The Experts below are selected from a list of 360 Experts worldwide ranked by ideXlab platform
Andrew I R Maas - One of the best experts on this subject based on the ideXlab platform.
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transforming research and Clinical Knowledge in traumatic brain injury pilot multicenter implementation of the common data elements for traumatic brain injury
Journal of Neurotrauma, 2013Co-Authors: Mary J Vassar, David O Okonkwo, Ava M Puccio, Hester F Lingsma, Andrew I R Maas, Shelly R Cooper, Alex B Valadka, Wayne A Gordon, Pratik Mukherjee, David M SchnyerAbstract:Abstract Traumatic brain injury (TBI) is among the leading causes of death and disability worldwide, with enormous negative social and economic impacts. The heterogeneity of TBI combined with the lack of precise outcome measures have been central to the discouraging results from Clinical trials. Current approaches to the characterization of disease severity and outcome have not changed in more than three decades. This prospective multicenter observational pilot study aimed to validate the feasibility of implementing the TBI Common Data Elements (TBI-CDEs). A total of 650 subjects who underwent computed tomography (CT) scans in the emergency department within 24 h of injury were enrolled at three level I trauma centers and one rehabilitation center. The TBI-CDE components collected included: 1) demographic, social and Clinical data; 2) biospecimens from blood drawn for genetic and proteomic biomarker analyses; 3) neuroimaging studies at 2 weeks using 3T magnetic resonance imaging (MRI); and 4) outcome asse...
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gfap bdp as an acute diagnostic marker in traumatic brain injury results from the prospective transforming research and Clinical Knowledge in traumatic brain injury study
Journal of Neurotrauma, 2013Co-Authors: David O Okonkwo, John K Yue, Ava M Puccio, David M Panczykowski, Tomoo Inoue, Paul J Mcmahon, Marco D Sorani, Esther L Yuh, Hester F Lingsma, Andrew I R MaasAbstract:Abstract Reliable diagnosis of traumatic brain injury (TBI) is a major public health need. Glial fibrillary acidic protein (GFAP) is expressed in the central nervous system, and breakdown products (GFAP-BDP) are released following parenchymal brain injury. Here, we evaluate the diagnostic accuracy of elevated levels of plasma GFAP-BDP in TBI. Participants were identified as part of the prospective Transforming Research And Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Study. Acute plasma samples (<24 h post-injury) were collected from patients presenting with brain injury who had CT imaging. The ability of GFAP-BDP level to discriminate patients with demonstrable traumatic lesions on CT, and with failure to return to pre-injury baseline at 6 months, was evaluated by the area under the receiver operating characteristic curve (AUC). Of the 215 patients included for analysis, 83% had mild, 4% had moderate, and 13% had severe TBI; 54% had acute traumatic lesions on CT. The ability of GFAP-BDP level...
David O Okonkwo - One of the best experts on this subject based on the ideXlab platform.
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transforming research and Clinical Knowledge in traumatic brain injury pilot multicenter implementation of the common data elements for traumatic brain injury
Journal of Neurotrauma, 2013Co-Authors: Mary J Vassar, David O Okonkwo, Ava M Puccio, Hester F Lingsma, Andrew I R Maas, Shelly R Cooper, Alex B Valadka, Wayne A Gordon, Pratik Mukherjee, David M SchnyerAbstract:Abstract Traumatic brain injury (TBI) is among the leading causes of death and disability worldwide, with enormous negative social and economic impacts. The heterogeneity of TBI combined with the lack of precise outcome measures have been central to the discouraging results from Clinical trials. Current approaches to the characterization of disease severity and outcome have not changed in more than three decades. This prospective multicenter observational pilot study aimed to validate the feasibility of implementing the TBI Common Data Elements (TBI-CDEs). A total of 650 subjects who underwent computed tomography (CT) scans in the emergency department within 24 h of injury were enrolled at three level I trauma centers and one rehabilitation center. The TBI-CDE components collected included: 1) demographic, social and Clinical data; 2) biospecimens from blood drawn for genetic and proteomic biomarker analyses; 3) neuroimaging studies at 2 weeks using 3T magnetic resonance imaging (MRI); and 4) outcome asse...
