Advancing care for traumatic brain injury: findings from the IMPACT studies and perspectives on future research
Summary Research in traumatic brain injury (TBI) is challenging for several reasons; in particular, the heterogeneity between patients regarding causes, pathophysiology, treatment, and outcome. Advances in basic science have failed to translate into successful clinical treatments, and the evidence u...
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| Veröffentlicht in: | Lancet neurology 2013-12, Vol.12 (12), p.1200-1210 |
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| creator | Maas, Andrew I R, Prof Murray, Gordon D, Prof Roozenbeek, Bob, MD Lingsma, Hester F, PhD Butcher, Isabella, PhD McHugh, Gillian S, PhD Weir, James, MSc Lu, Juan, MD Steyerberg, Ewout W, Prof |
| description | Summary Research in traumatic brain injury (TBI) is challenging for several reasons; in particular, the heterogeneity between patients regarding causes, pathophysiology, treatment, and outcome. Advances in basic science have failed to translate into successful clinical treatments, and the evidence underpinning guideline recommendations is weak. Because clinical research has been hampered by non-standardised data collection, restricted multidisciplinary collaboration, and the lack of sensitivity of classification and efficacy analyses, multidisciplinary collaborations are now being fostered. Approaches to deal with heterogeneity have been developed by the IMPACT study group. These approaches can increase statistical power in clinical trials by up to 50% and are also relevant to other heterogeneous neurological diseases, such as stroke and subarachnoid haemorrhage. Rather than trying to limit heterogeneity, we might also be able to exploit it by analysing differences in treatment and outcome between countries and centres in comparative effectiveness research. This approach has great potential to advance care in patients with TBI. |
| doi_str_mv | 10.1016/S1474-4422(13)70234-5 |
| format | Article |
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Advances in basic science have failed to translate into successful clinical treatments, and the evidence underpinning guideline recommendations is weak. Because clinical research has been hampered by non-standardised data collection, restricted multidisciplinary collaboration, and the lack of sensitivity of classification and efficacy analyses, multidisciplinary collaborations are now being fostered. Approaches to deal with heterogeneity have been developed by the IMPACT study group. These approaches can increase statistical power in clinical trials by up to 50% and are also relevant to other heterogeneous neurological diseases, such as stroke and subarachnoid haemorrhage. Rather than trying to limit heterogeneity, we might also be able to exploit it by analysing differences in treatment and outcome between countries and centres in comparative effectiveness research. This approach has great potential to advance care in patients with TBI.</description><identifier>ISSN: 1474-4422</identifier><identifier>EISSN: 1474-4465</identifier><identifier>DOI: 10.1016/S1474-4422(13)70234-5</identifier><identifier>PMID: 24139680</identifier><identifier>CODEN: LANCAO</identifier><language>eng</language><publisher>England: Elsevier Ltd</publisher><subject>Adult ; Blood Pressure ; Brain Injuries - epidemiology ; Brain Injuries - therapy ; Brain research ; Canada ; Classification ; Clinical trials ; Data collection ; Data Collection - standards ; Datasets ; Demographics ; Disease Management ; Europe ; Forecasting ; Glasgow Coma Scale ; Humans ; Integrated approach ; International Cooperation ; Medical prognosis ; Middle Aged ; Models, Neurological ; Multicenter Studies as Topic - methods ; Multicenter Studies as Topic - standards ; National Institute of Neurological Disorders and Stroke (U.S.) ; National Institutes of Health (U.S.) ; Neurology ; Observational studies ; Prognosis ; Randomized Controlled Trials as Topic - methods ; Randomized Controlled Trials as Topic - standards ; Research Design ; Symptom Assessment - standards ; Trauma Severity Indices ; Traumatic brain injury ; Treatment Outcome ; United States ; Variables</subject><ispartof>Lancet neurology, 2013-12, Vol.12 (12), p.1200-1210</ispartof><rights>Elsevier Ltd</rights><rights>2013 Elsevier Ltd</rights><rights>Copyright © 2013 Elsevier Ltd. All rights reserved.