Prediction of Outcome

Project Type
Independent
Principal Investigator Name
Kathy Bell
Principal Investigator Email
Start Date:
9/1/2007
End Date:
8/30/2012
Participating Centers:
Target Population(s):
Participants with TBI; 21-65 years of age.
Abstract:
The overall aim of this project is to develop user friendly, methodologically high quality models for prediction of a number of important outcomes following TBI. These outcomes will include neuropsychological status, functional status (including employment), emotional functioning, perceived quality of life, and post-traumatic symptoms. Prediction of outcome in individual cases is important for a number of reasons. Clinicians make diagnostic and therapeutic decisions based on prognosis. Prediction of outcome allows one to identify and provide appropriate treatment to those who need it. Prognostic information is also critical in counseling patients and their families to help them plan for the future. The importance of early identification of those who are likely to encounter long term limitations in their everyday life and the need to plan for care can not be over emphasized. While services for persons with TBI have always been limited, the situation has worsened since the introduction of the prospective payment system. Also challenging the system are the new cohort of injured soldiers returning from conflicts, whose futures depend on accurate functional prediction and diagnosis. We expect that this proposed project will yield evidence-based, high quality, practical, and useful predictions of future expected outcomes. Major benefits of such information are: 1. Clinicians can identify patients who are likely to have difficulties and thus refer or provide them with services aimed at preventing or reducing the magnitude of disabilities. Therefore the results have implications for changing clinical practice in a way that can improve quality of life of the survivors. 2. Resources can be more efficiently used. Survivors and their families can weigh expected outcomes in the context of available funds and how their available funds may be best used. 3. Performance of service providers can be examined against expected evidence-based data. Additionally, potential outcomes promised by providers’ services may be reviewed or even negotiated against such benchmark data. Today, in post acute TBI services at least, there is no data-driven matrix for making service decisions 4. Researchers can use such information in designing and/or analyzing observational rehabilitation treatment studies. The predictions to be provided will allow forming groups with similar prognosis that can be fairly compared or accounting for differences in the analysis 5. Researchers can use such information in the design and analysis of future randomized studies of intervention, including choice of measures depending on the nature of the intervention planned and allowing for better stratification and data analysis, thus decreasing sample size needed or increasing power of the study.