@article{ref1,
title="Assessing the severity of traumatic brain injury-time for a change?",
journal="Journal of clinical medicine",
year="2021",
author="Zasler, Nathan D. and van der Naalt, Joukje and Sharp, David J. and Goldstein, Lee E. and Diaz-Arrastia, Ramon and Tenovuo, Olli",
volume="10",
number="1",
pages="e148-e148",
abstract="Traumatic brain injury (TBI) has been described to be man's most complex disease, in man's most complex organ. Despite this vast complexity, variability, and  individuality, we still classify the severity of TBI based on non-specific, often  unreliable, and pathophysiologically poorly understood measures. Current  classifications are primarily based on clinical evaluations, which are non-specific  and poorly predictive of long-term disability. Brain imaging results have also been  used, yet there are multiple ways of doing brain imaging, at different timepoints in  this very dynamic injury. Severity itself is a vague concept. All prediction models  based on combining variables that can be assessed during the acute phase have  reached only modest predictive values for later outcome. Yet, these early labels of  severity often determine how the patient is treated by the healthcare system at  large. This opinion paper examines the problems and provides caveats regarding the  use of current severity labels and the many practical and scientific issues that  arise from doing so. The objective of this paper is to show the causes and  consequences of current practice and propose a new approach based on risk  classification. A new approach based on multimodal quantifiable data (including  imaging and biomarkers) and risk-labels would be of benefit both for the patients  and for TBI clinical research and should be a priority for international efforts in  the field.<p /> <p>Language: en</p>",
language="en",
issn="2077-0383",
doi="10.3390/jcm10010148",
url="http://dx.doi.org/10.3390/jcm10010148"
}