NINDS CDE Notice of Copyright
Glasgow Outcome Scale Extended (GOSE)
The Glasgow Outcome Scale-Extended is freely available: Glasgow Outcome Scale-Extended.
Core: Traumatic Brain Injury (TBI)
Supplemental: Stroke and Unruptured Cerebral Aneurysms and Subarachnoid Hemorrhage (SAH)
Short Description of Instrument
Purpose: The Glasgow Outcome Scale- Extended was developed as a more sensitive instrument to detect small but clinically relevant treatment effects (Weir et al., 2012) in people who sustain acute brain damage from head injury or non- traumatic brain insults. Developed in 1981 (Jennett, Snoek, Bond,& Brooks, 1981) the GOSE expanded the Glasgow Outcome Scale from 5 to 8 categories that in addition to assessing the disability or handicap of a person accessed whether the person had gotten better or worse after treatment for their initial insult. Like the GOS, the GOSE is not intended to provide detailed information about the specific difficulties faced by individual patients, but to give a general index of overall outcome.
Overview: The GOSE is a revision of the GOS that divides the upper three ratings into upper and lower categories – lower severe disability, upper severe disability, lower moderate disability, upper moderate disability, lower good recovery, upper good recovery.
Time: Depending on prior familiarity with the patient, the scale can be completed in as little as 5 minutes.
Psychometric Properties: An inter-rater reliability study of the structured interview found the standard format of the GOSE assessment within a written protocol is practical and reliable (Wilson, Pettigrew,& Teasdale, 1998). These scales are very commonly used to predict global outcomes and there is an extensive literature demonstrating reliability and validity for each scale.
Other Important Notes: Some have questioned the validity of the GOSE with children; there is an adaptation that can be used with children (Beers et al., 2012).
Ratings for the GOSE range from 1 to 8 (Dead to Upper Good Recovery).
The GOSE is generally rated by a clinician or research assistant who is familiar with the patient or who conducts a structured interview to obtain needed information. GOSE ratings are easily recoded to GOS ratings.
Wilson JT, Pettigrew LE, Teasdale GM. Structured interviews for the Glasgow Outcome Scale and the extended Glasgow Outcome Scale: guidelines for their use. J Neurotrauma. 1998;15(8):573–585.
Additional References:
Beers SR, Wisniewski SR, Garcia-Filion P, Tian Y, Hahner T, Berger RP, Bell MJ, Adelson PD. Validity of a pediatric version of the Glasgow Outcome Scale-Extended. J Neurotrauma. 2012;29(6):1126–1139.
Hellawell DJ, Signorini DF. The Edinburgh Extended Glasgow Outcome Scale (EEGOS): rationale and pilot studies. Int J Rehabil Res. 1997;20(4):345–354.
Jennett B, Snoek J, Bond MR, Brooks N. Disability after severe head injury: observations on the use of the Glasgow Outcome Scale. J Neurol Neurosurg Psychiatry. 1981;44(4):285–293.
Jennett B, Bond M. Assessment of outcome after severe brain damage. Lancet. 1975;1(7905):480–484.
Levin HS, Boake C, Song J, Mccauley S, Contant C, Diaz-Marchan P, Brundage S, Goodman H, Kotrla KJ. Validity and sensitivity to change of the extended Glasgow Outcome Scale in mild to moderate traumatic brain injury. J Neurotrauma. 2001;18(6):575–584.
Sander, A. (2002). The Extended Glasgow Outcome Scale. The Center for Outcome Measurement in Brain Injury. http://www.tbims.org/combi/gose       (accessed July 8, 2015 ).
Teasdale GM, Pettigrew LE, Wilson JT, Murray G, Jennett B. Analyzing outcome of treatment of severe head injury: a review and update on advancing the use of the Glasgow Outcome Scale. J Neurotrauma. 1998;15(8):587–597.
Weir J, Steyerberg EW, Butcher I, Lu J, Lingsma HF, McHugh GS, Roozenbeek B, Maas AI, Murray GD. Does the extended Glasgow Outcome Scale add value to the conventional Glasgow Outcome Scale? J Neurotrauma. 2012;29(1):53–58.
Wilson JT, Pettigrew LE, Teasdale GM. Emotional and cognitive consequences of head injury in relation to the glasgow outcome scale. J Neurol Neurosurg Psychiatry. 2000;69(2):204–209.
Wilson JT, Slieker FJ, Legrand V, Murray G, Stocchetti N, Maas AI. Observer variation in the assessment of outcome in traumatic brain injury: experience from a multicenter, international randomized clinical trial. Neurosurgery. 2007;61(1):123–128; discussion 128–129.
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