Evidence map›Paper›PMID 35588232›Full record

ArticleThe neuroradiology journal2023

Comparing blood biomarkers to clinical decision rules to select patients suspected of traumatic brain injury for head computed tomography.

Ying Li, Victoria Y Ding, Hui Chen, Guangming Zhu, Bin Jiang, Derek Boothroyd, Paymon G Rezaii, Anthony M Bet, Amy D Paulino, Art Weber and 3 more

Open access · greenAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The neuroradiology journal, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.

  1. Accuracy of GFAP and UCH-L1 in predicting brain abnormalities on CT scans after mild traumatic brain injury: a systematic review and meta-analysis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2025
    Pooled it
  2. Review
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  4. Review
  5. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 1 country.

Ying LiDepartment of Radiology, Neuroradiology Division, 6429Stanford University, Stanford, CA, USA.
Victoria Y DingQuantitative Sciences Unit, Department of Medicine, 6429Stanford University, Stanford, CA, USA.
Hui ChenDepartment of Radiology, Neuroradiology Division, 6429Stanford University, Stanford, CA, USA.
Guangming ZhuDepartment of Radiology, Neuroradiology Division, 6429Stanford University, Stanford, CA, USA.
Bin JiangDepartment of Radiology, Neuroradiology Division, 6429Stanford University, Stanford, CA, USA.
Derek BoothroydQuantitative Sciences Unit, Department of Medicine, 6429Stanford University, Stanford, CA, USA.
Paymon G RezaiiDepartment of Radiology, Neuroradiology Division, 6429Stanford University, Stanford, CA, USA.ORCID 0000-0002-4803-0853
Anthony M BetDepartment of Radiology, Neuroradiology Division, 6429Stanford University, Stanford, CA, USA.
Amy D Paulino506046Banyan Biomarkers Inc., San Diego, CA, USA.
Art Weber506046Banyan Biomarkers Inc., San Diego, CA, USA.
Olena Y GlushakovaDepartment of Neurosurgery, 6889Virginia Commonwealth University, Richmond, VA, USA.
Ronald L HayesDepartment of Neurosurgery, 6889Virginia Commonwealth University, Richmond, VA, USA.
Max WintermarkDepartment of Radiology, Neuroradiology Division, 6429Stanford University, Stanford, CA, USA.ORCID 0000-0002-6726-3951
Stanford University · USBanyan Biomarkers (United States) · USVirginia Commonwealth University · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionTraumatic brain injury (TBI) is a major public health concern in the U.S. Recommendations for patients admitted in the emergency department (ED) to receive head computed tomography (CT) scan are currently guided by various clinical decision rules.

objectiveTo compare how a blood biomarker approach compares with clinical decision rules in terms of predicting a positive head CT in adult patients suspected of TBI.

methodsWe retrospectively identified patients transported to our emergency department and underwent a noncontrast head CT due to suspicion of TBI and who had blood samples available. Published thresholds for serum and plasma glial fibrillary acidic protein (GFAP), ubiquitin carboxyl-terminal hydrolase-L1 (UCH-L1), and serum S100β were used to make CT recommendations. These blood biomarker-based recommendations were compared to those achieved under widely used clinical head CT decision rules (Canadian, New Orleans, NEXUS II, and ACEP Clinical Policy).

resultsOur study included 463 patients, of which 122 (26.3%) had one or more abnormalities presenting on head CT. Individual blood biomarkers achieved high negative predictive value (NPV) for abnormal head CT findings (88%-98%), although positive predictive value (PPV) was consistently low (25%-42%). A composite biomarker-based decision rule (GFAP+UCH-L1)'s NPV of 100% and PPV of 29% were comparable or better than those achieved under the clinical decision rules.

conclusionBlood biomarkers perform at least as well as clinical rules in terms of selecting TBI patients for head CT and may be easier to implement in the clinical setting. A prospective study is necessary to validate this approach.

Indexed as

Brain Injuries, TraumaticClinical Decision RulesAdultBiomarkersCanadaHumansProspective StudiesRetrospective StudiesTomography, X-Ray ComputedUbiquitin ThiolesteraseBiomarkersUbiquitin Thiolesterasebiomarkershead computed tomographyplasma glial fibrillary acidic proteinS100βtraumatic brain injuryubiquitin carboxyl-terminal hydrolase-L1

Identifiers

PMID35588232
PMCPMC9893157
OpenAlexW4281250861

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.