Modelling Rehabilitation Trajectory of Paediatric ABI Patients
Research type
Research Study
Full title
Dynamic Personalised Modelling of Rehabilitation Pathways of Children with Acquired Brain Injury (ABI)
IRAS ID
331258
Contact name
Edilson Arruda
Contact email
Sponsor organisation
University of Southampton
Clinicaltrials.gov Identifier
33312583, MSc student number, University of Southampton; 75216, ERGO number (Ethics approval) for MSc
Duration of Study in the UK
1 years, 12 months, days
Research summary
Children and young people who sustain severe acquired brain injury (ABI) from trauma, infection, stroke or hypoxia, often present to hospital in coma. Generally, they experience stages of reduced awareness up to recovery. Some of them, however, develop a Prolonged Disorder of Consciousness (PDOC). Currently, inability to predict accurately the outcome of individual patients is a barrier to the early use of novel pharmacological and surgical treatments aimed at improving neuronal connectivity, which have been proposed for patients with PDOC. This project will use anonymised data from the Bristol Royal Hospital for Children (BRHC) Clinical Neurorehabilitation database to explore the feasibility of using mathematical modelling to develop the predictive capacity that would allow early identification of patients who could potentially benefit from novel PDOC treatments, thus enabling targeted intervention and personalised care.
Whilst current methods are static and fit a prescribed model to a trajectory (Forsyth et al. 2010, Kelly et al. 2015) or predict the patient scores solely at discharge (Molteni et al 2021), we will use dynamic stochastic models to study the transition among outcome scores (King's Outcome Scale for Children with Head Injury - KOSCHI) before discharge, to produce a detailed model of the recovery trajectory at the patient level. We will compare our model with the current methods to evaluate the improvement on the uncertainty estimation within the possible recovery trajectories. Our framework will help dynamic personalised clinical decision making as the patient pathway evolves.
This is a joint project between the Clinical Department of Paediatric Neurorehabilitation, BRHC (Dr Peta Sharples) and the Faculty of Social Sciences, School of Mathematics, University of Southampton (Dr Edilson Arruda). If modelling of single-centre data suggests this approach to be feasible, we propose to extend the project to other paediatric neurorehabilitation centres via the UK Paediatric Neurorehabilitation Network.REC name
London - Camden & Kings Cross Research Ethics Committee
REC reference
23/LO/0808
Date of REC Opinion
9 Oct 2023
REC opinion
Favourable Opinion