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1. Prognostic models for depression and post-traumatic stress disorder symptoms following traumatic brain injury: a CENTER-TBI study

Author

Kelly Jones, Antonio Belli, Suzanne Polinder, Emmanuel Stamatakis, Hester F Lingsma, Dick Tibboel, Ronny Beer, Raimund Helbok, Horia Ples, Ari Ercole, Peter Cameron, Marek Czosnyka, Catherine McMahon, Peter Vajkoczy, Paul Dark, Alexandra Brazinova, Marek Majdan, Rahul Raj, William Stewart, Ewout W Steyerberg, Giuseppe Citerio, Nino Stocchetti, Alessia Vargiolu, Hester Lingsma, Helen Dawes, Benoit Misset, Faye Johnson, David van Klaveren, Simon Stanworth, Fiona Lecky, Peter Smielewski, Alice Theadom, Peter Bragge, David Nelson, János Sándor, Paul M Vespa, Olli Tenovuo, Olav Røise, Wim Van Hecke, Vincent Degos, David Menon, Bart Depreitere, Audny Anke, Rolf Rossaint, Mark Coburn, Victor Volovici, Daan Nieboer, Jonathan Rosand, Nada Andelic, Hans Clusmann, Emma Donoghue, Jonathan Coles, stefan jankowski, Jonathan Rhodes, Guy Williams, Rolf Lefering, Mathieu van der Jagt, Daniel Kondziella, Noah D Silverberg, Arturo Chieregato, Sophie Richter, Endre Czeiter, Stefan Winzeck, Jan Verheyden, András Büki, Benjamin Gravesteijn, Evgenios Kornaropoulos, Virginia Newcombe, Lindsay Wilson, Lindsay Horton, Amra Covic, Dominique Van Praag, Cecilia Åkerlund, Krisztina Amrein, Lasse Andreassen, Anna Antoni, Gérard Audibert, Philippe Azouvi, Ronald Bartels, Pál Barzó, Romuald Beauvais, Bo-Michael Bellander, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Guillermo Carbayo Lozano, Marco Carbonara, Simona Cavallo, Giorgio Chevallard, Marta Correia, Nicola Curry, Véronique De Keyser, Hugo den Boogert, Đula Đilvesi, Abhishek Dixit, Jens Dreier, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Jagoš Golubovic Ben Glocker, Johannes Gratz, Francesca Grossi, Deepak Gupta, Iain Haitsma, Eirik Helseth, Jilske Huijben, Bram Jacobs, Mike Jarrett, Mladen Karan, Erwin Kompanje, Noémi Kovács, Ana Kowark, Alfonso Lagares, Linda Lanyon, Steven Laureys, Didier Ledoux, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Marc Maegele, Alex Manara, Geoffrey Manley, Costanza Martino, Hugues Maréchal, Julia Mattern, Béla Melegh, Tomas Menovsky, Ana Mikolic, Visakh Muraleedharan, Lynnette Murray, Ancuta Negru, József Nyirádi, Otesile Olubukola, Matej Oresic, Fabrizio Ortolano, Aarno Palotie, Paul M Parizel, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Matti Pirinen, Inigo Pomposo, Louis Puybasset, Andreea Radoi, Arminas Ragauskas, Malinka Rambadagalla, Sylvia Richardson, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Christina Rosenlund, Guy Rosenthal, Sandra Rossi, Juan Sahuquillo, Oliver Sakowitz, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Elisabeth Schwendenwein, Charlie Sewalt, Toril Skandsen, Abayomi Sorinola, Robert Stevens, Nina Sundström, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Matt Thomas, Marjolein Timmers, Christos Tolias, Tony Trapani, Shirley Vallance, Egils Valeinis, Zoltán Vámos, Emmanuel Vega, Kimberley Velt, Anne Vik, Rimantas Vilcinis, Daphne Voormolen, Petar Vulekovic, Kevin K W Wang, Eveline Wiegers, Stefan Wolf, Zhihui Yang, Peter Ylén, Alexander Younsi, Frederick A Zeiler, Veronika Zelinkova, Agate Ziverte, Tommaso Zoerle, Joukje van der Naalt, Braden Te Ao, Caroline van Heugten, Francesco Della Corte, Ernest Van Veen, Andrew IR Maas, Andreas Unterberg, Thomas A van Essen, Mathilde Jost, Shuyuan Shi, Maria Luisa Azzolini, Maria Rosa Calvi, Jamie D Cooper, Claire Dahyot Fizelier, Guy Loup Dulière, Valery L Feigin, Pedro A Gomez, Russell L Gruen, Juanita A Haagsma, Peter J Hutchinson, Ji yao Jiang, Angelos G Kolias, Lars Owe Koskinen, Andrew I Z Maas, Ana M Castaño León, Jean François Payen, Anna Piippo Karjalainen, Dana Pisica, Jussi PPosti, Isabel Retel Helmrich, Jeffrey VRosenfeld, Daniel Rueckert Martin Rusnák, Renan SanchezPorras, Rico Frederik Schou, Cristina Maria Tudora, Gregory Van der Steen, Jeroen T J M van Dijck, Thijs Vande Vyvere, Roel P J van Wijk, and Nicole von Steinbüchel