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gfap bdp as an acute diagnostic marker in traumatic brain injury results from the prospective transforming research and Clinical Knowledge in traumatic brain injury study
Journal of Neurotrauma, 2013Co-Authors: David O Okonkwo, John K Yue, Ava M Puccio, David M Panczykowski, Tomoo Inoue, Paul J Mcmahon, Marco D Sorani, Esther L Yuh, Hester F Lingsma, Andrew I R MaasAbstract:Abstract Reliable diagnosis of traumatic brain injury (TBI) is a major public health need. Glial fibrillary acidic protein (GFAP) is expressed in the central nervous system, and breakdown products (GFAP-BDP) are released following parenchymal brain injury. Here, we evaluate the diagnostic accuracy of elevated levels of plasma GFAP-BDP in TBI. Participants were identified as part of the prospective Transforming Research And Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Study. Acute plasma samples (<24 h post-injury) were collected from patients presenting with brain injury who had CT imaging. The ability of GFAP-BDP level to discriminate patients with demonstrable traumatic lesions on CT, and with failure to return to pre-injury baseline at 6 months, was evaluated by the area under the receiver operating characteristic curve (AUC). Of the 215 patients included for analysis, 83% had mild, 4% had moderate, and 13% had severe TBI; 54% had acute traumatic lesions on CT. The ability of GFAP-BDP level...
Esther L Yuh - One of the best experts on this subject based on the ideXlab platform.
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recovery after mild traumatic brain injury in patients presenting to us level i trauma centers a transforming research and Clinical Knowledge in traumatic brain injury track tbi study
JAMA Neurology, 2019Co-Authors: Lindsay D Nelson, Esther L Yuh, Nancy R Temkin, Sureyya Dikmen, Jason Barber, Joseph T Giacino, Harvey S Levin, Michael Mccrea, Murray B SteinAbstract:Importance Most traumatic brain injuries (TBIs) are classified as mild (mTBI) based on admission Glasgow Coma Scale (GCS) scores of 13 to 15. The prevalence of persistent functional limitations for these patients is unclear. Objectives To characterize the natural history of recovery of daily function following mTBI vs peripheral orthopedic traumatic injury in the first 12 months postinjury using data from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) study, and, using Clinical computed tomographic (CT) scans, examine whether the presence (CT+) or absence (CT-) of acute intracranial findings in the mTBI group was associated with outcomes. Design, setting, and participants TRACK-TBI, a cohort study of patients with mTBI presenting to US level I trauma centers, enrolled patients from February 26, 2014, to August 8, 2018, and followed up for 12 months. A total of 1453 patients at 11 level I trauma center emergency departments or inpatient units met inclusion criteria (ie, mTBI [n = 1154] or peripheral orthopedic traumatic injury [n = 299]) and were enrolled within 24 hours of injury; mTBI participants had admission GCS scores of 13 to 15 and Clinical head CT scans. Patients with peripheral orthopedic trauma injury served as the control (OTC) group. Exposures Participants with mTBI or OTC. Main outcomes and measures The Glasgow Outcome Scale Extended (GOSE) scale score, reflecting injury-related functional limitations across broad life domains at 2 weeks and 3, 6, and 12 months postinjury was the primary outcome. The possible score range of the GOSE score is 1 (dead) to 8 (upper good recovery), with a score less than 8 indicating some degree of functional impairment. Results Of the 1453 participants, 953 (65.6%) were men; mean (SD) age was 40.9 (17.1) years in the mTBI group and 40.9 (15.4) years in the OTC group. Most participants (mTBI, 87%; OTC, 93%) reported functional limitations (GOSE Conclusions and relevance Most patients with mTBI presenting to US level I trauma centers report persistent, injury-related life difficulties at 1 year postinjury, suggesting the need for more systematic follow-up of patients with mTBI to provide treatments and reduce the risk of chronic problems after mTBI.
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gfap bdp as an acute diagnostic marker in traumatic brain injury results from the prospective transforming research and Clinical Knowledge in traumatic brain injury study
Journal of Neurotrauma, 2013Co-Authors: David O Okonkwo, John K Yue, Ava M Puccio, David M Panczykowski, Tomoo Inoue, Paul J Mcmahon, Marco D Sorani, Esther L Yuh, Hester F Lingsma, Andrew I R MaasAbstract:Abstract Reliable diagnosis of traumatic brain injury (TBI) is a major public health need. Glial fibrillary acidic protein (GFAP) is expressed in the central nervous system, and breakdown products (GFAP-BDP) are released following parenchymal brain injury. Here, we evaluate the diagnostic accuracy of elevated levels of plasma GFAP-BDP in TBI. Participants were identified as part of the prospective Transforming Research And Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Study. Acute plasma samples (<24 h post-injury) were collected from patients presenting with brain injury who had CT imaging. The ability of GFAP-BDP level to discriminate patients with demonstrable traumatic lesions on CT, and with failure to return to pre-injury baseline at 6 months, was evaluated by the area under the receiver operating characteristic curve (AUC). Of the 215 patients included for analysis, 83% had mild, 4% had moderate, and 13% had severe TBI; 54% had acute traumatic lesions on CT. The ability of GFAP-BDP level...
Alex B Valadka - One of the best experts on this subject based on the ideXlab platform.
