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Radiologic common data elements rates in pediatric mild traumatic brain injury
Andrew R Mayer1, Daniel M Cohen2, Christopher J Wertz2
1From The Mind Research Network/Lovelace Biomedical and Environmental Research Institute (A.R.M., C.J.W., A.B.D., J.S., F.M.H., J.P.P., N.A.S.); Departments of Psychiatry and Behavioral Sciences (A.R.M.), Psychology (A.R.M., R.A.C., R.A.Y.), and Neurology (A.R.M., J.P.P.), University of New Mexico, Albuquerque; Department of Pediatrics (D.M.C., H.G.T.), The Ohio State University, Columbus; Division of Emergency Medicine (D.M.C.) and Department of Radiology (N.A.Z.), Nationwide Children's Hospital, Columbus, OH; Radiology Associates of Albuquerque (C.P.); Emergency Medicine (G.P., S.J.O., A.P.), University of New Mexico Hospital, Albuquerque; Department of Radiology (B.A.B.), Case Western Reserve University School of Medicine, Cleveland, OH; The Research Institute at Nationwide Children's Hospital (C.L.), Columbus, OH; Department of Pediatrics, Rainbow Babies and Children's Hospital (N.M.M., A.M.B.), Case Western Reserve University, Cleveland, OH; Department of Psychology (E.D.B.), Brigham Young University, Provo, UT; Departments of Neurosurgery (T.B.M.), Cell Biology, Neurobiology and Anatomy (T.B.M.), and Biomedical Engineering (T.B.M.), Medical College of Wisconsin, Milwaukee; Center for Injury Research and Prevention (K.B.A., C.L.M.) and Division of Orthopedic Surgery (C.L.M.), Children's Hospital of Philadelphia; Department of Pediatrics (K.B.A., C.L.M.), University of Pennsylvania, Philadelphia; UBMD Department of Orthopaedics and Sports Medicine (J.J.L.), Jacobs School of Medicine, University at Buffalo, NY; Division of Emergency Medicine (R.M.), Boston Children's Hospital, MA; Department of Pediatrics and Emergency Medicine (R.L.Z.), Children's Hospital of Eastern Ontario Research Institute, University of Ottawa; and Department of Psychology (K.O.Y.), Alberta Children's Hospital Research Institute (K.O.Y.), and Hotchkiss Brain Institute (K.O.Y.), University of Calgary, Canada. amayer@mrn.org.
Radiologic common data elements (rCDE) specific to pediatric mild traumatic brain injury (pmTBI) were identified. However, findings suggest some rCDE may not be trauma-specific, necessitating refinement for accurate diagnosis.
Area of Science:
- Neurology
- Radiology
- Pediatrics
Background:
- Classifying structural MRI findings in pediatric mild traumatic brain injury (pmTBI) lacks standardized nosology.
- Radiologic common data elements (rCDE) aim to standardize reporting in research.
- Some rCDE are trauma-specific (probable), while others have multiple causes (possible).
Purpose of the Study:
- To test if probable rCDE are more frequent in pmTBI compared to controls.
- To assess if possible rCDE rates are similar between pmTBI and control groups.
- To evaluate the association of rCDE with outcomes in pediatric mild TBI.
Main Methods:
- Independent cohorts of pmTBI (n=287), healthy controls (HC; n=106), and orthopedic injury (OI; n=71) patients were recruited.
- Structural MRI was performed approximately 1 week post-injury.
- Patients were followed for 3-4 months to assess outcomes.
Main Results:
- Probable rCDE occurred in 4-5% of all groups, consistent with prior CT studies.
- Prevalence of possible rCDE and incidental findings were similar across pmTBI, OI, and HC groups.
- Possible rCDE and incidental findings were not linked to postconcussive symptoms or quality of life.
Conclusions:
- Current findings challenge the trauma-specific nature of certain rCDE in pediatric mild TBI.
- Refinement of rCDE is suggested for accurate radiological interpretation and diagnosis.
- Evolving diagnostic schemas require careful consideration of rCDE specificity.
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