Subjects
Psychiatry, RC435-571
Abstract

Background Traumatic brain injury (TBI) is associated with an increased risk of major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). We aimed to identify predictors and develop models for the prediction of depression and PTSD symptoms at 6 months post-TBI.Methods We analysed data from the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury study. We used linear regression to model the relationship between predictors and depression (Patient Health Questionnaire-9) and PTSD symptoms (PTSD Checklist for Diagnostic and Statistical Manual for Mental Health Disorders Fifth Edition). Predictors were selected based on Akaike’s Information Criterion. Additionally, we fitted logistic models for the endpoints ‘probable MDD’ and ‘probable PTSD’. We also examined the incremental prognostic value of 2–3 weeks of symptoms.Results We included 2163 adults (76% Glasgow Coma Scale=13–15). Depending on the scoring criteria, 7–18% screened positive for probable MDD and about 10% for probable PTSD. For both outcomes, the selected models included psychiatric history, employment status, sex, injury cause, alcohol intoxication and total injury severity; and for depression symptoms also preinjury health and education. The performance of the models was modest (proportion of explained variance=R2 8% and 7% for depression and PTSD, respectively). Symptoms assessed at 2–3 weeks had a large incremental prognostic value (delta R2=0.25, 95% CI 0.24 to 0.26 for depression symptoms; delta R2=0.30, 95% CI 0.29 to 0.31 for PTSD).Conclusion Preinjury characteristics, such as psychiatric history and unemployment, and injury characteristics, such as violent injury cause, can increase the risk of mental health problems after TBI. The identification of patients at risk should be guided by early screening of mental health.

Published
2025
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2. Genetic vulnerability and adverse mental health outcomes following mild traumatic brain injury: a meta-analysis of CENTER-TBI and TRACK-TBI cohortsResearch in context

