TRaumatic Encephalopathy Assessment and Tool development in ED
Research type
Research Study
Full title
Children's TRaumatic Encephalopathy (brain injury) Assessment and Tool development in the Emergency Department: Examining prevalence and range of post-concussion symptoms and developing Tools to identify children most at risk of sustained post-concussion symptoms
IRAS ID
313170
Contact name
Michael Griffiths
Contact email
Sponsor organisation
University of Liverpool
Duration of Study in the UK
1 years, 2 months, 0 days
Research summary
Traumatic Brain Injury (TBI) is one of the most common reasons for attendance at Alder Hey Children’s Hospital, with between 4-12 TBI cases presenting to the Emergency Department per day (n>3500 cases in 2019).
TBI presents a significant diagnostic challenge, as the diagnosis is based on history and symptomatology. Within the paediatric population, patients struggle to recognise and define their symptoms, whilst collateral histories may lack sufficient detail.
Research demonstrates 10-43% of children following mild TBI develop sustained post-traumatic symptoms: roughly 1000 cases in Liverpool per year. Once detected, symptoms can be relieved and their chronic impact mitigated by psychological therapy. Imaging modalities such as CT and MRI are useful in confirming significant structural damage in more severe injury. In milder injuries that constitute over 90% of cases however, scans are unable to identify those at risk of developing delayed symptoms.
Reflecting other studies, the Alder Hey psychology team report TBI children experience a range of neuro-cognitive difficulties, including behavioural, functional and attention problems. These problems impair educational achievement, with socially deprived children exhibiting particularly poor recovery.
Current assessment methods do not provide adequate sensitivity in identifying which children develop sustained post-traumatic symptoms. Across all severities of TBI in children, the majority are diagnosed with mild TBI and discharged without follow-up, in keeping with NICE guidelines.
A significant unmet need exists for an objective diagnostic tool to identify which patients develop post-traumatic symptoms. Our methods for tackling this are several: primarily using a novel assay to measure and compare biomarker levels post-TBI. Following this, we aim to follow-up patients remotely via text message to more comprehensively describe the nature and prevalence of post-TBI symptoms; identifying those requiring greater support. Combining this data will determine whether serum biomarkers are able to aid in the severity scoring of TBI, potentially facilitating the development of a composite assessment tool for use in the setting of acute head injuries.REC name
West of Scotland REC 1
REC reference
23/WS/0106
Date of REC Opinion
28 Aug 2023
REC opinion
Further Information Favourable Opinion