Evidence map›Paper›PMID 39720677›Full record

ArticleEClinicalMedicine2024

Predicting recovery in patients with mild traumatic brain injury and a normal CT using serum biomarkers and diffusion tensor imaging (CENTER-TBI): an observational cohort study.

Sophie Richter, Stefan Winzeck, Marta M Correia, Endre Czeiter, Daniel Whitehouse, Evgenios N Kornaropoulos, Guy B Williams, Jan Verheyden, Tilak Das, Olli Tenovuo and 11 more

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in EClinicalMedicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02210221 (Collaborative European NeuroTrauma Effectiveness Research in TBI), which is not on this map. Cited by 11 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

NCT02210221 completednot on this map

Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI)

Typeobservational_patient_registrySponsorUniversity Hospital, AntwerpRan2014 to 2021Enrolled4,559ConditionsTraumatic Brain Injury
3 · Its place in the literature

Who cites it

11 citing papers in PubMed, 1 synthesis or guideline pooled it.

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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

21 authors.

Sophie RichterDepartment of Medicine, University of Cambridge, Cambridge, UK.
Stefan WinzeckDepartment of Medicine, University of Cambridge, Cambridge, UK.
Marta M CorreiaMRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK.
Endre CzeiterNeurotrauma Research Group, Szentágothai Research Centre, University of Pécs, Pécs, Hungary.
Daniel WhitehouseDepartment of Medicine, University of Cambridge, Cambridge, UK.
Evgenios N KornaropoulosDepartment of Medicine, University of Cambridge, Cambridge, UK.
Guy B WilliamsWolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK.
Jan VerheydenResearch and Development, icometrix, Leuven, Belgium.
Tilak DasDepartment of Radiology, Addenbrooke's Hospital, Cambridge, UK.
Olli TenovuoTurku Brain Injury Center, Turku University Hospital & University of Turku, Turku, Finland.
Jussi P PostiTurku Brain Injury Center, Turku University Hospital & University of Turku, Turku, Finland.
Anne VikDepartment of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Kent Gøran MoenDepartment of Neurosurgery, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
Asta K HåbergDepartment of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Kevin WangCenter for Neurotauma, MultiOmic & Biomarkers, Department of Neurobiology, Neuroscience Institute, Morehouse School of Medicine, Atlanta, USA.
Andras BukiÖrebro University, School of Medical Sciences, Örebro, Sweden.
Andrew MaasDepartment of Neurosurgery, Antwerp University Hospital, Edegem, Belgium.
Ewout SteyerbergDepartment of Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.
David K MenonDepartment of Medicine, University of Cambridge, Cambridge, UK.
Virginia F J NewcombeDepartment of Medicine, University of Cambridge, Cambridge, UK.
Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury Magnetic Resonance Imaging (CENTER-TBI MRI) Substudy Participants and Investigators

Funding

Wellcome Trust
6 · The paper itself

Abstract

Background: Even patients with normal computed tomography (CT) head imaging may experience persistent symptoms for months to years after mild traumatic brain injury (mTBI). There is currently no good way to predict recovery and triage patients who may benefit from early follow-up and targeted intervention. We aimed to assess if existing prognostic models can be improved by serum biomarkers or diffusion tensor imaging metrics (DTI) from MRI, and if serum biomarkers can identify patients for DTI. Methods: We included 1025 patients aged >18 years with a Glasgow Coma Score >12 and normal CT from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study which recruited between December 19,2014 and December 17, 2017 (NCT02210221). Biomarkers (GFAP, NFL, S100B) were obtained at a median of 8.8 h (Q1-Q3 4.2-16.7) and DTI at 13 days (3-19) after injury. DTI metrics were available in 153 patients for 48 white matter tracts (ICBM-DTI-81 atlas). Incomplete recovery at three months was defined as an extended Glasgow Outcome Scale score <8. Existing prognostic models were fitted with and without biomarkers, or with and without DTI, and internally validated using bootstrapping. Findings: 385 (38%) patients had incomplete recovery. Adding biomarkers did not improve performance beyond the best existing clinical prognostic model [optimism-corrected AUC 0.69 (95% CI 0.65-0.72) and R Interpretation: DTI substantially improved existing prognostic models for functional outcome in patients with mTBI and a normal CT, and biomarkers could help select patients for MRI. If validated, DTI could allow for targeted follow-up and enrichment of clinical trials of early interventions to improve outcome. Funding: EU Seventh Framework Programme, Hannelore Kohl Stiftung, One Mind, Integra LifeSciences, NeuroTrauma Sciences.

Indexed as

BiomarkersConcussionImagingOutcomePrognosticationTraumatic brain injury

Identifiers

PMID39720677
PMCPMC11667275

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Registered trials

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.