories, which aimed at providing more nuanced distinction between each category. Since their introductions, both the original and extended versions of

52-527: A 2016 review on the management of traumatic brain injury that examined over 160 randomized controlled trials published between 1980 and 2015, the GOS or GOSE was the outcome measurement reported in over two-thirds of the trials. While the GOS is a widely used outcomes measure for assessing patients with brain injury, many other neurological outcome scales exist, including the Modified Rankin Scale ,

78-461: A doctor at the University of Liverpool . Jennett studied at Liverpool Medical School . He finished top of his year and was President of the national British Medical Students Association. Jennett's first mentor in medicine, Henry Cohen, 1st Baron Cohen of Birkenhead , encouraged him toward a career in neurosurgery. He went on to take posts at Oxford, Cardiff and Manchester as well as a spell in

104-542: A few weeks after that final publication, having been diagnosed with multiple myeloma five years earlier. His wife Sheila and his three children survived him. Modified Rankin Scale The modified Rankin Scale ( mRS ) is a commonly used scale for measuring the degree of disability or dependence in the daily activities of people who have suffered a stroke or other causes of neurological disability. It has become

130-556: A new combined NHS/University position in Glasgow. Over the next ten years he became a Professor and moved to a purpose built unit at the Southern General Hospital. Prior to moving to Glasgow, Jennett published work on epilepsy following head injuries. He published Introduction to Neurosurgery in 1964. Jennett set up a prospective computerised data bank to collect the features and outcome of head injuries. Data

156-500: A phrase which remains in widespread use today. His work with the Glasgow-based Neuropathologists Adams and Graham significantly reduced mortality and disability. Many international collaborative studies followed, comparing outcomes after different severity of injury and with alternative therapeutic regimes. In 1976 there was furore over a BBC Panorama Programme which questioned the criteria for

182-675: A short paper in The Lancet . This was the first use of the term "economy-class syndrome". Jennett retired in 1991. In his later years, he was named Commander of the Order of the British Empire (CBE) and received an honorary doctorate from St Andrews University . His continuing work included a 2002 monograph, The Vegetative State , and his final publication appeared in the British Journal of Neurosurgery in 2008. He died

208-399: 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

234-587: The Royal Army Medical Corps . His academic interests were not congruent with the times and he was turned down for promotion in Oxford, Manchester and Dundee. He believed that the NHS at the time placed too much emphasis on patronage and were not supportive of academic interests. He considered a permanent move to America after a one-year Rockefeller Fellowship at UCLA , but was headhunted in 1963 for

260-491: 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,

286-524: The Cerebral Performance Category Scale, and Functional Status Examination. Both the original GOS and the GOSE were found to have significant inter-rater variability shortly after they were introduced. This resulted in the development of a structured interview format with detailed guidelines to improve reliability and consistency between different raters. Shortly after the development of the structured interview guidelines, it

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312-550: The appropriate use of high-cost medical technology. He was President of the International Society for Technology Assessment and in 1984 he published High Technology Medicine: Benefits and Burdens followed a series of BBC talks Doctors, Patients & Responsibilities which were widely praised. In 1988 he developed deep-vein thrombosis (DVT) which he blamed on the cramped seating on an aircraft. Along with colleagues who had similar experiences, he published

338-635: 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. The original Glasgow outcome scale outlined five possible outcome categories: death, persistent vegetative state, severe disability, moderate disability and good recovery. The Extended Glasgow Outcome Scale (GOSE) subdivided

364-538: The care of patients with brain injuries. in 1972, Jennett and the neurologist Fred Plum coined the term vegetative state . Jennett was born and raised in Twickenham to Irish and Scottish parents. Jennett was evacuated from Twickenham during the Second World War. He first moved to rural Scotland and later to Southport, Lancashire where he attended King George V Grammar School before training as

390-539: The emotional aspects associated with the injury or recovery. Bryan Jennett William Bryan Jennett CBE (1 March 1926 – 26 January 2008) was a British neurosurgeon, a faculty member at the University of Glasgow Medical School , and the first full-time chair of neurosurgery in Scotland. He was the co-developer of the assessment tool known as the Glasgow Coma Scale and made advancements in

416-567: The establishment of brain death in potential organ donors. Jennett was in demand as a speaker and in the UK contributed to medical panels and was called to Court as an expert witness, most notably for the Tony Bland case. Jennett was Dean of Medicine at Glasgow in the 1980s. He worked with Barbara Stocking and Chris Ham of the King's Fund to establish a series of Consensus Conferences to deal with

442-476: 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,

468-584: The mRS can be improved by using a structured questionnaire during the interview process and by having raters undergo a multimedia training process. The multimedia mRS training system which was developed by Prof. K. Lees' group at the University of Glasgow is available online . The mRS is frequently criticized for its subjective nature which is viewed as skewing results, but is used throughout hospital systems to assess rehabilitation needs and outpatient course. These criticisms were addressed by researchers creating structured interviews which ask simple questions both

494-527: The most widely used clinical outcome measure for stroke clinical trials . The scale was originally introduced in 1957 by Dr. John Rankin of Stobhill Hospital , Glasgow, Scotland as a 5-level scale ranging from 1 to 5. It was then modified by either van Swieten et al. or perhaps Prof. C. Warlow's group at Western General Hospital in Edinburgh for use in the UK-TIA study in the late 1980s to include

520-617: 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 level of consciousness, 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

546-653: The same eight outcome categories as the GOSE. The Glasgow Outcome Scale is widely used in clinical settings to evaluate patients who have suffered brain injury. It is the recommended outcomes measure for major trauma and head injury by many national-level organizations, including the NIH National Institute of Child Health and Human Development, and the National Institute of Neurological Disorders and Stroke. The Glasgow Outcome Scale has also been extensively used in research and clinical trials. In

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572-461: 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

598-450: The three upper categories of the original GOS. This resulted in eight total outcome categories: death, persistent vegetative state, lower severe disability, upper severe disability, lower moderate disability, upper moderate disability, lower good recovery, and upper good recovery. The Glasgow Outcome Scale-Pediatric Revision (GOSE-P) adjusts the interview questions to account for age and developmental differences in pediatric patients. It uses

624-459: The value '0' for patients who had no symptoms. As late as 2005 the scale was still being reported as ranging from 0 to 5. Somewhere between 2005 and 2008 the final change was made to add the value '6' to designate patients who had died. The modern version of modified version differs from Rankin's original scale mainly in the addition of grade 0, indicating a lack of symptoms, and the addition of grade 6 indicating dead. Interobserver reliability of

650-595: Was compiled from Glasgow, the United States, and the Netherlands over a long period and led to a series of papers in the 1970s, the introduction of the near universally adopted Glasgow Coma Scale (GCS) with Graham Teasdale , and the Glasgow Outcome Scale with Bond. In 1972 working with Dr Plum of America, Jennett published The Persistent Vegetative State – defining a condition and coining

676-563: Was reported that use of this format greatly improved the reliability of both the GOS and GOSE. However, some critics still voice concerns over these figures, and report that inter-rater variability remains high when used by untrained assessors. One criticism of the GOS is that it does not account for the patient's perspective of the injury and satisfaction with life after the injury. The GOS may not measure specific aspects of recovery or quality of life that are important to patients and families. It does not directly assess for patient satisfaction or

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