Association of Positive MRI Findings and Clinical Outcomes in Sub-acute and Chronic Phases of Pediatric Mild Traumatic Brain Injury

ObjectiveThis study aims to examine the rates of incidental findings (IF) and radiologic common data elements (rCDE), and to explore how these magnetic resonance imaging (MRI) findings contribute to a broad assessment of clinical outcomes (symptoms, cognitive and behavioral functioning, and quality of life) in the sub-acute (SA: ∼1 week), early chronic (EC: ∼4 months), and late chronic (LC: ∼1 year) phases of pediatric mild traumatic brain injuries (pmTBI).BackgroundIt is unclear whether MRI findings have clinical implications following injury.Design/MethodsTwo hundred thirty-three pmTBI patients and 168 HC aged 8–18 completed an MRI scan and a comprehensive clinical assessment at SA visit, with a subset completing the clinical assessment at EC (182 pmTBI; 158 HC) and LC (143 pmTBI; 141 pmTBI) visits. All MRI findings were noted by board-certified neuroradiologists and coded based on published criteria for rCDE by 2 independent researchers, who were blinded to diagnosis group. A series of 2 × 3 (group [pmTBI vs HC] × MRI findings [IF vs rCDE vs normal]) generalized linear model was conducted for outcomes at each visit. Possible and probable rCDE were pooled for the latter analyses.ResultsOne hundred sixty-four participants (40.9%) showed positive MRI findings (113 IF, 43 possible rCDE, 8 probable rCDE). As expected, probable rCDE was exclusively observed in pmTBI patients (Fisher's exact one-sided = 0.012), however the incidence of IF and possible rCDE was similar between groups (χ2 = 2.969; p's = 0.085). While group effects were observed on several outcome measures, no interaction of Group × MRI findings survived the correction for multiple comparisons (p's > 0.01). An MRI findings effect (p < 0.001) was observed on child-rated Children's Behavior Questionnaire at SA visit (normal > IF and rCDE; p's = 0.009). However, this effect was no longer significant at EC and LC (p's = 0.439).ConclusionsOverall, the current results do not suggest that MRI findings have clinical implications or interacts with pmTBI to worsen outcomes.

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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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Diverse MRI findings and clinical outcomes of acute Marchiafava-Bignami disease

Acta Radiologica ◽

10.1177/0284185120943040 ◽

2020 ◽

pp. 028418512094304

Author(s):

Wei Li ◽

Chao Ran ◽

Jun Ma

Keyword(s):

Clinical Outcomes ◽

Clinical Manifestations ◽

Acute Onset ◽

Restricted Diffusion ◽

Type I ◽

Type Ii ◽

Mri Findings ◽

Type Iii ◽

Mri Features ◽

Magnetic Resonance Imaging Mri

Background The acute onset of Marchiafava-Bignami disease (MBD) is difficult to capture, and its clinical manifestations are overlapped. Magnetic resonance imaging (MRI) is very useful in the diagnosis of acute MBD. Purpose To investigate the MRI features and clinical outcomes of acute MBD. Materials and Methods Sagittal T2-weighted (T2W) or T1-weighted (T1W) imaging, axial T1W and T2W imaging, and axial FLAIR and diffusion-weighted imaging (DWI) sequences were performed in 17 patients with acute MBD on 1.5-T MR. According to the different ranges of callosal restricted diffusion, MBD was divided into Type I (n = 7, the completely involved), Type II (n = 5, the mostly involved), and Type III (n = 5, the partly involved). The MRI findings and outcomes of each type were retrospectively analyzed. Results With the reduced range of the callosal restricted diffusion, the callosal atrophy or cavitation was more common: no case of Type I; 1 (20%) case of Type II; and 3 (60%) cases of Type III. With the increased range of callosal restricted diffusion, the extracallosal involvement was more common: 6 (86%) cases of Type I; 3 (60%) cases of Type II; and 1 (20%) case of Type III. During the follow-up, five cases had neuropsychiatric sequelae: 1 (14%) case of type I; 1 (20%) case of Type II; 3 (60%) cases of Type III. Conclusion The MRI findings and clinical outcomes of acute MBD are regular. The extensive restricted diffusion of acute MBD may present the curable condition. Callosal heterogeneity may affect the outcome of acute MBD.

