Project title:

Optimised imaging for integrated serial evaluation in traumatic brain injury prognosis (OPTIMISE-TBI Prognosis).

In brief

Dr Virginia Newcombe's project focuses on traumatic brain injury. She is collecting evidence using magnetic resonance imaging (MRI) to show with which injuries people will experience ongoing problems. She says taking the guesswork out of traumatic brain injury will give patients and their families more certainty about the future.

What is the project?

Every year in the UK, traumatic brain injury – caused by car accidents, falls and assaults – affects around one million people. Patients who survive can experience ongoing problems for months or years. It is common enough but clinicians still find it difficult predicting who will have lasting problems. Early treatment decisions and discussions about outcomes are made using very little evidence.

'Using MRIs we can better see the extent and distribution of an injury a person has than with CT scans,' says Virginia. 'But we still don't know whether they can predict the outcome of injury. This project could help us understand when is the best time to use MRI to predict a patient's outcome. We may also find out for which patients MRI will be most useful and what MRI sequences we can learn the most from.'

Why is it important?

Traumatic brain injury is a major cause of death and disability, particularly under 40 year olds. For survivors, the likelihood of full recovery and the quality of life they can expect varies wildly. For the family of a survivor the future can be very uncertain.

'Because of the sheer complexity of traumatic brain injury, we face significant barriers in determining an accurate prognosis and coming up with effective treatment. We need to improve patient care using evidence-based strategies and to do this we urgently need research to map the characteristics that predict outcomes.'

'This project could cast new light on traumatic brain injury to help us predict on-going issues so we can give the best treatment. What we learn has enormous potential to improve a patient’s recovery and ultimately the quality of the life they will go on to enjoy.'

How will the project be done?

Virginia's project will run for five years. During this time, over 500 patients with mild and severe traumatic brain injury will undergo MRIs at up to three time points (in the first week, then at the subacute and chronic phases of injury). Data collection will occur in collaboration with groups from Norway and Finland. Prediction models will be developed based on this data.

Data will be externally validated in a large multi-national data set from a European Union collaborative project called CENTER-TBI.

Biography

Virginia completed her PhD in Neurotrauma/Neuroimaging in 2009. Her interest in understanding how the acute management of traumatic brain injury affects the long term outcomes of patients has lead her to spend a period of time working in Neurorehabilitation. Virginia is currently finishing her specialty training in Intensive Care and Emergency Medicine at Addenbrooke’s Hospital, Cambridge.

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