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Prognostic Validation of the NINDS Common Data Elements for the Radiologic Reporting of Acute Traumatic Brain Injuries: A CENTER-TBI Study
- Source :
- Journal of Neurotrauma, 37(11), 1269-1282. MARY ANN LIEBERT, INC, Journal of neurotrauma, Journal of Neurotrauma, 37(11), 1269-1282. Mary Ann Liebert Inc.
- Publication Year :
- 2020
- Publisher :
- MARY ANN LIEBERT, INC, 2020.
-
Abstract
- The aim of this study is to investigate the prognostic value of using the National Institute of Neurological Disorders and Stroke (NINDS) standardized imaging-based pathoanatomic descriptors for the evaluation and reporting of acute traumatic brain injury (TBI) lesions. For a total of 3392 patients (2244 males and 1148 females, median age = 51 years) enrolled in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, we extracted 96 Common Data Elements (CDEs) from the structured reports, spanning all three levels of pathoanatomic information (i.e., 20 "basic," 60 "descriptive," and 16 "advanced" CDE variables per patient). Six-month clinical outcome scores were dichotomized into favorable (Glasgow Outcome Scale Extended [GOS-E] = 5-8) versus unfavorable (GOS-E = 1-4). Regularized logistic regression models were constructed and compared using the optimism-corrected area under the curve (AUC). An abnormality was reported for the majority of patients (64.51%). In 79.11% of those patients, there was at least one coexisting pathoanatomic lesion or associated finding. An increase in lesion severity, laterality, and volume was associated with more unfavorable outcomes. Compared with the full set of pathoanatomic descriptors (i.e., all three categories of information), reporting "basic" CDE information provides at least equal discrimination between patients with favorable versus unfavorable outcome (AUC = 0.8121 vs. 0.8155, respectively). Addition of a selected subset of "descriptive" detail to the basic CDEs could improve outcome prediction (AUC = 0.8248). Addition of "advanced" or "emerging/exploratory" information had minimal prognostic value. Our results show that the NINDS standardized-imaging based pathoanatomic descriptors can be used in large-scale studies and provide important insights into acute TBI lesion patterns. When used in clinical predictive models, they can provide excellent discrimination between patients with favorable and unfavorable 6-month outcomes. If further validated, our findings could support the development of structured and itemized templates in routine clinical radiology.
- Subjects :
- Adult
Male
Research Report
SELECTION
medicine.medical_specialty
Neurology
Adolescent
Databases, Factual
Traumatic brain injury
INTRACEREBRAL HEMORRHAGE
Poison control
Logistic regression
Young Adult
Common Data Element
Internal medicine
TOMOGRAPHY
Injury prevention
Brain Injuries, Traumatic
medicine
Humans
National Institute of Neurological Disorders and Stroke (U.S.)
Longitudinal Studies
structured reporting
Child
Stroke
Aged
Intracerebral hemorrhage
Aged, 80 and over
Common Data Elements
business.industry
Glasgow Outcome Scale
traumatic brain injury
Infant, Newborn
Infant
Reproducibility of Results
computed tomography
Middle Aged
medicine.disease
Prognosis
United States
Child, Preschool
SIMULATION
Female
Neurology (clinical)
Human medicine
business
Tomography, X-Ray Computed
Subjects
Details
- Language :
- English
- ISSN :
- 08977151 and 15579042
- Database :
- OpenAIRE
- Journal :
- Journal of Neurotrauma, 37(11), 1269-1282. MARY ANN LIEBERT, INC, Journal of neurotrauma, Journal of Neurotrauma, 37(11), 1269-1282. Mary Ann Liebert Inc.
- Accession number :
- edsair.doi.dedup.....1f4425d7ee69ee38d7b5dc04aa1d12db