Feasibility and Utility of a Flexible Outcome Assessment Battery for Longitudinal Traumatic Brain Injury Research: A TRACK-TBI Study.
Feasibility and Utility of a Flexible Outcome Assessment Battery for Longitudinal Traumatic Brain Injury Research: A TRACK-TBI Study.
复制标题
用于纵向创伤性脑损伤研究的灵活结果评估组合的可行性和实用性：TRACK-TBI 研究。
DOI：
10.1089/neu.2022.0141
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发表时间：
2023
影响因子：
4.2
通讯作者：
Va
中科院分区：
文献类型：
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作者：
Bodien,YelenaG;Barber,Jason;Taylor,SabrinaR;Boase,Kim;Corrigan,JohnD;Dikmen,Sureyya;Gardner,RaquelC;Kramer,JoelH;Levin,Harvey;Machamer,Joan;McAllister,Thomas;Nelson,LindsayD;Ngwenya,LauraB;Sherer,Mark;Stein,MurrayB;Va
在纵向队列研究中，创伤性脑损伤(TBI)的影响很难测量，因为不同的损伤前特征和损伤机制会产生不同的损伤特征和恢复轨迹。为准备进行颅脑损伤的转化研究和临床知识(Track-TBI)研究，我们设计了多维灵活结局评估组合(FAB)，该研究跟踪了从无并发症的轻度脑损伤到昏迷的患者。FAB依赖于一种决策算法，该算法将参与者分配到全面(CAB)或简化评估小组(AAB)，并指导恢复的所有阶段的测试选择。为了评估FAB的可行性，我们计算了伤后2周(2周)、3、6和12个月(3个月、6个月、12个月)完成FAB并获得有效分数的参与者的比例。我们通过检查6M和12M格拉斯哥结果量表扩展(GOSE)得分的差异来评估FAB的效用，这些得分来自启用FAB的参与者亚组与应用于2w时的传统结果评估方法。在受伤后2w(n= 2094)、3m(n= 1871)、6m(n= 1736)和12m(n= 1607)的参与者中，95-99%的人通过面对面或电话获得了FAB的全部或部分有效完成分数。在2w时，通过FAB使能方法评估的功能水平与6M和12M GOSE评分相关(成比例的ODDSP<； 0.001)。这些发现表明，FAB提供的参与者分类方法可能使数据收集更有效，以改进对自然病史变化和脑外伤治疗效果的检测。
The effects of traumatic brain injury (TBI) are difficult to measure in longitudinal cohort studies, because disparate pre-injury characteristics and injury mechanisms produce variable impairment profiles and recovery trajectories. In preparation for the Transforming Research and Clinical Knowledge in TBI (TRACK-TBI) study, which followed patients with injuries ranging from uncomplicated mild TBI to coma, we designed a multi-dimensional Flexible outcome Assessment Battery (FAB). The FAB relies on a decision-making algorithm that assigns participants to a Comprehensive (CAB) or Abbreviated Assessment Battery (AAB) and guides test selection across all phases of recovery. To assess feasibility of the FAB, we calculated the proportion of participants followed at 2 weeks (2w) and at 3, 6, and 12 months (3m, 6m, 12m) post-injury who completed the FAB and received valid scores. We evaluated utility of the FAB by examining differences in 6m and 12m Glasgow Outcome Scale-Extended (GOSE) scores between participant subgroups derived from the FAB-enabled versus traditional approach to outcome assessment applied at 2w. Among participants followed at 2w (n= 2094), 3m (n= 1871), 6m (n= 1736), and 12m (n= 1607) post-injury, 95–99% received valid completion scores on the FAB, in full or in part, either in person or by telephone. Level of function assessed by the FAB-enabled approach at 2w was associated with 6m and 12m GOSE scores (proportional oddsp< 0.001). These findings suggest that the participant classification methodology afforded by the FAB may enable more effective data collection to improve detection of natural history changes and TBI treatment effects.