Promising New Technology for Triaging Patients with TBIs

In March of 2017, researchers from multiple clinical data acquisition sites published the results of their testing of a new brain electrical activity biomarker to see how well it would help triage patients with traumatic brain injuries (TBI). Every year, over 2.5 million emergency room visits are made by people who have suffered a TBI. For these patients, it is critical to know as soon as possible how serious their TBI is so that it can be treated properly.

Currently, computed tomography (CT) scan is the pragmatically accepted criterion standard for identifying acute intracranial injuries in the ED, although the vast majority of those with mild TBI (mTBI), estimated to be as high as 90%, are found to be negative for clinically important brain injury.[5-7] Yet many of these patients eventually experience substantial impairment which is underdiagnosed in the ED setting. Clinical decision rules (e.g., New Orleans Criteria [NOC],[8] Canadian CT Head Rule [CCHR][6, 9]) currently focus on CT scanning and have high sensitivity at the expense of very low specificity,[10-12] contributing to potential long-term health risks associated with overscanning.[10, 13] Care pathways that reduce the radiation exposure risks and allow for screening of mTBI patients in nonhospital settings could provide substantial benefit to mTBI patients. (Hanley, 2017, pp.618)

If these brain electrical activity biomarkers can quickly and accurately triage TBI patients, then patients will receive faster, quality care to prevent further impairments.

Hanley, D., Prichep, L. S., Bazarian, J., Huff, J. S., Nauheim, R., Garrett, J.,… & Hack, D. C. (2017). Emergency department triage of traumatic head injury using a brain electrical activity biomarker: A multisite prospective observational validation trial. Academic Emergency Medicine, 24(5), 617-627. http://dx.doi.org.erl.lib.byu.edu/10.1097/HTR.0000000000000187

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