Author

Mart Kals, Lindsay Wilson, Daniel F. Levey, Livia Parodi, Ewout W. Steyerberg, Sylvia Richardson, Feng He, Xiaoying Sun, Sonia Jain, Aarno Palotie, Samuli Ripatti, Jonathan Rosand, Geoff T. Manley, Andrew I.R. Maas, Murray B. Stein, David K. Menon, Cecilia Ackerlund, Hadie Adams, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Ana M. Castaño-León, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Hans Clusmann, Mark Steven Coburn, Jonathan Coles, Jamie D. Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Đula Đilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubović, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J. Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Lars-Owe Koskinen, Noémi Kovács, Ana Kowark, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Marc Maegele, Marek Majdan, Alex Manara, Hugues Maréchal, Costanza Martino, Julia Mattern, Charles McFadyen, Catherine McMahon, Béla Melegh, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Ancuta Negru, David Nelson, Virginia Newcombe, Daan Nieboer, József Nyirádi, Matej Oresic, Fabrizio Ortolano, Olubukola Otesile, Paul M. Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Dana Pisica, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Rădoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Veronika Rehorčíková, Isabel Retel Helmrich, Jonathan Rhodes, Sophie Richter, Saulius Rocka, Cecilie Roe, Olav Roise, Jeffrey Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Charlie Sewalt, Ranjit D. Singh, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Robert Stevens, William Stewart, Nino Stocchetti, Nina Sundström, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Aurore Thibaut, Matt Thomas, Dick Tibboel, Marjolijn Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Andreas Unterberg, Peter Vajkoczy, Egils Valeinis, Shirley Vallance, Zoltán Vámos, Mathieu van der Jagt, Joukje van der Naalt, Gregory Van der Steen, Jeroen T.J.M. van Dijck, Inge A. van Erp, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Ernest van Veen, Roel van Wijk, Thijs Vande Vyvere, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Nicole von Steinbüchel, Daphne Voormolen, Peter Vulekovic, Daniel Whitehouse, Eveline Wiegers, Guy Williams, Stefan Wolf, Zhihui Yang, Peter Ylén, Alexander Younsi, Frederick A. Zeiler, Agate Ziverte, Tommaso Zoerle, Opeolu Adeoye, Neeraj Badjatia, Jason Barber, Michael Bergin, Kim Boase, Yelena Bodien, Randall Chesnut, John Corrigan, Karen Crawford, Ramon Diaz-Arrastia, Sureyya Dikmen, Ann-Christine Duhaime, Richard Ellenbogen, Venkata Feeser, Adam R. Ferguson, Brandon Foreman, Etienne Gaudette, Joseph Giacino, Luis Gonzalez, Shankar Gopinath, Ramesh Grandhi, Rao Gullapalli, Claude Hemphill, Gillian Hotz, Russell Huie, Ruchira Jha, Dirk C. Keene, Ryan Kitagawa, Frederick Korley, Joel Kramer, Natalie Kreitzer, Harvey Levin, Chris Lindsell, Joan Machamer, Christopher Madden, Alastair Martin, Thomas McAllister, Michael McCrea, Randall Merchant, Pratik Mukherjee, Lindsay Nelson, Laura B. Ngwenya, Florence Noel, Amber Nolan, David Okonkwo, Eva Palacios, Daniel Perl, Ava Puccio, Miri Rabinowitz, Claudia Robertson, Richard Ben Rodgers, Eric Rosenthal, Angelle Sander, Danielle Sandsmark, Andrea Schneider, David Schnyer, Seth Seabury, Mark Sherer, Gabriella Sugar, Nancy Temkin, Arthur Toga, Abel Torres-Espin, Alex Valadka, Mary Vassar, Kevin Wang, Vincent Wang, John K. Yue, Esther Yuh, and Ross Zafonte

Subjects
Traumatic brain injury, Mental health, Post-traumatic stress disorder, Depression, Polygenic risk score, Medicine (General), R5-920
Abstract

Summary: Background: Post-traumatic stress disorder (PTSD) and depression are common after mild traumatic brain injury (mTBI), but their biological drivers are uncertain. We therefore explored whether polygenic risk scores (PRS) derived for PTSD and major depressive disorder (MDD) are associated with the development of cognate TBI-related phenotypes. Methods: Meta-analyses were conducted using data from two multicenter, prospective observational cohort studies of patients with mTBI: the CENTER-TBI study (ClinicalTrials.gov ID NCT02210221) in Europe (December 2014–December 2017) and the TRACK-TBI study in the US (March 2014–July 2018). In both cohorts, the most common causes of injury were road traffic accidents and falls. Primary outcomes, specifically probable PTSD and depression, were defined at 6 months post-injury using scores ≥33 on the PTSD Checklist-5 and ≥15 on the Patient Health Questionnaire-9, respectively. We calculated PTSD-PRS and MDD-PRS for patients aged ≥17 years who had a Glasgow Coma Scale score of 13–15 upon hospital arrival and assessed their association with PTSD and depression following TBI. We also evaluated the transferability of the findings in a cohort of African Americans. Findings: Overall, 11.8% (219/1869) and 6.7% (124/1869) patients were classified as having probable PTSD and depression, respectively. The PTSD-PRS was significantly associated with higher adjusted odds of PTSD in both cohorts, with a pooled odds ratio (OR) of 1.55 [95% confidence interval (CI) 1.30–1.84, p

Published
2024
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3. Association of early blood-based biomarkers and six-month functional outcomes in conventional severity categories of traumatic brain injury: capturing the continuous spectrum of injuryResearch in context

