Abstract Details

Title Validation of the NINDS Common Data Elements Cranial Tomography (CT) Rating Variables for Traumatic Brain Injury (TBI)

Topic Critical Care/Emergency Neurology/Trauma

Presentation(s) P06 - (-)

Poster/Presentation
Number 234

Objective

Background BACKGROUND: The lack of uniform, precisely defined, and universally accepted measures for assessing severity of TBI based on CT imaging makes it difficult to characterize severity of injury and to compare findings across different studies. To meet this challenge, NINDS convened a series of expert workshops to develop a set of CDEs for TBI, with the goal of standardizing the collection of variables in clinical research. No studies to date have examined the validity of the CT CDEs, or analyzed the clustering and discriminant properties of these variables.

Design/Methods DESIGN/METHODS: CT scans obtained upon admission from 292 patients hospitalized for TBI were rated using the Advanced CDEs. Raters were trained research assistants. Inter-rater and intra-rater reliability was assessed using ?statistics for categorical variables and correlation statistics for continuous variables. Principal Components Analysis (PCA) and Discriminant Components Analysis (DCA) was used to identify clusters in the data and to assess relationship with functional outcome 6-months after injury, measured using the Glasgow Coma Scale-Extended (GOS-E).

Results RESULTS: Excellent reliability was obtained for all variables except pathology in the basal cisterns (compressed/absent). PCA demonstrates four principal components which explain over 60% of the variance. DCA of CT CDEs is able to discriminate between patients who made a good recovery (GOSE 7-8) from those with less favorable outcomes (GOSE 1-6), (p < 0.001).

Conclusions CONCLUSIONS: CT CDEs are potentially useful in clinical studies of TBI. Variables can be reliably collected by trained research assistants. PCA identifies clusters that have clinical and biologic plausibility, and DCA distinguishes on the basis of long-term functional outcome.

Authors/Disclosures
Erin P. McCormack PRESENTER	No disclosure on file
Leah Harburg	No disclosure on file
Kimbra L. Kenney, MD, FAAN	Dr. Kenney has nothing to disclose.
Jose Biller, MD, FACP, FAHA, FAAN (Loyola University Stritch School of Medicine)	Dr. Biller has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wolters Kluwer. Dr. Biller has received publishing royalties from a publication relating to health care.
Jose Biller, MD, FACP, FAHA, FAAN (Loyola University Stritch School of Medicine)	Dr. Biller has received personal compensation in the range of $5,000-$9,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Wolters Kluwer. Dr. Biller has received publishing royalties from a publication relating to health care.
Carol Moore (Henry Jackson Foundation/USUHS)	No disclosure on file
Ramon R. Diaz-Arrastia, MD, PhD, FAAN (University of Pennsylvania)	Dr. Diaz-Arrastia has stock in BrainBox, LLC. Dr. Diaz-Arrastia has stock in Nia Therpeutics. The institution of Dr. Diaz-Arrastia has received research support from National Institutes of Health. The institution of Dr. Diaz-Arrastia has received research support from Department of Defense.
Augusto Grinspan, MD (Acorda Therapeutics, Inc.)	Dr. Grinspan has received personal compensation for serving as an employee of Insightec.

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