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ed disposition of the glasgow coma scale 13 to 15 traumatic brain injury patient analysis of the transforming research and Clinical Knowledge in tbi study
American Journal of Emergency Medicine, 2014Co-Authors: Jonathan J Ratcliff, John K Yue, Wayne A Gordon, Opeolu Adeoye, Christopher J Lindsell, Kimberly W Hart, Arthur Pancioli, Jason T Mcmullan, Daniel K Nishijima, Alex B ValadkaAbstract:Objective Mild traumatic brain injury (mTBI) patients are frequently admitted to high levels of care despite limited evidence suggesting benefit. Such decisions may contribute to the significant cost of caring for mTBI patients. Understanding the factors that drive disposition decision making and how disposition is associated with outcomes is necessary for developing an evidence-base supporting disposition decisions. We evaluated factors associated with emergency department triage of mTBI patients to 1 of 3 levels of care: home, inpatient floor, or intensive care unit (ICU).
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transforming research and Clinical Knowledge in traumatic brain injury pilot multicenter implementation of the common data elements for traumatic brain injury
Journal of Neurotrauma, 2013Co-Authors: Mary J Vassar, David O Okonkwo, Ava M Puccio, Hester F Lingsma, Andrew I R Maas, Shelly R Cooper, Alex B Valadka, Wayne A Gordon, Pratik Mukherjee, David M SchnyerAbstract:Abstract Traumatic brain injury (TBI) is among the leading causes of death and disability worldwide, with enormous negative social and economic impacts. The heterogeneity of TBI combined with the lack of precise outcome measures have been central to the discouraging results from Clinical trials. Current approaches to the characterization of disease severity and outcome have not changed in more than three decades. This prospective multicenter observational pilot study aimed to validate the feasibility of implementing the TBI Common Data Elements (TBI-CDEs). A total of 650 subjects who underwent computed tomography (CT) scans in the emergency department within 24 h of injury were enrolled at three level I trauma centers and one rehabilitation center. The TBI-CDE components collected included: 1) demographic, social and Clinical data; 2) biospecimens from blood drawn for genetic and proteomic biomarker analyses; 3) neuroimaging studies at 2 weeks using 3T magnetic resonance imaging (MRI); and 4) outcome asse...
Blackford Middleton - One of the best experts on this subject based on the ideXlab platform.
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comparison of Clinical Knowledge management capabilities of commercially available and leading internally developed electronic health records
BMC Medical Informatics and Decision Making, 2011Co-Authors: Dean F. Sittig, Adam Wright, Seth Meltzer, Linas Simonaitis, Scott R Evans, Paul W Nichol, Blackford MiddletonAbstract:Background We have carried out an extensive qualitative research program focused on the barriers and facilitators to successful adoption and use of various features of advanced, state-of-the-art electronic health records (EHRs) within large, academic, teaching facilities with long-standing EHR research and development programs. We have recently begun investigating smaller, community hospitals and out-patient clinics that rely on commercially-available EHRs. We sought to assess whether the current generation of commercially-available EHRs are capable of providing the Clinical Knowledge management features, functions, tools, and techniques required to deliver and maintain the Clinical decision support (CDS) interventions required to support the recently defined "meaningful use" criteria.
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the state of the art in Clinical Knowledge management an inventory of tools and techniques
International Journal of Medical Informatics, 2010Co-Authors: Dean F. Sittig, Adam Wright, Linas Simonaitis, James D Carpenter, George Allen, Bradley N Doebbeling, Anwar Mohammad Sirajuddin, Joan S Ash, Blackford MiddletonAbstract:Purpose: To explore the need for, and use of, high-quality, collaborative, Clinical Knowledge management (CKM) tools and techniques to manage Clinical decision support (CDS) content. Methods: In order to better understand the current state of the art in CKM, we developed a survey of potential CKM tools and techniques. We conducted an exploratory study by querying a convenience sample of respondents about their use of specific practices in CKM. Results: The following tools and techniques should be priorities in organizations interested in developing successful computer-based provider order entry (CPOE) and CDS implementations: (1) a multidisciplinary team responsible for creating and maintaining the Clinical content; (2) an external organizational repository of Clinical content with web-based viewer that allows anyone in the organization to review it; (3) an online, collaborative, interactive, Internet-based tool to facilitate content development; (4) an enterprise-wide tool to maintain the controlled Clinical terminology concepts. Even organizations that have been successfully using computer-based provider order entry with advanced Clinical decision support features for well over 15 years are not using all of the CKM tools or practices that we identified. Conclusions: If we are to further stimulate progress in the area of Clinical decision support, we must continue to develop and refine our understanding and use of advanced CKM capabilities.