</rights><rights>Copyright Elsevier Limited Jan 2013</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c627t-37c477191a964eed02f791e128e97b04d4662077daf2d42da3029c769c0c9d5c3</citedby><cites>FETCH-LOGICAL-c627t-37c477191a964eed02f791e128e97b04d4662077daf2d42da3029c769c0c9d5c3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S1474442213702345$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65534</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24139680$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maas, Andrew I R, Prof</creatorcontrib><creatorcontrib>Murray, Gordon D, Prof</creatorcontrib><creatorcontrib>Roozenbeek, Bob, MD</creatorcontrib><creatorcontrib>Lingsma, Hester F, PhD</creatorcontrib><creatorcontrib>Butcher, Isabella, PhD</creatorcontrib><creatorcontrib>McHugh, Gillian S, PhD</creatorcontrib><creatorcontrib>Weir, James, MSc</creatorcontrib><creatorcontrib>Lu, Juan, MD</creatorcontrib><creatorcontrib>Steyerberg, Ewout W, Prof</creatorcontrib><creatorcontrib>for the International Mission on Prognosis Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) Study Group</creatorcontrib><creatorcontrib>International Mission on Prognosis Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) Study Group</creatorcontrib><title>Advancing care for traumatic brain injury: findings from the IMPACT studies and perspectives on future research</title><title>Lancet neurology</title><addtitle>Lancet Neurol</addtitle><description>Summary Research in traumatic brain injury (TBI) is challenging for several reasons; in particular, the heterogeneity between patients regarding causes, pathophysiology, treatment, and outcome. Advances in basic science have failed to translate into successful clinical treatments, and the evidence underpinning guideline recommendations is weak. Because clinical research has been hampered by non-standardised data collection, restricted multidisciplinary collaboration, and the lack of sensitivity of classification and efficacy analyses, multidisciplinary collaborations are now being fostered. Approaches to deal with heterogeneity have been developed by the IMPACT study group. These approaches can increase statistical power in clinical trials by up to 50% and are also relevant to other heterogeneous neurological diseases, such as stroke and subarachnoid haemorrhage. Rather than trying to limit heterogeneity, we might also be able to exploit it by analysing differences in treatment and outcome between countries and centres in comparative effectiveness research. This approach has great potential to advance care in patients with TBI.</description><subject>Adult</subject><subject>Blood Pressure</subject><subject>Brain Injuries - epidemiology</subject><subject>Brain Injuries - therapy</subject><subject>Brain research</subject><subject>Canada</subject><subject>Classification</subject><subject>Clinical trials</subject><subject>Data collection</subject><subject>Data Collection - standards</subject><subject>Datasets</subject><subject>Demographics</subject><subject>Disease Management</subject><subject>Europe</subject><subject>Forecasting</subject><subject>Glasgow Coma Scale</subject><subject>Humans</subject><subject>Integrated approach</subject><subject>International Cooperation</subject><subject>Medical prognosis</subject><subject>Middle Aged</subject><subject>Models, Neurological</subject><subject>Multicenter Studies as Topic - methods</subject><subject>Multicenter Studies as Topic - standards</subject><subject>National Institute of Neurological Disorders and Stroke (U.S.)</subject><subject>National Institutes of Health (U.S.)</subject><subject>Neurology</subject><subject>Observational studies</subject><subject>Prognosis</subject><subject>Randomized Controlled Trials as Topic - methods</subject><subject>Randomized Controlled Trials as Topic - standards</subject><subject>Research Design</subject><subject>Symptom Assessment - standards</subject><subject>Trauma Severity Indices</subject><subject>Traumatic brain injury</subject><subject>Treatment Outcome</subject><subject>United States</subject><subject>Variables</subject><issn>1474-4422</issn><issn>1474-4465</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkd9rFDEQxxdRbK3-CUrAl_qwmkyyycYH5ThaLVQUrM8hl8zanHvZM9k9uP_e3A8r9KU-TRg-8xkm36p6yehbRpl8950JJWohAM4Zf6MocFE3j6rTY1s2j-_eACfVs5yXlAITLXtanYBgXMuWnlbDzG9sdCH-JM4mJN2QyJjstLJjcGSRbIgkxOWUtu9JF6IvYCZdGlZkvEVy9eXbbH5D8jj5gJnY6MkaU16jG8OmNIZIummcijdhRpvc7fPqSWf7jC-O9az6cXlxM_9cX3_9dDWfXddOghprrpxQimlmtRSInkKnNEMGLWq1oMILKYEq5W0HXoC3nIJ2SmpHnfaN42fV-cG7TsPvCfNoViE77HsbcZiyYQ2lLQXQ7cOo0CCBy0b9B9roYhbNzvr6HrocphTLzYWSQnOgAgrVHCiXhpwTdmadwsqmrWHU7HI2-5zNLkTDuNnnbJoy9-ponxYr9HdTf4MtwMcDgOWTNwGTyS5gdOhDKukYP4QHV3y4Z3B9iMHZ_hduMf-7xmQw9CDZORjfGxr-BzV8yjs</recordid><startdate>20131201</startdate><enddate>20131201</enddate><creator>Maas, Andrew I R, Prof</creator><creator>Murray, Gordon D, Prof</creator><creator>Roozenbeek, Bob, MD</creator><creator>Lingsma, Hester F, PhD</creator><creator>Butcher, Isabella, PhD</creator><creator>McHugh, Gillian S, PhD</creator><creator>Weir, James, MSc</creator><creator>Lu, Juan, MD</creator><creator>Steyerberg, Ewout W, Prof</creator><general>Elsevier Ltd</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>0TZ</scope><scope>3V.