Author

Lindsay Wilson, Virginia F.J. Newcombe, Daniel P. Whitehouse, Stefania Mondello, Andrew I.R. Maas, David K. Menon, Cecilia Ackerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Ana M. Castaño-León, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Hans Clusmann, Mark Steven Coburn, Jonathan Coles, Jamie D. Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Đula Đilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubović, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J. Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Kornaropoulos, Lars-Owe Koskinen, Noémi Kovács, Ana Kowark, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Marc Maegele, Marek Majdan, Alex Manara, Geoffrey Manley, Hugues Maréchal, Costanza Martino, Julia Mattern, Catherine McMahon, Béla Melegh, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Nandesh Nair, Ancuta Negru, David Nelson, Daan Nieboer, József Nyirádi, Matej Oresic, Fabrizio Ortolano, Olubukola Otesile, Aarno Palotie, Paul M. Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Dana Pisica, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Rădoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Isabel Retel Helmrich, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Jonathan Rosand, Jeffrey Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Ranjit D. Singh, Charlie Sewalt, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Robert Stevens, William Stewart, Ewout W. Steyerberg, Nino Stocchetti, Nina Sundström, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Aurore Thibaut, Dick Tibboel, Marjolijn Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Andreas Unterberg, Peter Vajkoczy, Egils Valeinis, Shirley Vallance, Zoltán Vámos, Mathieu van der Jagt, Joukje van der Naalt, Gregory Van der Steen, Jeroen T.J.M. van Dijck, Inge A. van Erp, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Ernest van Veen, Roel P.J. van Wijk, Thijs Vande Vyvere, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Nicole von Steinbüchel, Daphne Voormolen, Peter Vulekovic, Kevin K.W. Wang, Eveline Wiegers, Guy Williams, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Alexander Younsi, Frederick A. Zeiler, Veronika Zelinkova, Agate Ziverte, and Tommaso Zoerle

Subjects
Traumatic brain injury, Blood biomarkers, GFAP, NFL, UCH-L1, Outcomes, Medicine, Medicine (General), R5-920
Abstract

Summary: Background: Traumatic brain injury is conventionally categorised as mild, moderate, or severe on the Glasgow Coma Scale (GCS). Recently developed biomarkers can provide more objective and nuanced measures of the extent of brain injury. Methods: Exposure–response relationships were investigated in 2479 patients aged ≥16 enrolled in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) prospective observational cohort study. Neurofilament protein-light (NFL), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and glial fibrillary acidic protein (GFAP) were assayed from serum sampled in the first 24 h; concentrations were divided into quintiles within GCS severity groups. Relationships with the Glasgow Outcome Scale-Extended were examined using modified Poisson regression including age, sex, major extracranial injury, time to sample, and log biomarker concentration as covariates. Findings: Within severity groups there were associations between biomarkers and outcomes after adjustment for covariates: GCS 13–15 and negative CT imaging (relative risks [RRs] from 1.28 to 3.72), GCS 13–15 and positive CT (1.21–2.81), GCS 9–12 (1.16–2.02), GCS 3–8 (1.09–1.94). RRs were associated with clinically important differences in expectations of prognosis. In patients with GCS 3 (RRs 1.51–1.80) percentages of unfavourable outcome were 37–51% in the lowest quintiles of biomarker levels and reached 90–94% in the highest quintiles. Similarly, for GCS 15 (RRs 1.83–3.79), the percentages were 2–4% and 19–28% in the lowest and highest biomarker quintiles, respectively. Interpretation: Conventional TBI severity classification is inadequate and underestimates heterogeneity of brain injury and associated outcomes. The adoption of circulating biomarkers can add to clinical assessment of injury severity. Funding: European Union 7th Framework program (EC grant 602150), Hannelore Kohl Stiftung, One Mind, Integra LifeSciences, Neuro-Trauma Sciences, NIHR Rosetrees Trust.

Published
2024
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4. Comparative effectiveness of decompressive craniectomy versus craniotomy for traumatic acute subdural hematoma (CENTER-TBI): an observational cohort studyResearch in context

Author

Thomas A. van Essen, Inge A.M. van Erp, Hester F. Lingsma, Dana Pisică, John K. Yue, Ranjit D. Singh, Jeroen T.J.M. van Dijck, Victor Volovici, Alexander Younsi, Angelos Kolias, Lianne D. Peppel, Majanka Heijenbrok-Kal, Gerard M. Ribbers, David K. Menon, Peter J.A. Hutchinson, Geoffrey T. Manley, Bart Depreitere, Ewout W. Steyerberg, Andrew I.R. Maas, Godard C.W. de Ruiter, Wilco C. Peul, Cecilia Åkerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Ana M. Castaño-León, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Hans Clusmann, Mark Steven Coburn, Jonathan Coles, Jamie D. Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Đula Đilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubović, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J. Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Kornaropoulos, Lars-Owe Koskinen, Noémi Kovács, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Marc Maegele, Marek Majdan, Alex Manara, Geoffrey Manley, Hugues Maréchal, Costanza Martino, Julia Mattern, Catherine McMahon, Béla Melegh, David Menon, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Nandesh Nair, Ancuta Negru, David Nelson, Virginia Newcombe, Daan Nieboer, József Nyirádi, Matej Oresic, Fabrizio Ortolano, Olubukola Otesile, Aarno Palotie, Paul M. Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Dana Pisica, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Rădoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Veronika Rehorčíková, Isabel Retel Helmrich, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Jonathan Rosand, Jeffrey Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Charlie Sewalt, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Ana Kowark, Robert Stevens, William Stewart, Nino Stocchetti, Nina Sundström, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Dick Tibboel, Marjolijn Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Andreas Unterberg, Peter Vajkoczy, Egils Valeinis, Shirley Vallance, Zoltán Vámos, Mathieu Van der Jagt, Joukje van der Naalt, Gregory Van der Steen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Ernest Van Veen, Roel van Wijk, Thijs Vande Vyvere, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Nicole von Steinbüchel, Daphne Voormolen, Petar Vulekovic, Kevin K.W. Wang, Eveline Wiegers, Guy Williams, Lindsay Wilson, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Frederick A. Zeiler, Agate Ziverte, and Tommaso Zoerle

