Reclassifying Traumatic Brain Injury—What Are the Next Steps?

“The other thing that I think we really need to improve upon is medical informatics,” said Dr. Manley, noting that better clinical decision-making tools are needed to assist clinicians who do not focus solely on TBI. “Most importantly, I think we need a prospective, multivariate TBI database. I’m not sure we even know what TBI is in 2009. Almost everything we do as clinicians is based on what we learned from the Traumatic Coma Data Bank, which contains patient data collected over 25 years ago,” said Dr. Manley. Prospective observational studies across the entire TBI injury spectrum will require 1,000 to 2,000 patients, rather than 20 to 30, to develop a clearer picture of TBI and help to focus future research and clinical efforts.

In March 2009, a total of 49 institutions and government agencies, including the NIH, National Institute on Disability and Rehabilitation Reasearch, Defense Centers of Excellence, Defense and Veterans Brain Injury Center, Veterans Affairs, and other stakeholders, organized a consensus conference in Washington, DC to discuss these issues. “What I hope you’ll see by the end of the year is a series of white papers that essentially outline what these common data elements are for TBI demographics, neuroimaging, biomarkers, outcome, and assessment of psychological health. The vision is to provide the tools to standardize data collection to improve TBI research and clinical care.”