Statistical methods to support a model pediatric traumatic brain injury data bank

描述（由申请人提供）：虽然每年有超过50万的美国儿童因头部受伤而进入急诊室，但儿童创伤性脑损伤（TBI）的许多方面仍然没有得到很好的了解。研究人员在更好地了解脑外伤方面取得了长足的进步，以帮助实现NICHD的使命，确保“……所有儿童都有机会在没有疾病或残疾的情况下，充分发挥其健康和富有成效的生活潜力，并通过最佳康复确保所有人的健康、生产力、独立和福祉。”对于儿童脑外伤，这项研究尤其具有挑战性，而且成本高昂。因此，大多数研究都是小规模的，关于人群差异的信息有限。只有将几项研究结合起来分析，才能发现各种损伤和人口统计学上的症状差异。联合分析小型纵向数据集的统计方法已经有了一些发展。这项工作为解决这个问题建立了一个通用的框架，但是没有填补如何处理现实世界数据复杂性的细节。本提案的总体目标是通过对创伤后不同年龄创伤性脑损伤恢复变化的案例研究，确定联合分析儿科创伤性脑损伤类似研究的可行性和益处。该项目的具体目标是：1。使用现有的元分析方法研究年龄的影响

DESCRIPTION (provided by applicant): While annually over 1/2 million American children visit the emergency room with a head injury, many aspects of pediatric traumatic brain injury (TBI) are still not well understood. Researchers have been making great strides toward a better understanding of TBI to help fulfill the mission of the NICHD to ensure "...that all children have the chance to achieve their full potential for healthy and productive lives, free from disease or disability, and to ensure the health, productivity, independence, and well-being of all people through optimal rehabilitation." For pediatric TBI, this research is particularly challenging and costly to conduct. Thus, most studies are small with limited information about differences across populations. Only analyzing several studies together would permit the discovery of symptom differences across broad spectra of injuries and demographics. There has already been some development of statistical methods for jointly analyzing small collections of longitudinal data. This work has established a general framework for approaching this problem, but has not filled in the details of how to deal with real-world data complications. The broad goal of this proposal is to establish the feasibility and benefit of jointly analyzing similar studies of pediatric TBI through a case study of the variation in TBI recovery across age at injury. The specific aims of the project are to: 1. Use currently available meta-analytic methods to study the effect of age at injury on short- and long- term symptoms of TBI using two completed observational study datasets, while simultaneously precisely identifying current methodological limitations. 2. Develop new statistical methods based on established meta-analytic and missing data approaches to jointly analyze pediatric TBI datasets from observational studies. 3. Identify next steps for creating the Ohio Pediatric TBI Data Bank. The OPT Data Bank would be a data warehouse for studies of pediatric TBI originating at one of the three major Ohio children's hospitals. It would facilitate improved studies of pediatric TBI via the joint analysis of a larger data set, and would serve as a model for data sharing in a wide range of similar fields. The achievement of these aims will pave the way for improved understanding of the effects of TBI in the pediatric population. In turn, this will lead to improved treatment of these children and adolescents. Second, the newly developed statistical methods will be applicable to a broad range of similar medical areas, thus significantly improving the evidence base for making sound patient-centered decisions.