Subjects
Acute subdural hematoma, Decompressive craniectomy, Craniotomy, Comparative effectiveness research, Instrumental variable analysis, Practice variation, Medicine (General), R5-920
Abstract

Summary: Background: Limited evidence existed on the comparative effectiveness of decompressive craniectomy (DC) versus craniotomy for evacuation of traumatic acute subdural hematoma (ASDH) until the recently published randomised clinical trial RESCUE-ASDH. In this study, that ran concurrently, we aimed to determine current practice patterns and compare outcomes of primary DC versus craniotomy. Methods: We conducted an analysis of centre treatment preference within the prospective, multicentre, observational Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (known as CENTER-TBI) and NeuroTraumatology Quality Registry (known as Net-QuRe) studies, which enrolled patients throughout Europe and Israel (2014–2020). We included patients with an ASDH who underwent acute neurosurgical evacuation. Patients with severe pre-existing neurological disorders were excluded. In an instrumental variable analysis, we compared outcomes between centres according to treatment preference, measured by the case-mix adjusted proportion DC per centre. The primary outcome was functional outcome rated by the 6-months Glasgow Outcome Scale Extended, estimated with ordinal regression as a common odds ratio (OR), adjusted for prespecified confounders. Variation in centre preference was quantified with the median odds ratio (MOR). CENTER-TBI is registered with ClinicalTrials.gov, number NCT02210221, and the Resource Identification Portal (Research Resource Identifier SCR_015582). Findings: Between December 19, 2014 and December 17, 2017, 4559 patients with traumatic brain injury were enrolled in CENTER-TBI of whom 336 (7%) underwent acute surgery for ASDH evacuation; 91 (27%) underwent DC and 245 (63%) craniotomy. The proportion primary DC within total acute surgery cases ranged from 6 to 67% with an interquartile range (IQR) of 12–26% among 46 centres; the odds of receiving a DC for prognostically similar patients in one centre versus another randomly selected centre were trebled (adjusted median odds ratio 2.7, p

Published
2023
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5. System dynamics simulation of transport mode choice transitions under structural and parametric uncertainty

Author

Henri Wiman, Anu Tuominen, Johannes Mesimäki, Merja Penttinen, Satu Innamaa, and Peter Ylén

Subjects
System dynamics, Toy models, Exploratory modelling, Decarbonisation, Sustainability transitions, Complexity, Transportation engineering, TA1001-1280, Transportation and communications, HE1-9990
Abstract

Abstract Complex social processes introduce difficulties to validating causal parameters and identifying the correct system structure in modelling. Policy impact assessment for sustainability transitions should therefore not expend too many resources modelling any single set of assumptions about the world. Furthermore, keeping models relatively simple allows more effective communication and stakeholder collaboration. This paper presents an exploratory system dynamics model of urban mode choice. We demonstrate that, despite structural and parametric uncertainty, it is possible to rank alternative policy approaches and identify high-leverage uncertainties as targets of policy action or further analysis. We also show how different narrative theories of change can have drastically different or unintuitive outcomes for the same intervention. Simulation can benefit both impact assessment and the further scrutiny and refinement of change narratives. We argue that the following methodological choices and their synergies made our modelling approach effective: exploratory modelling, focus on endogeneity, coarse resolution and avoidance of abstract variables.

