Remote Follow-Up Technologies in Traumatic Brain Injury: A Scoping Review

Abstract

Traumatic brain injury (TBI) remains a leading cause of death and disability worldwide. Motivations for outcome data collection in TBI are threefold: to improve patient outcomes, to facilitate research, and to provide the means and methods for wider injury surveillance. Such data play a pivotal role in population health, and ways to increase the reliability of data collection following TBI should be pursued. As a result, technology-aided follow-up of patients with neurotrauma is on the rise; there is, therefore, a need to describe how such technologies have been used. A scoping review was conducted and reported using the PRISMA extension (PRISMA-ScR). Five electronic databases (Embase, MEDLINE, Global Health, PsycInfo, and Scopus) were searched systematically using keywords derived from the concepts of “telemedicine,” “TBI,” “outcome assessment,” and “patient-generated health data.” Forty studies described follow-up technologies (FUTs) utilizing telephones (52.5%, n = 21), short message service (SMS; 10%, n = 4), smartphones (22.5%, n = 9), videoconferencing (10%, n = 4), digital assistants (2.5%, n = 1), and custom devices (2.5%, n = 1) among cohorts of patients with TBI of varying injury severity. Where reported, clinical facilitators, remote follow-up timing and intervals between sessions, synchronicity of follow-up instances, proxy involvement, outcome measures utilized, and technology evaluation efforts are described. FUTs can aid more temporally sensitive assessments and capture fluctuating sequelae, a benefit of particular relevance to TBI cohorts. However, the evidence base surrounding FUTs remains in its infancy, particularly with respect to large samples, low- and middle-income patient cohorts, and the validation of outcome measures for deployment via such remote technology.

Telemedicine in Neurosurgical Trauma during the COVID-19 Pandemic: A Single-Center Experience

“…On the other hand, the majority of trauma patients were effectively treated locally. The strategy for these patients often included follow-up consults, which are crucial for patients with a traumatic brain injury or intracranial hemorrhages [ 37 ]. Timely and precise feedback about patient neurological alterations by referring physicians in these cases is essential.…”

Response Rate Patterns in Adolescents With Concussion Using Mobile Health and Remote Patient Monitoring: Observational Study

“…The adoption of ecological momentary assessments using mobile health (mHealth) has increased for monitoring disease prognosis and rehabilitation [ 14 15 ], and can be used in concussion symptom monitoring. mHealth apps have been developed for patients with a concussion to report their real-time symptoms and activities multiple times per day to collect more granular information on symptom trajectory than is provided during periodic clinic visits [ 16 17 ].…”

“…Previous studies have used mHealth technology to facilitate follow-up for patients with traumatic brain injury, providing an opportunity for patients to report important details on the variability of symptoms and other sequelae [ 14 18 ]. Patients can provide real-time symptoms instead of relying on memory at the next in-person visit, which can be influenced by recall bias [ 19 ].…”

Investigating the application of “Guttmann Cognitest”® in older adults and people with acquired brain injury

“…Following the same logic, these tools could be extremely useful also in clinical contexts to monitor people diagnosed with brain pathologies, as acquired brain injuries (ABI) ( 15 ). It could allow to optimize human and economic resources and improve healthcare quality by simplifying and speeding up patient's assessments, and maximizing patient's monitoring possibilities, as done for non-cognitive outcomes [see for example ( 16 )].…”