Advancing Concussion Assessment in Pediatrics (A-CAP): a prospective, concurrent cohort, longitudinal study of mild
Keith Owen Yeates1,2,3, Miriam Beauchamp4, William Craig5
1Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
Insights
The Advancing Concussion Assessment in Pediatrics (A-CAP) study investigates neurobiological and psychosocial markers to improve diagnosis and outcome prediction for pediatric mild traumatic brain injury (mTBI). This research aims to provide evidence-based guidance for managing pediatric mTBI.
Area of Science:
- Pediatric neurology
- Neuroscience
- Public health
Background:
- Pediatric mild traumatic brain injury (mTBI) presents a significant public health challenge.
- Current diagnostic and prognostic tools for pediatric mTBI lack established gold standards.
- There is an urgent need for evidence-based clinical management guidelines.
Purpose of the Study:
- To assess neurobiological and psychosocial markers for diagnosing pediatric mTBI.
- To examine associations between markers and post-injury outcomes in children.
- To enhance the prediction of outcomes for pediatric mTBI.
Main Methods:
- Prospective, longitudinal cohort study of children (8-17 years) with mTBI or orthopedic injury (OI).
- Recruitment across five emergency departments within the Pediatric Emergency Research Canada network.
- Data collection includes injury information, neurobiological/psychosocial markers, and outcomes at 10 days, 3, and 6 months post-injury, with weekly symptom tracking.
Main Results:
- The study is designed to test hypotheses that markers can differentiate mTBI from OI.
- Analyses will determine if markers can predict mTBI outcomes.
- Multivariable and cross-domain modeling will be employed with a planned sample size of 700 mTBI and 300 OI cases.
Conclusions:
- The A-CAP study aims to establish robust diagnostic and prognostic tools for pediatric mTBI.
- Findings will contribute to improved clinical guidance and management strategies.
- The research will be disseminated through scientific conferences and peer-reviewed publications.
Introduction:
Paediatric mild traumatic brain injury (mTBI) is a public health burden. Clinicians urgently need evidence-based guidance to manage mTBI, but gold standards for diagnosing and predicting the outcomes of mTBI are lacking. The objective of the Advancing Concussion Assessment in Pediatrics (A-CAP) study is to assess a broad pool of neurobiological and psychosocial markers to examine associations with postinjury outcomes in a large sample of children with either mTBI or orthopaedic injury (OI), with the goal of improving the diagnosis and prognostication of outcomes of paediatric mTBI.
Methods And Analysis:
A-CAP is a prospective, longitudinal cohort study of children aged 8.00-16.99 years with either mTBI or OI, recruited during acute emergency department (ED) visits at five sites from the Pediatric Emergency Research Canada network. Injury information is collected in the ED; follow-up assessments at 10 days and 3 and 6 months postinjury measure a variety of neurobiological and psychosocial markers, covariates/confounders and outcomes. Weekly postconcussive symptom ratings are obtained electronically. Recruitment began in September 2016 and will occur for approximately 24 months. Analyses will test the major hypotheses that neurobiological and psychosocial markers can: (1) differentiate mTBI from OI and (2) predict outcomes of mTBI. Models initially will focus within domains (eg, genes, imaging biomarkers, psychosocial markers), followed by multivariable modelling across domains. The planned sample size (700 mTBI, 300 OI) provides adequate statistical power and allows for internal cross-validation of some analyses.
Ethics And Dissemination:
The ethics boards at all participating institutions have approved the study and all participants and their parents will provide informed consent or assent. Dissemination will follow an integrated knowledge translation plan, with study findings presented at scientific conferences and in multiple manuscripts in peer-reviewed journals.
