J Head Trauma Rehabil Vol. 31, No. 1, pp. 52–61 Copyright c  2016 Wolters Kluwer Health | Lippincott Williams & Wilkins Development and Initial Validation of Military Deployment-Related TBI Quality-of-Life Item Banks Peter A. Toyinbo, MBChB, PhD, CPH; Rodney D. Vanderploeg, PhD; Alison J. Donnell, PhD; Sandra A. Mutolo, MSW; Karon F. Cook, PhD; Pamela A. Kisala, MA; David S. Tulsky, PhD Objective: To investigate unique factors that affect health-related quality of life (QOL) in individuals with military deployment–related traumatic brain injury (MDR-TBI) and to develop appropriate assessment tools, consistent with the TBI-QOL/PROMIS/Neuro-QOL systems. Participants: Three focus groups from each of the 4 Veterans Administration (VA) Polytrauma Rehabilitation Centers, consisting of 20 veterans with mild to severe MDR-TBI, and 36 VA providers were involved in early stage of new item banks development. The item banks were field tested in a sample (N = 485) of veterans enrolled in VA and diagnosed with an MDR-TBI. Design: Focus groups and survey. Outcome Measures: Developed item banks and short forms for Guilt, Posttraumatic Stress Disorder/ Trauma, and Military-Related Loss. Results: Three new item banks representing unique domains of MDR-TBI health outcomes were created: 15 new Posttraumatic Stress Disorder items plus 16 SCI-QOL legacy Trauma items, 37 new Military-Related Loss items plus 18 TBI-QOL legacy Grief/Loss items, and 33 new Guilt items. Exploratory and confirmatory factor analyses plus bifactor analysis of the items supported sufficient unidimensionality of the new item pools. Convergent and discriminant analyses results, as well as known group comparisons, provided initial support for the validity and clinical utility of the new item response theory–calibrated item banks and their short forms. Conclusion: This work provides a unique opportunity to identify issues specific to individuals with MDR- TBI and ensure that they are captured in QOL assessment, thus extending the existing TBI-QOL measurement system. Key words: health-related quality of life, outcome assessment (healthcare), patient-reported outcomes, quality of life, rehabilitation, traumatic brain injury Author Affiliations: Health Services Research and Development (HSR&D)/Rehabilitation Research and Development (RR&D) Center of Innovation on Disability and Rehabilitation Research (CINDRR) (Drs Toyinbo and Vanderploeg, and Ms Mutolo), and Mental Health and Behavioral Sciences Service (Drs Vanderploeg and Donnell), James A. Haley Veterans’ Hospital, Tampa, Florida; Departments of Psychiatry & Behavioral Neurosciences (Dr Vanderploeg) and Psychology (Dr Vanderploeg), University of South Florida, Tampa; Defense and Veterans Brain Injury Center, Tampa, Florida (Drs Vanderploeg and Donnell); Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, Chicago, Illinois (Dr Cook); Rusk Institute/Departments of Rehabilitation Medicine, Orthopedic Surgery, and General Medicine, New York University Langone Medical Center, New York (Dr Tulsky); Rusk Institute/Department of Rehabilitation Medicine, New York University Langone Medical Center, New York (Ms Kisala); and Kessler Foundation, West Orange, New Jersey (Dr Tulsky). This research was supported by the Department of Veterans Affairs, Veterans Health Administration, and VA RR&D grant B6237R, Development of a Quality of Life Tool for Deployment-Related TBI, to Shirley Groer and Rodney D. Vanderploeg. Further support was provided by James A. Haley Veterans’ Hospital and the Defense and Veterans Brain Injury Center. The authors thank Shirley Groer, PhD, for her invaluable contributions to the original grant application, and study design and management. They also thank Stephen L. Luther, PhD, for his invaluable consultation on the manuscript preparation. The views expressed herein are those of the authors and do not necessarily reflect the views or the official policy of the Department of Army, Department of Defense, Department of Veterans Affairs, or US Government. H EALTH-RELATED QUALITY OF LIFE (HRQOL) is a multidimensional construct that “refers to the extent to which one’s usual or expected physical, emotional, and social well-being are affected by a medical condition or its treatment.” 1(p73) . In 2004, the National Institutes of Health funded the development of the Patient Reported Outcomes Measurement Information System (PROMIS) to as- sess important health-related changes in individuals’ No work resembling the enclosed article has been published or is being submitted for publication elsewhere. All authors have certified in writing that they have read the final version of the manuscript and have made a substantial contri- bution to the research and final manuscript in accordance with the guidelines of the Uniform Requirements. Supplemental digital content is available for this article. Direct URL citation appears in the printed text and are provided in the HTML and PDF versions of this article on the journal’s Web site (www.headtraumarehab.com). The authors declare no conflicts of interest. Corresponding Author: Rodney D. Vanderploeg, PhD, James A. Haley Veterans’ Hospital Psychology Service (116B), 13000 Bruce B. Downs Blvd, Tampa, FL 33612. (Rodney.Vanderploeg@va.gov). DOI: 10.1097/HTR.0000000000000089 Copyright © 2016 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited. 52