Understanding the clinical utility of biomarkers after mild traumatic brain injury

Summary

An estimated 60 million people worldwide each year sustain a traumatic brain injury of which 80%–90% are classified as a mild TBI (mTBI, concussion). Common causes include sporting injuries, falls and road traffic collisions.

There is a growing appreciation that“mild” is a misnomer as these patients may have ongoing functional, symptomatic and cognitive deficits that may benefit from further management.Our failure to prognosticate in this group means those with persisting problems are often lost to the ongoing care they need. Blood biomarkers offer the potential to aid both diagnosis and prognostication in mTBI in the Emergency Department (ED) setting.

This project will be part of the NIHR EME funded study BRAINS-TBI (Biomarkers for RAtional Investigation for Neurological decision Support in TBI, Chief Investigator Newcombe); a UK multi-centre study of ~2000 patients. BRAINS-TBI aims to answer two key questions: 1) Can biomarkers predict which patients are at risk of long-term problems?  2) Can biomarkers safely reduce the number of CT scans performed in EDs (embedded RCT)

Understanding the potential clinical utility of biomarkers requires an understanding of existing care pathways, how these are enacted in practice, and where the information provided by biomarkers would make the most difference to both clinical decision making and ultimately patient outcomes. Patients who participate in BRAINS-TBI will be followed up at intervals to 6 months after injury including assessment of mental health and cognitive function.

Project aims

This project will aim to understand the relationship of clinical features, early biomarkers and any treatment offered with the trajectory of recovery.

It will offer the opportunity to develop expertise in statistics (both data-driven AI modelling and hypothesis-driven path analysis) and data integration.

There will be opportunities to integrate imaging data. The project will be tailored to a candidate’s skills and interests.

Contact details

Dr Virginia Newcombe - vfjn2@cam.ac.uk

Opportunities

This project is open to applicants who want to do a:

• PhD