Evidence map›Paper›PMID 42318809›Full record

ArticleEuropean journal of neurology2026

External Validation of a Prognostic Model for Outcome After Mild Traumatic Brain Injury at 6 Months Post Injury.

Robin van Pinxteren, Marilien C Marzolla, Melloney L M Wijenberg, Caroline M van Heugten, Frits H M van Osch, Joukje van der Naalt, Jacoba M Spikman, Marieke E Timmerman, Jeroen J Roor

Abstract readMulticenter StudyValidation Study
PubMed Full text at PMC Publisher
In one paragraph

Article in European journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

What it found

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2 · The registry

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3 · Its place in the literature

Who cites it

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4 · The record

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5 · Who and what money

Authors and funding

9 authors.

Robin van PinxterenDepartment of Medical Psychology, VieCuri Medical Center, Venlo, the Netherlands.
Marilien C MarzollaDepartment of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.ORCID https://orcid.org/0000-0002-2711-3131
Melloney L M WijenbergAdelante, Center of Expertise in Rehabilitation and Audiology, Hoensbroek, the Netherlands.ORCID https://orcid.org/0000-0002-8059-4747
Caroline M van HeugtenDepartment of Neuropsychology and Psychopharmacology, Faculty of Psychology and Neuroscience, Maastricht University, Maastricht, the Netherlands.ORCID https://orcid.org/0000-0003-4272-7315
Frits H M van OschDepartment of Clinical Epidemiology, VieCuri Medical Center, Venlo, the Netherlands.ORCID https://orcid.org/0000-0003-4329-2560
Joukje van der NaaltDepartment of Neurology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.ORCID https://orcid.org/0000-0001-9873-2418
Jacoba M SpikmanDepartment of Neurology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.ORCID https://orcid.org/0000-0002-6477-0763
Marieke E TimmermanDepartment of Psychometrics and Statistics, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.ORCID https://orcid.org/0000-0003-1579-6964
Jeroen J RoorDepartment of Medical Psychology, VieCuri Medical Center, Venlo, the Netherlands.ORCID https://orcid.org/0000-0003-3729-229X

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWhile most people fully recover after mild traumatic brain injury (mTBI), a substantial minority experience persistent symptoms and incomplete recovery. This may be prevented by early interventions specifically targeting patients at risk of incomplete recovery. The UPFRONT-model was developed to identify patients at risk of poor functional outcome. This study aimed to externally validate the UPFRONT-model in an independent sample.

methodsA prospective, longitudinal, multicenter cohort study with 126 mTBI patients recruited from emergency and neurology departments (ED) of six hospitals in the Netherlands was performed. Predictors in the UPFRONT-model included educational level, Glasgow Coma Scale (GCS), neck pain at injury, alcohol intoxication, Post Traumatic Amnesia (PTA), pre-injury mental health, anxiety, depression, coping, and the number and severity of post-traumatic complaints. Functional recovery at 6 months was assessed using the Glasgow Outcome Scale Extended (GOS-E). The external validity of the UPRFONT model was assessed with measures of calibration and discrimination.

resultsThe model showed acceptable discriminative ability (AUC = 0.74), comparable to the development sample (AUC = 0.77). However, calibration revealed systematic underestimation of recovery (predicted: 46%; observed: 75%), with a calibration intercept of 1.52 and a slope of 0.70. Despite differences in some predictor effects, psychological variables were robust and consistent across samples.

conclusionThe UPFRONT-model demonstrated solid discriminative performance in an external cohort, but tended to underestimate the likelihood of complete recovery. Further validation and optimization are needed before clinical implementation. The model holds promise for early identification of at-risk patients, enabling targeted interventions following mTBI.

Indexed as

Brain ConcussionRecovery of FunctionAdultFemaleGlasgow Coma ScaleGlasgow Outcome ScaleHumansLongitudinal StudiesMaleMiddle AgedNetherlandsPrognosisProspective StudiesGlasgow outcome scale extendedmild traumatic brain injurypredictive modelvalidation study

Identifiers

PMID42318809
PMCPMC13280801

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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.