Special Report: Traumatic Brain Injury Advancements


In hopes of establishing common language for the degree of injury associated with Traumatic Brain Injuries (TBI), how TBI is measured and classified, and treatment and potential outcomes Archives of Physical Medicine and Rehabilitation published a total of nine new articles in its November issue (Vol. 91, No. 11). In an introductory commentary, the TBI Work Group writes that the publications will provide the first set of recommendations intended to promote greater consistency and collaboration among researchers on TBI and psychological health, regardless of funding source.

For their position statement, “a clear, concise definition of traumatic brain injury is fundamental for reporting, comparison, and interpretation of studies on TBI,” writes a group led by David Menon, MD, from the University of Cambridge.1

“Shifting epidemiologic patterns, an escalating recognition of significance of mild TBI, and a better grip of the subtler neurocognitive neuroaffective deficits that may result from these injuries make this need even more vital.” Traumatic brain injury is defined as an alteration in brain function or other evidence of brain pathology caused by an external force.

The work group defines altered brain function as one of the following clinical signs:1

  • Any period of loss of or decreased level of consciousness;
  • Any loss of memory of events immediately before or after the injury;
  • Neurologic deficits such as weakness, loss of balance, change in vision, paralysis, sensory loss, or aphasia; or
  • Any alteration in mental state such as confusion, disorientation, or slowed thinking.

Following are article highlights:
Advancing Integrated Research in Psychological Health and Traumatic Brain injury: Common Data Elements
Without a set of common data elements (CDE) comparison of findings across studies is challenging. With this in mind, researchers looked at the use of different measures to assess similar study variables and/or assess outcomes limits important advances in psychological health (PH) and TBI research.

Common Data Elements for Traumatic Brain Injury: Recommendations from the Interagency Working Group on Demographics and Clinical Assessment
Comparing results across studies in traumatic brain injury (TBI) has been difficult because of the variability in data coding, definitions, and collection procedures. The global aim of the Working Group on Demographics and Clinical Assessment was to develop recommendations on the coding of clinical and demographic variables for TBI studies applicable across the broad spectrum of TBI, and to classify these as core, supplemental, or emerging.

Common Data Elements in Radiologic Imaging of Traumatic Brain Injury
Radiologic brain imaging is the most useful means of visualizing and categorizing the location, nature, and degree of damage to the central nervous system sustained by patients with TBI. In addition to determining acute patient management and prognosis, imaging is crucial for the characterization and classification of injuries for natural history studies and clinical trials.

Common Data Elements for Posttraumatic Stress Disorder Research
A work group was formed under the co-sponsorship of five U.S. federal agencies to identify common data elements for research related to posttraumatic stress disorder.

—Source: American Congress of Rehabilitation Medicine


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