ArticleBMJ global health2026
Outlining the global variation in resources for traumatic brain injury care: site-level data from the Global Neurotrauma Outcomes Study (GNOS).
Article in BMJ global health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04212754 (Management and Outcomes Following Emergency Surgery for Traumatic Brain Injury - a Multi-centre, International, Prospective Cohort Study), which is not on this map. Cited by 1 paper.
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.
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.
Management and Outcomes Following Emergency Surgery for Traumatic Brain Injury - a Multi-centre, International, Prospective Cohort Study (the Global Neurotrauma Outcomes Study)
Who cites it
1 citing paper in PubMed.
- Future Directions and Evolution Strategies for the Clinical Management of Traumatic Brain Injury.Journal of clinical medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
33 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionTraumatic brain injury (TBI), a leading cause of global morbidity and mortality, has notably poorer outcomes in resource-poor settings. Managing TBI effectively requires functional integration of several interdependent phases of care which, in resource-poor settings, may be both individually fragile and poorly coordinated. However, there is a paucity of global data quantifying systemic deficiencies in TBI care across varying resource settings which hinders targeted improvement. To address this, we present an analysis of site surveys from centres contributing to the Global Neurotrauma Outcomes Study, to illustrate the global variation in health system performance with respect to TBI management.
methodsThe GNOS was a prospective, international, multicentre cohort study conducted between 1 November 2018 and 31 January 2020 across 159 centres that perform emergency surgery for TBI. Participating centres completed a 50-point site survey, assessing local resource availability and guideline usage across the TBI care pathway, including prehospital, intraoperative and rehabilitative care. Responses were stratified by each country's Human Development Index (HDI).
resultsThe site survey was completed by 153/159 (96%) centres. Variation in resource availability across HDI strata was least prevalent within operating theatres, whereas the biggest disparities were observed in prehospital and rehabilitation care. Resource-poor settings reported deficiencies in both the capital resources and skilled human resources needed to deliver TBI care. Overall, participants most commonly suggested that improvements in prehospital care would have the greatest impact on patient outcomes in TBI (53/153, 35%), although participants from the more resource-poor settings more commonly suggested improvements in intensive care management (6/14, 43%).
conclusionThere are profound HDI-associated disparities in the resources for TBI care, which likely account for the global variation in patient mortality. Our study suggests improving the provision of non-operative interventions within TBI care pathways may offer the most successful approach to improve patient outcomes. TRIAL REGISTRATION NUMBER: NCT04212754.
Indexed as
Identifiers
What OpenQuestion holds
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.