@article{ref1,
title="A cross-study analysis for reproducible sub-classification of traumatic brain injury",
journal="Frontiers in neurology",
year="2018",
author="Si, Bing and Dumkrieger, Gina and Wu, Teresa and Zafonte, Ross and Dodick, David W. and Schwedt, Todd J. and Li, Jing",
volume="9",
number="",
pages="e606-e606",
abstract="<b>Objective:</b> To identify reproducible sub-classes of traumatic brain injury (TBI) that correlate with patient outcomes. <b>Methods:</b> Two TBI datasets from the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System were utilized, Transforming Research and Clinical Knowledge in Traumatic Brain Injury (TRACK-TBI) Pilot and Citicoline Brain Injury Treatment Trial (COBRIT). Patients included in these analyses had closed head injuries with Glasgow Comas Scale (GCS) scores of 13-15 at arrival at the Emergency Department (ED). Sparse hiearchical clustering was applied to identify TBI sub-classes within each dataset. The reproducibility of the sub-classes was evaluated by investigating similarities in clinical variable profiles and patient outcomes in each sub-class between the two datasets, as well as by using a statistical metric called in-group proportion (IGP). <b>Results:</b> Seven TBI sub-classes were identified in the first dataset. There were between-class differences in patient outcomes at 90 days (Glasgow Outcome Scale Extended (GOSE): <i>p</i> < 0.001) and 180 days (Trail Making Test (TMT): <i>p</i> = 0.03). Four of seven sub-classes were reproducible in the second dataset with very high IGPs (94, 100, 99, 97%). Seven TBI sub-classes were also identified in the second dataset. There were significant between-class differences in patient outcomes at 180 days (GOSE: <i>p</i> = 0.024; Brief Symptom Inventory (BSI) <i>p</i> = 0.007; TMT: <i>p</i> < 0.001). Three of seven sub-classes were reproducible in the second dataset with very high IGPs (100% for all). <b>Conclusions:</b> Reproducible TBI sub-classes were identified across two independent datasets, suggesting that these sub-classes exist in a general population. Differences in patient outcomes according to sub-class assignment suggest that this sub-classification could be used to guide post-TBI prognosis.<p /> <p>Language: en</p>",
language="en",
issn="1664-2295",
doi="10.3389/fneur.2018.00606",
url="http://dx.doi.org/10.3389/fneur.2018.00606"
}