Imaging Common Data Elements as Predictors of Long-Term Outcome in Pediatric TBI

将通用数据元素成像作为儿科 TBI 长期结果的预测因子

• 批准号: 8749839
• 负责人: Jill Hunter
• 金额: $ 7.83万
• 依托单位: BAYLOR COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-10 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8749839
• 关键词: Academic achievement; Acidosis; Acute; Address; Adolescent; Age; Apnea; Brain Injuries; Brain imaging; Caring; Cause of Death; Centers for Disease Control and Prevention (U.S.); Cerebral Edema; Cerebral perfusion pressure; Characteristics; Child; Childhood; Childhood Injury; Clinical; Clinical Data; Clinical Treatment; Code; Cognition; Collection; Common Data Element; Data; Epidemiology; Funding; Gender; Glasgow Coma Scale; Head; Hospitalization; Hour; Hypertension; Hypoxia; Image; Incidence; Individual; Injury; International; Intracranial Hypertension; Lesion; Location; Long-Term Effects; Longitudinal Studies; Magnetic Resonance Imaging; Measures; Medical; Modality; Modeling; Natural History; Neurological status; Operative Surgical Procedures; Outcome; Outcome Measure; Parents; Participant; Pathology; Patients; Pattern; Physiological; Quality of life; Recovery; Recruitment Activity; Rehabilitation therapy; Relative (related person); Research; Research Infrastructure; Scanning; Sedation procedure; Site; Socioeconomic Status; Subdural Hematoma; Temperature; Time; Trauma; Traumatic Brain Injury; United States; X-Ray Computed Tomography; aged; base; clinical practice; cohort; cost; disability; disorder prevention; functional outcomes; improved; intraventricular hemorrhage; mortality; neuroimaging; outcome forecast; parent project; pediatric traumatic brain injury; prognostic; prospective; psychosocial adjustment; public health relevance; standard of care; tool

DESCRIPTION (provided by applicant): Imaging Common Data Elements as Predictors of Long-Term Outcome in Pediatric TBI Traumatic brain injury (TBI) is the most common cause of acquired brain injury, mortality, and disability in children and adolescents, with long-term effect on cognition, academic achievement, psychosocial adjustment, and quality of life. Despite the high incidence of TBI in children and youth, there are few prognostic models using acute injury characteristics that are specific to children, and those that do exist have relatively poor accuracy. The proposed project builds on our group's ongoing study entitled "Characterizing the Short and Long Term Consequences of Traumatic Brain Injury (TBI) Among Children in the United States" funded by the Centers for Disease Control and Prevention (CDC), which is a large, multi-site, prospective, longitudinal study to examine factors contributing to recovery patterns in children with complicated mild, moderate and severe pediatric TBI. In the existing study, a total of 500 children aged 8-18 years who are hospitalized for complicated mild (as defined by Glasgow Coma Scale (GCS) score of 13-15 with the presence of abnormal findings on imaging) and moderate-severe closed (non-penetrating) TBI will be recruited and assessed serially at 6-7 time points (baseline functioning, acute care discharge, rehabilitation discharge (f applicable), and 6, 12, 24 and 36 months after injury) using select outcome measures from the International Common Data Elements (CDEs) for TBI. The proposed study involves the additional parallel collection and analysis of acute clinical imaging from this cohort and will utilize the existing infrastructure of the parent study to leverage costs associated with participat recruitment, and collection of demographic, injury, and outcome data which will be used in conjunction with the imaging data. The imaging data from all project sites in the parent study will undergo centralized analysis by a pediatric neuroradiologist to derive Federal Interagency Traumatic Brain Injury Research (FITBIR)-compatible, comprehensive neuroimaging CDEs for TBI, including Basic and Supplemental level items, which code the presence, location and extent of pathology evident on imaging. Specific Aim 1 involves the identification of the neuroimaging CDEs for TBI (based on standard of care initial CT imaging) most predictive of functional outcome in children with complicated mild to severe TBI. Specific Aim 2 involves the assessment of whether CT-derived radiographic variables improve the prediction of long- term outcome in conjunction with a combination of other CDE-consistent acute demographic, physiological, and clinical neurological status variables as compared to either clinical indicators or imaging alone. Specific Aim 3 involves determination of the relative sensitivity of initial CT findings versus subsequent scans performed in the first week in predicting later outcome for participants in whom multiple CT scans are performed.The information gained from this study will inform future research and clinical practice by identification of pathoanatomic features evident on imaging that, in combination with other demographic and clinical indicators, enhance prognosis following pediatric TBI.

描述（由申请人提供）：将常见数据元素作为小儿TBI创伤性脑损伤（TBI）的长期预后的预测指标（TBI）是儿童和青少年中获得的脑损伤，死亡率和残疾的最常见原因，对认知，学术成就，心理社会调整和生活质量具有长期影响。尽管儿童和青少年的TBI发病率很高，但使用急性损伤特征的预后模型很少，而这些模型是针对儿童的，而确实存在的预后模型的准确性相对较差。提出的项目基于我们小组正在进行的研究，题为“表征了美国儿童中创伤性脑损伤（TBI）的短期和长期后果”，由疾病控制与预防中心（CDC）资助，该研究是一项大型，多站点的，前瞻性的，纵向的研究，研究有助于恢复型和严重的ped的恢复模式的因素。在现有的研究中，总共有500名8-18岁儿童因复杂的轻度住院治疗（由格拉斯哥昏迷量表（GCS）得分为13-15，在成像上存在异常发现），中度重点封闭（非培训）TBI将被招募并在6--7个时间分（均为7-7个时间点）（均为7至7的时间）（均为7-7个时间表）（均为7至7）。受伤后的6、12、24和36个月）使用TBI的国际公共数据元素（CDE）的精选结果度量。拟议的研究涉及该队列中急性临床成像的其他平行收集和分析，并将利用父母研究的现有基础设施来利用与参与者募集有关的成本，以及收集人口统计学，伤害和结果数据，这些数据将与成像数据结合使用。来自父母研究中所有项目站点的成像数据将 对小儿神经放射科医生进行集中分析，以得出联邦机构间创伤性脑损伤研究（FITBIR） - 易于体现的TBI，包括基本和补充水平的项目，这些cdes的存在，这些级别和补充水平项目对影像学上的病理学的存在，位置和程度进行了编码。具体目标1涉及鉴定TBI的神经影像CD（基于护理标准的初始CT成像），最适合复杂的轻度至重度TBI儿童的功能结果。具体目标2涉及评估CT衍生的放射学变量是否与其他CDE偶然的急性人口统计学，生理和临床神经系统状态变量相结合，是否可以改善长期结局的预测。 或单独成像。具体目标3涉及确定初始CT调查结果的相对敏感性与在第一周进行的随后进行的扫描，以预测进行多次CT扫描的参与者的后期结果。从本研究中获得的信息将通过与其他人口统计学指标相结合的成像中可见的病理学特征来识别未来的研究和临床实践，以识别病原体特征。