Data Mining to Understand How Health Status Preceding Traumatic Brain Injury Affects Functional Outcome: A Population-Based Sex-Stratified Study

Chan, Vincy; Sutton, Mitchell; Mollayeva, Tatyana; Escobar, Michael; Hurst, Mackenzie; Colantonio, Angela

doi:10.1016/j.apmr.2020.05.017

Cited by 16 publications

(13 citation statements)

References 18 publications

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“…However, service integration, particularly meso-level integrations, may provide added benefits to the individuals, their families or caregivers, and health professionals by addressing some barriers identified in this review. For example, the inclusion of diverse disciplines in the treatment plan to address cognitive and motor impairments may be beneficial [ 80 ] as the challenges associated with cognitive and motor impairments reduce functional gain during inpatient rehabilitation among individuals with TBI [ 13 ]. For families and caregivers, collaboration between disciplines at a single facility may reduce travel-related barriers, as traveling between facilities, often in the same day, has been noted as a barrier for accessing required care from different providers [ 49 ].…”

Section: Discussionmentioning

confidence: 99%

A systematic review on integrated care for traumatic brain injury, mental health, and substance use

et al. 2022

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Traumatic brain injuries (TBI) and mental health or substance use disorders (MHSU) are global public health concerns due to their prevalence and impact on individuals and societies. However, care for individuals with TBI and MHSU remains fragmented with a lack of appropriate services and supports across the continuum of healthcare. This systematic review provided an evidence-based foundation to inform opportunities to mobilize and adapt existing resources to integrate care for individuals with TBI and MHSU by comprehensively summarizing existing integrated activities and reported barriers and facilitators to care integration. MEDLINE, EMBASE, PsycINFO, CINAHL, Cochrane Central Register of Controlled Trials, Sociological Abstracts, and Dissertations & Theses Global were independently reviewed by two reviewers based on pre-determined eligibility criteria. Data on the integration activity, level and type of integration, reported barriers and facilitators, and the strategies aligning with the World Health Organization’s (WHO) Framework on Integrated Person-Centred Care were extracted to form the basis for a narrative synthesis. Fifty-nine peer-reviewed articles were included, describing treatments (N = 49), programs (N = 4), or screening activities (N = 7). Studies discussing clinical integration at the micro- (N = 38) and meso- (N = 10) levels, service integration at the micro- (N = 6) and meso- (N = 5) levels, and functional integration at the meso-level (N = 1) were identified. A minority of articles reported on facilitators (e.g., cognitive accommodations in treatment plans; N = 7), barriers (e.g., lack of education on cognitive challenges associated with TBI; N = 2), or both (N = 6), related to integrating care. This review demonstrated that integrated TBI and MHSU care already exists across a range of levels and types. Given the finite and competing demands for healthcare resources, cognitive accommodations across treatment plans to facilitate integrated TBI and MHSU care should be considered. Multidisciplinary teams should also be explored to provide opportunities for education among health professionals so they can be familiar with TBI and MHSU. Trial registration: Prospero Registration: CRD42018108343.

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Section: Discussionmentioning

confidence: 99%

A systematic review on integrated care for traumatic brain injury, mental health, and substance use

et al. 2022

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“…We evaluated the health status preceding a TBI event reported by previous studies 6,32,33 . From all the possible ICD-10 codes classifying patients' main and associated diagnoses, a previous data mining and validation study identified 43 factors that were significantly overrepresented in patients with TBI compared to reference patients (individually matched based on sex, age, place of residence, and income quintile) within the 5 years preceding their TBI event.…”

Section: Health Status Preceding the Injury Eventmentioning

confidence: 99%

Health Status Transitions Related to Traumatic Brain Injury.

Escobar

Mollayeva

Tran

et al. 2021

Preprint

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For centuries, the study of traumatic brain injury (TBI) has been centred on historical observation and analyses of personal, social, and environmental processes, which have been examined separately. Today, however, computation implementation and vast patient data repositories are producing datasets of such volume and complexity as to challenge traditional scientific methodology. Drastically different approaches show great promise for research on TBI. We report a computational analysis of health status over time using population-wide health administrative data of patients with TBI. Our approach facilitates health status at injury event evaluation and classification, and unfolds health status trajectories, from that of preceding injury to the injury event itself, as they concern external causes of injury and injury severity. Taken together, the contrasting and interwoven aspects of health status on a time continuum can influence injury event trajectories and should be considered in TBI risk analysis for the improvement of diagnosis, treatment, and prevention.

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“…Health status impacts FIM scores, is linked to SDH and can be used for clinical decision-making or predicting functional outcomes. For example, gender-related differences exist in the health status factors that result in worse functional status after TBI for men (dementia, epilepsy, chronic cardiovascular pathology, mental health disorders) ( 74 ). Third, changes in SDH over time are rarely accounted for in physiatry research, a critical flaw that has been a barrier to understanding changes in function with different treatment approaches.…”

Section: Proposed Novel Measurement Approaches 194mentioning

confidence: 99%

Social Determinants of Health in Physiatry: Challenges and Opportunities for Clinical Decision Making and Improving Treatment Precision

Conic

Geis

Vincent

2021

Front. Public Health

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Physiatry is a medical specialty focused on improving functional outcomes in patients with a variety of medical conditions that affect the brain, spinal cord, peripheral nerves, muscles, bones, joints, ligaments, and tendons. Social determinants of health (SDH) play a key role in determining therapeutic process and patient functional outcomes. Big data and precision medicine have been used in other fields and to some extent in physiatry to predict patient outcomes, however many challenges remain. The interplay between SDH and physiatry outcomes is highly variable depending on different phases of care, and more favorable patient profiles in acute care may be less favorable in the outpatient setting. Furthermore, SDH influence which treatments or interventional procedures are accessible to the patient and thus determine outcomes. This opinion paper describes utility of existing datasets in combination with novel data such as movement, gait patterning and patient perceived outcomes could be analyzed with artificial intelligence methods to determine the best treatment plan for individual patients in order to achieve maximal functional capacity.

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Data Mining to Understand How Health Status Preceding Traumatic Brain Injury Affects Functional Outcome: A Population-Based Sex-Stratified Study

Cited by 16 publications

References 18 publications

A systematic review on integrated care for traumatic brain injury, mental health, and substance use

A systematic review on integrated care for traumatic brain injury, mental health, and substance use

Health Status Transitions Related to Traumatic Brain Injury.

Social Determinants of Health in Physiatry: Challenges and Opportunities for Clinical Decision Making and Improving Treatment Precision

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