Orientation Log

Acquired Brain Injury: (Jackson et al, 1998, n = 15 rehabilitation inpatients, 11 TBI, 3 stroke, 1 multi-trauma, mean age = 42.2(26.3), age range = 16-85; total of 75 O-Log scores)

• SEM for individual items = 0.114 - 0.450
• SEM for total score = 0.637

Traumatic Brain Injury: (Novack et al, 2000; n = 68 patients with moderate to severe TBI; mean age = 39.8 years; age range = 16-88 years; mean time since injury = 26 days (range = 4-94); 554 total O-Log observations)

• A score of 25 or greater is associated with normal orientation, comparable to a score of 75 or greater on the Galveston Orientation and Amnesia Test (GOAT)

Traumatic Brain Injury: (Novack et al., 2000)

• Mean score on O-Log = 25.8 (range = 2 to 30)

Traumatic Brain Injury: (Alderson et al, 2002; n = 389 individuals with primarily moderate to severe TBI, mean age 39.4 (17.9), age range = 10-93 years, male = 72.2%) 

• Data below were collected prospectively on serial tests of a subgroup of 90 and applied to the larger sample to develop templates for orientation recovery. All ten administrations of the O-Log were made with no more than two days separating each administration.

Means and 95% confidence intervals for O-Log performance for two levels of injury severity (n = 90)

Acquired Brain Injury: (Jackson et al, 1998) 

• Excellent interrater reliability (ICC = 0.993 for total O-Log, ICC = 0.851 - 1.00 for individual items)

Acquired Brain Injury: (Jackson et al, 1998) 

• Excellent internal consistency of place, time and situation domain scales (Cronbach's alpha's = 0.806, 0.865 and 0.834, respectively)
• Excellent internal consistency of Total O-Log (Cronbach's alpha = 0.922)

Traumatic Brain Injury: (Kean et al., 2011; n = 90; mean age = 48.25 (18.87) years; age range = 17-93 years; mean interval from injury to admission = 23.79 (14.08, range = 2-59) days; 257 ratings total)

• Adequate person separation value of 1.61, which corresponds to a reliability coefficient of 0.72.

Concurrent validity: 

Traumatic Brain Injury: (Novack et al., 2000)

• Excellent correlation between Galveston Orientation and Amnesia Test (GOAT) and O-Log scores (r = .901, p < 0.001) 
• Excellent correlation between estimates of posttraumatic amnesia (PTA) duration (r = 0.99, p < 0.0001) using a cut-off score of at or above 76 for the GOAT and 25 or better for the O-Log
• Excellent correlation between the minimum O-Log score and total Function Independence Measure (FIM) score on admission (r = 0.783, p =0.001)
• Adequate correlation between scores on the O-Log and the Glasgow Coma Scale (GCS) (r = 0.434, p < 0.003)

Traumatic Brain Injury: (Israelian et al., 2000; n = 43; mean age = 45.79; age range = 16-93; male = 32; mean GCS (n = 26) = 7.88 (4.28, range = 3-15); mean time since injury when data collection began = 27.09 (16.51, range = 6-71) days; patients assigned to one of four groups based on O-Log score on admission: 0, 1-10, 11-20, and >20)

• Adequate correlations between score on the GCS and the O-Log score at admission (r = 0.420, p < 0.04) and discharge (r = 0.422, p < 0.04)
• Significant improvement in O-Log scores over the course of hospitalization from day of admission to day of discharge (F(1,39) = 76.21, p < 0.001)
  • Significant Group x Score interaction (F(3,39) = 3.31, p < 0.03), with patients in the two lowest score groups showing the greatest gains over time, followed by patients in the two higher scoring groups who showed more modest gains.
• Significant main effect for day (F(8,272) = 25.34, p < 0.001) and tests of within-subject contrasts showed a significant linear trend (F(1,34) = 74.92, p < 0.001) that suggested orientation scores on the O-Log increased in a linear fashion over the course of testing for all patient groups.
  • Significant Group x Day interaction (F(24,272) = 1.64, p < 0.03), with patients in the four groups starting out at significantly different levels of orientation and by the end of testing the two higher scoring groups were equally oriented, while the two lower scoring groups remained different in their orientation level. This finding suggests that patients who score 11 or higher on the O-Log at admission have a better prognosis for recovery of orientation. 

Traumatic Brain Injury: (Kean et al., 2011) 

• Excellent correlations between raw scores (r = 0.901, p < 0.001) and between estimates of duration of PTA (r = 0.99, p < 0.0001) for O-Log and GOAT

Predictive validity: 

Traumatic Brain Injury: (Novack et al., 2000)

• Adequate predictive validity of minimum O-Log score with rehabilitation discharge total FIM score (r = 0.575, p < 0.001) 

Traumatic Brain Injury: (Alderson et al., 2002; n = 229 from pool of 389; mean age = 41.3 (18.6) years; male = 68.6%; primarily moderate (GCS 9-12, 17.7%) to severe (GCS < 9, 65.5%) TBI patients who were disoriented at inpatient rehabilitation admission) 

• Initial O-log performance, time since injury and number of O-log assessments predicted resolution of disorientation for 76.4% of sample

Traumatic Brain Injury: (Dowler et al., 2000; n = 60 individuals with moderate to severe TBI; mean age 31.3 (13.6) years; mean time since injury = 6 months (SD=4 weeks)) 

• Poor to adequate but significant correlation between minimum rehabilitation O-Log score and Community Integration Questionnaire score (r = 0.395) and Disability Rating Scale scores (r = -0.295) at 12 months post-injury. 
• Poor to adequate but significant correlations between minimum O-Log scores in rehabilitation and neuropsychological tests (r = -0.295-0.395).

Traumatic Brain Injury: (Frey et al., 2007; n = 83 inpatients with TBI; mean age 47.4 (20.4) years) 

• PTA determined by O-Log demonstrated better prediction of rehabilitation outcomes than GOAT 

Traumatic Brain Injury:

• Excellent correlation of O-Log score to admission total FIM score (r = 0.783) and adequate correlation to GCS score (r = .434) (Novack et al, 2000)
• O-log scores of 25 or greater were associated with significantly higher Disability Rating Scale (DRS) and FIM scores (Alderson et al, 2002)
• Adequate correlation with O-Log and GOAT (r = 0.72). (Frey et al, 2007) 

Aquired Brain Injury: (Penna and Novack, 2007; n = 45; mean age = 39.7 (18.5) years; inpatients with acquired brain injury, including TBI, CVA, brain tumor)

• Excellent correlation with MMSE (r = 0.65) and Cog-Log (r = 0.75)

Traumatic Brain Injury: (Kean et al, 2011) 

• Rasch analysis of O-Log results were below criterion level of person separation (reliability coefficient of .72), only able to determine 1 or 2 strata of patients. Authors suggest that O-Log is insufficient to capture the complexity of cognitive issues in TBI recovery, suggest combining it with other instruments.