Prognostic Validation of the NINDS Common Data Elements for the Radiologic Reporting of Acute Traumatic Brain Injuries: A CENTER-TBI Study.
The aim of this study is to investigate the prognostic value of using the National Institute of Neurological Disorders and Stroke (NINDS) standardized imaging-based pathoanatomic descriptors for the evaluation and reporting of acute traumatic brain injury (TBI) lesions. For a total of 3392 patients (2244 males and 1148 females, median age = 51 years) enrolled in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study, we extracted 96 Common Data Elements (CDEs) from the structured reports, spanning all three levels of pathoanatomic information (i.e., 20 "basic," 60 "descriptive," and 16 "advanced" CDE variables per patient). Six-month clinical outcome scores were dichotomized into favorable (Glasgow Outcome Scale Extended [GOS-E] = 5-8) versus unfavorable (GOS-E = 1-4). Regularized logistic regression models were constructed and compared using the optimism-corrected area under the curve (AUC). An abnormality was reported for the majority of patients (64.51%). In 79.11% of those patients, there was at least one coexisting pathoanatomic lesion or associated finding. An increase in lesion severity, laterality, and volume was associated with more unfavorable outcomes. Compared with the full set of pathoanatomic descriptors (i.e., all three categories of information), reporting "basic" CDE information provides at least equal discrimination between patients with favorable versus unfavorable outcome (AUC = 0.8121 vs. 0.8155, respectively). Addition of a selected subset of "descriptive" detail to the basic CDEs could improve outcome prediction (AUC = 0.8248). Addition of "advanced" or "emerging/exploratory" information had minimal prognostic value. Our results show that the NINDS standardized-imaging based pathoanatomic descriptors can be used in large-scale studies and provide important insights into acute TBI lesion patterns. When used in clinical predictive models, they can provide excellent discrimination between patients with favorable and unfavorable 6-month outcomes. If further validated, our findings could support the development of structured and itemized templates in routine clinical radiology.
['Vande Vyvere|Thijs|T|', 'De La Rosa|Ezequiel|E|', 'Wilms|Guido|G|', 'Nieboer|Daan|D|', 'Steyerberg|Ewout|E|', 'Maas|Andrew I R|AIR|', 'Verheyden|Jan|J|', 'van den Hauwe|Luc|L|', 'Parizel|Paul M|PM|', '|||']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D000070642:Brain Injuries, Traumatic D002648:Child D002675:Child, Preschool D065709:Common Data Elements D016208:Databases, Factual D005260:Female D006801:Humans D007223:Infant D007231:Infant, Newborn D008137:Longitudinal Studies D008297:Male D008875:Middle Aged D055825:National Institute of Neurological Disorders and Stroke (U.S.) D011379:Prognosis D015203:Reproducibility of Results D058028:Research Report D014057:Tomography, X-Ray Computed D014481:United States D055815:Young Adult
Common Data Elements traumatic brain injury structured reporting computed tomography