</scope><scope>7RV</scope><scope>7TK</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C2</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>NAPCQ</scope><scope>PHGZM</scope><scope>PHGZT</scope><scope>PJZUB</scope><scope>PKEHL</scope><scope>PPXIY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20131201</creationdate><title>Advancing care for traumatic brain injury: findings from the IMPACT studies and perspectives on future research</title><author>Maas, Andrew I R, Prof ; Murray, Gordon D, Prof ; Roozenbeek, Bob, MD ; Lingsma, Hester F, PhD ; Butcher, Isabella, PhD ; McHugh, Gillian S, PhD ; Weir, James, MSc ; Lu, Juan, MD ; Steyerberg, Ewout W, Prof</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c627t-37c477191a964eed02f791e128e97b04d4662077daf2d42da3029c769c0c9d5c3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Blood Pressure</topic><topic>Brain Injuries - 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Academic</collection><jtitle>Lancet neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maas, Andrew I R, Prof</au><au>Murray, Gordon D, Prof</au><au>Roozenbeek, Bob, MD</au><au>Lingsma, Hester F, PhD</au><au>Butcher, Isabella, PhD</au><au>McHugh, Gillian S, PhD</au><au>Weir, James, MSc</au><au>Lu, Juan, MD</au><au>Steyerberg, Ewout W, Prof</au><aucorp>for the International Mission on Prognosis Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) Study Group</aucorp><aucorp>International Mission on Prognosis Analysis of Clinical Trials in Traumatic Brain Injury (IMPACT) Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Advancing care for traumatic brain injury: findings from the IMPACT studies and perspectives on future research</atitle><jtitle>Lancet neurology</jtitle><addtitle>Lancet Neurol</addtitle><date>2013-12-01</date><risdate>2013</risdate><volume>12</volume><issue>12</issue><spage>1200</spage><epage>1210</epage><pages>1200-1210</pages><issn>1474-4422</issn><eissn>1474-4465</eissn><coden>LANCAO</coden><abstract>Summary Research in traumatic brain injury (TBI) is challenging for several reasons; in particular, the heterogeneity between patients regarding causes, pathophysiology, treatment, and outcome. Advances in basic science have failed to translate into successful clinical treatments, and the evidence underpinning guideline recommendations is weak. Because clinical research has been hampered by non-standardised data collection, restricted multidisciplinary collaboration, and the lack of sensitivity of classification and efficacy analyses, multidisciplinary collaborations are now being fostered. Approaches to deal with heterogeneity have been developed by the IMPACT study group. These approaches can increase statistical power in clinical trials by up to 50% and are also relevant to other heterogeneous neurological diseases, such as stroke and subarachnoid haemorrhage. Rather than trying to limit heterogeneity, we might also be able to exploit it by analysing differences in treatment and outcome between countries and centres in comparative effectiveness research. This approach has great potential to advance care in patients with TBI.</abstract><cop>England</cop><pub>Elsevier Ltd</pub><pmid>24139680</pmid><doi>10.1016/S1474-4422(13)70234-5</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Lancet neurology, 2013-12, Vol.12 (12), p.1200-1210 |
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| subjects | Adult Blood Pressure Brain Injuries - epidemiology Brain Injuries - therapy Brain research Canada Classification Clinical trials Data collection Data Collection - standards Datasets Demographics Disease Management Europe Forecasting Glasgow Coma Scale Humans Integrated approach International Cooperation Medical prognosis Middle Aged Models, Neurological Multicenter Studies as Topic - methods Multicenter Studies as Topic - standards National Institute of Neurological Disorders and Stroke (U.S.) National Institutes of Health (U.S.) Neurology Observational studies Prognosis Randomized Controlled Trials as Topic - methods Randomized Controlled Trials as Topic - standards Research Design Symptom Assessment - standards Trauma Severity Indices Traumatic brain injury Treatment Outcome United States Variables |
| title | Advancing care for traumatic brain injury: findings from the IMPACT studies and perspectives on future research |
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