FITBIR: Accelerating Synthesis of TBI Research Using Novel Methods (FAST RUN Methods)
Abstract
Rationale: Since 2000, more than 375,000 U.S. Military Service members have sustained a traumatic brain injury (TBI). In 2014, about 2.87 million TBI-related emergency department visits, hospitalizations, and deaths occurred in the United States, including over 837,000 among children. Recent research has shown that TBI is often associated with problems with functioning, psychological health concerns, and decreased quality of life. However, many important research gaps remain. For example, determining how symptoms change over time, how symptoms are impacted by TBI severity, and determining appropriate interventions, intervention timing, and how to target interventions to specific subgroups (like Service members/Veterans vs. civilians) is not well established. The FITBIR database is a compilation of many TBI research datasets. It is the largest repository of TBI research, containing over 3.7 million records for over 70,000 participants. These data have strong potential to improve our understanding of TBI prevention, diagnosis, management, and treatment. Our Project Fits with the FY19 CDMRP FITBIR Analysis Award Topics: We have assembled a team of national experts, each of whom will lead one of six published papers covering the following TBI outcome studies: (1) Cognitive Functioning and Neurologic Outcomes, (2) PTSD, (3) Depression and Suicide, (4) Substance Use, (5) Sleep, and (6) Employment, Functioning, and Quality of Life. Each paper will examine patient and injury factors that can impact outcomes including (1) time since injury, (2) TBI severity, (3) Service member/Veteran vs. civilian status, and (4) other demographics. These projects align with the following stated goals of the funding announcement: utilization of FITBIR to inform clinical practice guidelines for TBI; examination of patients who get better after treatment vs. those who do not to better understand the profiles of injury; analysis of how TBI and its outcomes relate to quality of life, employment, and other psychosocial measures; correlation of injury severity and treatment outcomes in patients with varying TBI severities (mild, moderate, severe); exploration of chronic (more than 1 year post-injury) patient characteristics (e.g., psychiatric symptoms, sleep disturbance, cognitive deficits) that may inform particular treatment approaches; definition and analysis of outcomes related to post-concussion syndrome from weeks, months, or years after injury; and identification of signs and symptoms of neurodegenerative disease during follow-up. Objectives: With our project, “FITBIR: Accelerating Synthesis of TBI Research Using Novel Methods,” (FAST RUN Methods), we utilize novel methods to accelerate the synthesis of FITBIR data to uncover new findings and improve the outcomes of civilians, Service members, and Veterans with TBI. We also use advanced software and analysis techniques to facilitate future use of FITBIR among other stakeholders and accelerate synthesis of existing FITBIR data. We will achieve our objective by using publicly available, open-source, cutting-edge software and information technology methods, including R and Shiny Apps software. We plan to share and make publicly available the methodologic products we develop so that future researchers, policy makers, and other stakeholders can access up-to-date, merged results for core FITBIR variables as data sets are updated and expanded. We will create interactive data visualization products designed for connecting the FITBIR database to web platforms in the future. Study Design, Clinical Implications, Risks, and Benefits: Overall, we will improve the understanding of key TBI-related psychological health and functioning outcomes. There are few risks associated with this research because FITBIR data are all de-identified so that no publicly available data contain private or identifiable information about participants. There are many benefits to our proposed studies. We will h
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Mar 10, 2021
- Source ID
- W81XWH2010564
Entities
People
- Maya O Neil
Organizations
- Oregon Health & Science University
- United States Army