The TRACK-TBI Approach: Redefining Severity and Outcome Assessments

Advances in traumatic brain injury (TBI) research have been limited by imprecise classification and diagnostic approaches and insensitive outcome measures. The National Institute of Neurological Disorders and Stroke TBI Common Data Elements (CDEs) project aimed to standardize data collection across TBI research, discover new diagnostic tools, and develop a multidimensional outcomes endpoint sensitive to differential profiles of recovery. Progress from implementing the TBI CDEs is described via the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot) study. Refinements to the TBI CDEs are incorporated into several ongoing large-scale prospective trials comprising a comprehensive, harmonized dataset capable of refining severity markers and outcome endpoints.

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Challenges to the Standardization of Trauma Data Collection in Burn, Traumatic Brain Injury, Spinal Cord Injury, and Other Trauma Populations: A Call for Common Data Elements for Acute and Longitudinal Trauma Databases

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2018.10.004 ◽

2019 ◽

Vol 100 (5) ◽

pp. 891-898

Author(s):

Laura C. Simko ◽

Liang Chen ◽

Dagmar Amtmann ◽

Nicole Gibran ◽

David Herndon ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Spinal Cord ◽

Spinal Cord Injury ◽

Brain Injury ◽

Data Collection ◽

Common Data Elements ◽

Cord Injury ◽

Data Elements

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Concordance of common data elements for assessment of subjective cognitive complaints after mild-traumatic brain injury: a TRACK-TBI Pilot Study

Brain Injury ◽

10.1080/02699052.2018.1481527 ◽

2018 ◽

Vol 32 (9) ◽

pp. 1071-1078 ◽

Cited By ~ 4

Author(s):

Laura B. Ngwenya ◽

Raquel C. Gardner ◽

John K. Yue ◽

John F. Burke ◽

Adam R. Ferguson ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Pilot Study ◽

Mild Traumatic Brain Injury ◽

Cognitive Complaints ◽

Common Data Elements ◽

Data Elements ◽

Subjective Cognitive Complaints

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Validating Multi-Dimensional Outcome Assessment Using the Traumatic Brain Injury Common Data Elements: An Analysis of the TRACK-TBI Pilot Study Sample

Journal of Neurotrauma ◽

10.1089/neu.2017.5139 ◽

2017 ◽

Vol 34 (22) ◽

pp. 3158-3172 ◽

Cited By ~ 15

Author(s):

Lindsay D. Nelson ◽

Jana Ranson ◽

Adam R. Ferguson ◽

Joseph Giacino ◽

David O. Okonkwo ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Pilot Study ◽

Outcome Assessment ◽

Common Data Elements ◽

Data Elements

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Radiologic common data elements rates in pediatric mild traumatic brain injury

Neurology ◽

10.1212/wnl.0000000000008488 ◽

2019 ◽

Vol 94 (3) ◽

pp. e241-e253 ◽

Cited By ~ 1

Author(s):

Andrew R. Mayer ◽

Daniel M. Cohen ◽

Christopher J. Wertz ◽

Andrew B. Dodd ◽

Jody Shoemaker ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Mild Traumatic Brain Injury ◽

Incidental Findings ◽

Large Scale ◽

Structural Mri ◽

Mri Findings ◽

Common Data Elements ◽

Data Elements

ObjectiveThe nosology for classifying structural MRI findings following pediatric mild traumatic brain injury (pmTBI) remains actively debated. Radiologic common data elements (rCDE) were developed to standardize reporting in research settings. However, some rCDE are more specific to trauma (probable rCDE). Other more recently proposed rCDE have multiple etiologies (possible rCDE), and may therefore be more common in all children. Independent cohorts of patients with pmTBI and controls were therefore recruited from multiple sites (New Mexico and Ohio) to test the dual hypothesis of a higher incidence of probable rCDE (pmTBI > controls) vs similar rates of possible rCDE on structural MRI.MethodsPatients with subacute pmTBI (n = 287), matched healthy controls (HC; n = 106), and orthopedically injured (OI; n = 71) patients underwent imaging approximately 1 week postinjury and were followed for 3–4 months.ResultsProbable rCDE were specific to pmTBI, occurring in 4%–5% of each sample, rates consistent with previous large-scale CT studies. In contrast, prevalence rates for incidental findings and possible rCDE were similar across groups (pmTBI vs OI vs HC). The prevalence of possible rCDE was also the only finding that varied as a function of site. Possible rCDE and incidental findings were not associated with postconcussive symptomatology or quality of life 3–4 months postinjury.ConclusionCollectively, current findings question the trauma-related specificity of certain rCDE, as well how these rCDE are radiologically interpreted. Refinement of rCDE in the context of pmTBI may be warranted, especially as diagnostic schema are evolving to stratify patients with structural MRI abnormalities as having a moderate injury.

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