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Existence of Cervical Discopathy in Non-Cyclic Mastodynia

Breast Care ◽

10.1159/000501792 ◽

2019 ◽

Vol 15 (2) ◽

pp. 178-181

Author(s):

Mustafa Alimoğulları ◽

Hakan Buluş

Keyword(s):

Subjective Symptom ◽

Treatment Results ◽

Mri Findings ◽

Appropriate Treatment ◽

Cervical Magnetic Resonance Imaging ◽

Vas Scores ◽

The Mean ◽

Magnetic Resonance Imaging Mri ◽

Time Of Presentation

Background: Mastodynia is a subjective symptom that impairs the quality of life. It may be directly related with breast disorders. Moreover, a substantial rate is caused of reflective pain. Objectives: Non-cyclic mastodynia is multifactorial, and treatment should be planned according to the underlying cause. In this study, we aim to evaluate the existence of cervical discopathy via cervical magnetic resonance imaging (MRI) in the etiology of non-cyclic mastodynia. Methods: The study included 60 patients with normal physical examination results and imaging findings. Management was determined individually in patients. Patients with pathological MRI findings were evaluated by physical therapy, rehabilitation, and neurosurgery specialists, and appropriate treatment was planned. Patients were evaluated with the visual analogue scale (VAS) scoring system at initial presentation and after 1 and 3 months of treatment. Results: The majority of patients had positive findings on MRI (53 [88.4%] vs. 7 [11.6%]). The mean VAS scores at the time of presentation, after 1, and after 3 months of treatment were 7.41, 6.39, and 3.35, respectively. The decrease in the scores was statistically significant (p ≤ 0,01). Conclusions: We suggest that cervical discopathy should be kept in mind in cases of idiopathic non-cyclic mastodynia. Furthermore, cervical discopathy-related mastodynia seems to have a good response to appropriate treatment.

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Auditing Clinical Outcomes after Introducing Off-Licence Prescribing of Atypical Antipsychotic Melperone for Patients with Treatment Refractory Schizophrenia

The Scientific World JOURNAL ◽

10.1100/2012/512047 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Frank Röhricht ◽

Seema Gadhia ◽

Rinku Alam ◽

Melissa Willis

Keyword(s):

Clinical Outcomes ◽

Atypical Antipsychotic ◽

Clinical Implications ◽

Prospective Data ◽

Symptom Scores ◽

Favourable Side Effect Profile ◽

Previously Treated ◽

Treatment Refractory ◽

Third Line

Aims and Method. To evaluate the practical utility of off-licence prescribing and clinical outcomes of treatment with atypical antipsychotic Melperone.Method: Prospective data collection on patient’s clinical characteristics and outcomes.Results. 17 patients with a diagnosis of refractory schizophrenia were identified as suitable for off-license prescribing of Melperone and commenced treatment (13 were previously treated with Clozapine). Seven of those currently remain on Melperone (41%), and for six patents, the BPRS symptom scores reduced significantly over time (24–61%) additionally patients displayed improvements of their quality of life. Six patients were discontinued due to noncompliance and/or side effects. Melperone was ineffective in the other four patients.Clinical Implications. The example of a small group of patients responding well to a comparably safe and inexpensive atypical antipsychotic with favourable side effect profile should encourage clinicians to use this tool as third-line treatment and to conduct more systematic clinical research.

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Common Data Elements for Traumatic Brain Injury: Recommendations From the Interagency Working Group on Demographics and Clinical Assessment

Archives of Physical Medicine and Rehabilitation ◽

10.1016/j.apmr.2010.07.232 ◽

2010 ◽

Vol 91 (11) ◽

pp. 1641-1649 ◽

Cited By ~ 97

Author(s):

Andrew I. Maas ◽

Cynthia L. Harrison-Felix ◽

David Menon ◽

P. David Adelson ◽

Tom Balkin ◽

...

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Clinical Assessment ◽

Working Group ◽

Common Data Elements ◽

Data Elements

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Articular Cartilage Repair in the Knee: Postoperative Imaging

The Journal of Knee Surgery ◽

10.1055/s-0040-1716357 ◽

2020 ◽

Vol 34 (01) ◽

pp. 002-010

Author(s):

Brian W. Yang ◽

Christopher M. Brusalis ◽

Peter D. Fabricant ◽

Harry G. Greditzer

Keyword(s):

Clinical Outcomes ◽

Cartilage Repair ◽

Clinical Decision Making ◽

Treatment Options ◽

Clinical Decision ◽

Mri Findings ◽

Postoperative Imaging ◽

Patient Reported ◽

Magnetic Resonance Imaging Mri

AbstractDiagnostic and therapeutic advancements have improved clinical outcomes for patients with focal chondral injuries of the knee. An increased number and complexity of surgical treatment options have, in turn, resulted in a commensurate proliferation of patients requiring postoperative evaluation and management. In addition to patient-reported clinical outcomes, magnetic resonance imaging (MRI) offers clinicians with noninvasive, objective data to assist with postoperative clinical decision making. However, successful MRI interpretation in this setting is clinically challenging; it relies upon an understanding of the evolving and procedure-specific nature of normal postoperative imaging. Moreover, further research is required to better elucidate the correlation between MRI findings and long-term clinical outcomes. This article focuses on how specific morphologic features identified on MRI can be utilized to evaluate patients following the most commonly performed cartilage repair surgeries of the knee.

