833 The Importance of Trajectory Curves for the Implementation of Outcome Benchmarks in a Clinical Setting

Introduction The creation of individualized treatment plans that address social participation in burn survivors requires an understanding of the expected changes over time from the original burn injury. The Life Impact Burn Recovery Evaluation (LIBRE) Profile is a patient-reported outcome measure for social participation after burn injury. Visual representation of expected change over time of a population is achieved through the development of trajectory curves (TCs), serving as benchmarks for recovery. In order to optimize the implementation of LIBRE Profile TCs, a literature review was conducted to examine utilization of TCs in other clinical settings. Methods A review of studies published from 2014–2019, demonstrating TCs as growth or treatment models in clinical settings, was performed. Literature was identified by searching “trajectory curves,” “trajectory models,” and “clinic” or “clinical” in PubMed. Articles focusing on three areas of inquiry were included: 1) measuring individual patient growth; 2) comparing progress for similar patient cohorts to provide contextualized reference for personal growth; 3) predictive medicine/risk assessment for interventional care in various conditions. Results The initial literature review identified 141 manuscripts. A total of 107 were excluded and 34 manuscripts were reviewed and categorized based on the three areas of inquiry (Figure 1; Table 1). Positive results from TCs in all areas of inquiry were noted in 22 of the 34 the chosen studies. General trends for each area of inquiry include: an increased ability for parents and clinicians to track individual patient progress in what was primarily anthropometric studies; articles relating to comparative cohort tracking show that trajectory-driven analytical approaches offer displays of progress across similar clinical groups of recovery for given conditions. Use of TCs in predictive care or risk assessment typically relate to acute conditions such as asthma, traumatic brain injury, or degenerative conditions (neurocognitive or musculoskeletal). For the most part, these diagnoses depict a positive trend for clinicians to identify future outcomes using fitted trajectories. Conclusions These findings support the clinical use of trajectory curves to present patient-specific, cohort-relative, and predictive treatment for outcome-based results post-burn for burn survivors. Applicability of Research to Practice Future research will assess the use of LIBRE Profile recovery trajectories as benchmarks for optimization of social participation outcomes.