Comparison of question wording for self-reported traumatic brain injuries among adults: findings from the 2023 SummerStyles survey.

BACKGROUND

Surveillance of traumatic brain injury (TBI) in the USA has historically relied on healthcare administrative datasets, but these methods likely undercount the true burden of TBI. Self-report measures may help obtain more comprehensive estimates. A fundamental question is whether TBI prevalence estimated through self-report varies by whether and how TBI signs and symptoms are ascertained in the survey question(s).

METHODS

Self-report data were collected from 4303 adults in the summer wave of Porter Novelli's 2023 ConsumerStyles survey. Respondents were randomised to receive a question about their 12-month experience of head injury and a grouped list of TBI signs/symptoms or a question about their 12-month experience of head injury and an option to select individual TBI signs and symptoms that resulted from the head injury. All respondents who indicated they experienced a head injury received a set of follow-up questions.

RESULTS

A significantly higher percentage of people who received the 'individual signs/symptoms' question self-reported a TBI (8.3%) than those who received the 'grouped signs/symptoms' question (4.3%) χ2=19.6, p<0.0001. Among TBI cases identified, there were no statistical differences between question type in relation to whether the respondent reported being evaluated for or diagnosed with a TBI, nor any demographic differences.

CONCLUSIONS

These results demonstrate that how TBI is ascertained in a survey can meaningfully impact reporting of TBI prevalence and provides evidence that question wording and structure affect estimates on national surveys.