Informing the development of an outcome set and banks of items to measure mobility among individuals with acquired brain injury using natural language processing

Background: The sheer number of measures evaluating mobility and inconsistencies in terminology make it challenging to extract potential core domains and items. Automating a portion of the data synthesis would allow us to cover a much larger volume of studies and databases in a smaller fraction of the time compared to the usual process. Thus, the objective of this study was to identify a comprehensive outcome set and develop preliminary banks of items of mobility among individuals with acquired brain injury (ABI) using Natural Language Processing (NLP).

Methods: An umbrella review of 47 reviews evaluating the content of mobility measures among individuals with ABI was conducted. A search was performed on 5 databases between 2000 and 2020. Two independent reviewers retrieved copies of the measures and extracted mobility domains and items. A pre-trained BERT model (state-of-the-art model for NLP) provided vector representations for each sentence. Using the International Classification of Functioning, Disability, and Health Framework (ICF) ontology as a guide for clustering, a k-means algorithm was used to retrieve clusters of similar sentences from their embeddings. The resulting embedding clusters were evaluated using the Silhouette score and fine-tuned according to expert input.

Results: The study identified 246 mobility measures, including 474 domains and 2109 items. Encoding the clusters using the ICF ontology and expert knowledge helped in regrouping the items in a way that is more closely related to mobility terminology. Our best results identified banks of items that were used to create a 24 comprehensive outcome sets of mobility, including Upper Extremity Mobility, Emotional Function, Balance, Motor Control, Self-care, Social Life and Relationships, Cognition, Walking, Postural Transition, Recreation, and Leisure Activities, Activities of Daily Living, Physical Functioning, Communication, Work/Study, Climbing, Sensory Functions, General Health, Fatigue, Functional Independence, Pain, Alcohol and Drugs Use, Transportation, Sleeping, and Finances.

Conclusion: The banks of items of mobility domains represent a first step toward establishing a comprehensive outcome set and a common language of mobility to develop the ontology. It enables researchers and healthcare professionals to begin exposing the content of mobility measures as a way to assess mobility comprehensively.


Rehab Alhasani, Mathieu Godbout, Audrey Durand, Claudine Auger, Anouk Lamontagne, Sara Ahmed


Journal: BMC Neurology
Volume: 22
Issue: 1
Pages: 464 -
Year: 2022
DOI: 10.1186/s12883-022-02938-1

Further Study Information

Current Stage: Completed
Funding source(s): (1) Initiatives pour le développement de Nouvelles technolo-gies et Pratiques en Réadaptation (INSPIRE) Lindsay Foundation, (2) the Canadian Foundation of Innovation Funding for the Biomedical Research and Informatics Living Laboratory for Innovative Advances of New Technologies in Community Mobility Rehabilitation (BRIL-LIANT) (https:// www.brill iant-cf). The funding bodies played no role in the design of the study and collection, analysis, and interpretation of data and in writing the manuscript

Health Area

Disease Category: Neurology

Disease Name: Acquired brain injury

Target Population

Age Range: Unknown

Sex: Either

Nature of Intervention: Other

Stakeholders Involved

Study Type

- Systematic review of outcomes measured in trials


- Systematic review

A comprehensive search of the literature was performed using electronic databases
of Ovid MEDLINE, CINHAL, Cochrane Library and EMBASE from 2000 to March 2020.

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