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Challenges in the Measurement of Staffing: A Review of Reviews

Innovation in Aging ◽

10.1093/geroni/igab046.555 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 145-145

Author(s):

Magdalena Osinska ◽

Catherine Blatter ◽

Michael Simon ◽

Franziska Zúñiga

Keyword(s):

Quality Of Care ◽

Research Field ◽

Cross Sectional ◽

Term Care ◽

Common Data Elements ◽

The Usa ◽

Review Of Reviews ◽

Cross Sectional Design ◽

Data Elements

Abstract The question concerning the relationship of staffing and quality of care of residents in residential long-term care (LTC) has been explored extensively; however, no consistent evidence has been brought forth so far. Inconsistent measurement of staffing might hinder this research field to move forward. We assessed its measurement in a narrative review of reviews that explore the staff – quality of care relationship. We identified 12 systematic reviews, covering 1960 to May 2018. Most studies included had a cross-sectional design, were performed in the USA and worked with secondary, administrative data (e.g., OSCAR). Comparability of studies was limited by diverse definitions and measurement methods for staffing, including data about grade-mix, number of staff, and staff-resident ratios. We suggest performing international multi-case studies to compare and contrast LTC staffing and develop appropriate international common data elements. Logic models support the description of the expected relationship between staffing aspects and quality.

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The Neuropsychology of Traumatic Brain Injury: Looking Back, Peering Ahead

Journal of the International Neuropsychological Society ◽

10.1017/s1355617717000686 ◽

2017 ◽

Vol 23 (9-10) ◽

pp. 806-817 ◽

Cited By ~ 8

Author(s):

Keith Owen Yeates ◽

Harvey S. Levin ◽

Jennie Ponsford

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Cognitive Rehabilitation ◽

Neuropsychological Testing ◽

Critical Role ◽

Future Research ◽

Common Data Elements ◽

The Past ◽

Data Elements

AbstractThe past 50 years have been a period of exciting progress in neuropsychological research on traumatic brain injury (TBI). Neuropsychologists and neuropsychological testing have played a critical role in these advances. This study looks back at three major scientific advances in research on TBI that have been critical in pushing the field forward over the past several decades: The advent of modern neuroimaging; the recognition of the importance of non-injury factors in determining recovery from TBI; and the growth of cognitive rehabilitation. Thanks to these advances, we now have a better understanding of the pathophysiology of TBI and how recovery from the injury is also shaped by pre-injury, comorbid, and contextual factors, and we also have increasing evidence that active interventions, including cognitive rehabilitation, can help to promote better outcomes. The study also peers ahead to discern two important directions that seem destined to influence research on TBI over the next 50 years: the development of large, multi-site observational studies and randomized controlled trials, bolstered by international research consortia and the adoption of common data elements; and attempts to translate research into health care and health policy by the application of rigorous methods drawn from implementation science. Future research shaped by these trends should provide critical evidence regarding the outcomes of TBI and its treatment, and should help to disseminate and implement the knowledge gained from research to the betterment of the quality of life of persons with TBI. (JINS, 2017,23, 806–817)

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Advancing Long-Term Care Science Through Using Common Data Elements: Candidate Measures for Care Outcomes of Personhood, Well-Being, and Quality of Life

Gerontology and Geriatric Medicine ◽

10.1177/2333721419842672 ◽

2019 ◽

Vol 5 ◽

pp. 233372141984267 ◽

Cited By ~ 4

Author(s):

David Edvardsson ◽

Rebecca Baxter ◽

Laura Corneliusson ◽

Ruth A. Anderson ◽

Anna Beeber ◽

...

Keyword(s):

Quality Of Life ◽

Organizational Context ◽

Long Term Care ◽

Well Being ◽

Term Care ◽

Common Data Elements ◽

Care Outcomes ◽

Data Elements

To support the development of internationally comparable common data elements (CDEs) that can be used to measure essential aspects of long-term care (LTC) across low-, middle-, and high-income countries, a group of researchers in medicine, nursing, behavioral, and social sciences from 21 different countries have joined forces and launched the Worldwide Elements to Harmonize Research in LTC Living Environments (WE-THRIVE) initiative. This initiative aims to develop a common data infrastructure for international use across the domains of organizational context, workforce and staffing, person-centered care, and care outcomes, as these are critical to LTC quality, experiences, and outcomes. This article reports measurement recommendations for the care outcomes domain, focusing on previously prioritized care outcomes concepts of well-being, quality of life (QoL), and personhood for residents in LTC. Through literature review and expert ranking, we recommend nine measures of well-being, QoL, and personhood, as a basis for developing CDEs for long-term care outcomes across countries. Data in LTC have often included deficit-oriented measures; while important, reductions do not necessarily mean that residents are concurrently experiencing well-being. Enhancing measurement efforts with the inclusion of these positive LTC outcomes across countries would facilitate international LTC research and align with global shifts toward healthy aging and person-centered LTC models.

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