Published
2022
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6. Concomitant spine trauma in patients with traumatic brain injury: Patient characteristics and outcomes

Author

Lennart Riemann, Obada T. Alhalabi, Andreas W. Unterberg, Alexander Younsi, The CENTER-TBI investigators and participants, Cecilia Åkerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Hans Clusmann, Mark Coburn, Jonathan Coles, Jamie D. Cooper, Marta Correia, Amra Cović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Ðula Ðilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubovic, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J. Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Kornaropoulos, Lars-Owe Koskinen, Noémi Kovács, Ana Kowark, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Andrew I.R. Maas, Ana M. Castaño-León, Marc Maegele, Marek Majdan, Alex Manara, Geoffrey Manley, Costanza Martino, Hugues Maréchal, Julia Mattern, Catherine McMahon, Béla Melegh, David Menon, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Ancuta Negru, David Nelson, Virginia Newcombe, Daan Nieboer, József Nyirádi, Otesile Olubukola, Matej Oresic, Fabrizio Ortolano, Aarno Palotie, Paul M. Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Dana Pisica, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Radoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Isabel Retel Helmrich, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Jonathan Rosand, Jeffrey V. Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Charlie Sewalt, Ranjit D. Singh, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Robert Stevens, William Stewart, Ewout W. Steyerberg, Nino Stocchetti, Nina Sundström, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Dick Tibboel, Marjolein Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Andreas Unterberg, Peter Vajkoczy, Shirley Vallance, Egils Valeinis, Zoltán Vámos, Mathieu van der Jagt, Gregory Van der Steen, Joukje van der Naalt, Jeroen T.J.M. van Dijck, Inge A. van Erp, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Ernest van Veen, Thijs Vande Vyvere, Roel P. J. van Wijk, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Nicole von Steinbüchel, Daphne Voormolen, Petar Vulekovic, Kevin K.W. Wang, Daniel Whitehouse, Eveline Wiegers, Guy Williams, Lindsay Wilson, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Frederick A. Zeiler, Veronika Zelinkova, Agate Ziverte, and Tommaso Zoerle

Subjects
traumatic brain injury, traumatic spine injury, outcome, CENTER-TBI, spine trauma, Neurology. Diseases of the nervous system, RC346-429
Abstract

ObjectiveSpine injury is highly prevalent in patients with poly-trauma, but data on the co-occurrence of spine trauma in patients with traumatic brain injury (TBI) are scarce. In this study, we used the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) database to assess the prevalence, characteristics, and outcomes of patients with TBI and a concurrent traumatic spinal injury (TSI).MethodsData from the European multi-center CENTER-TBI study were analyzed. Adult patients with TBI (≥18 years) presenting with a concomitant, isolated TSI of at least serious severity (Abbreviated Injury Scale; AIS ≥3) were included. For outcome analysis, comparison groups of TBI patients with TSI and systemic injuries (non-isolated TSI) and without TSI were created using propensity score matching. Rates of mortality, unfavorable outcomes (Glasgow Outcome Scale Extended; GOSe < 5), and full recovery (GOSe 7–8) of all patients and separately for patients with only mild TBI (mTBI) were compared between groups at 6-month follow-up.ResultsA total of 164 (4%) of the 4,254 CENTER-TBI core study patients suffered from a concomitant isolated TSI. The median age was 53 [interquartile range (IQR): 37–66] years and 71% of patients were men. mTBI was documented in 62% of cases, followed by severe TBI (26%), and spine injuries were mostly cervical (63%) or thoracic (31%). Surgical spine stabilization was performed in 19% of cases and 57% of patients were admitted to the ICU. Mortality at 6 months was 11% and only 36% of patients regained full recovery. There were no significant differences in the 6-month rates of mortality, unfavorable outcomes, or full recovery between TBI patients with and without concomitant isolated TSI. However, concomitant non-isolated TSI was associated with an unfavorable outcome and a higher mortality. In patients with mTBI, a negative association with full recovery could be observed for both concomitant isolated and non-isolated TSI.ConclusionRates of mortality, unfavorable outcomes, and full recovery in TBI patients with and without concomitant, isolated TSIs were comparable after 6 months. However, in patients with mTBI, concomitant TSI was a negative predictor for a full recovery. These findings might indicate that patients with moderate to severe TBI do not necessarily exhibit worse outcomes when having a concomitant TSI, whereas patients with mTBI might be more affected.

Published
2022
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7. Neurocognitive correlates of probable posttraumatic stress disorder following traumatic brain injury

Author

Dominique L.G. Van Praag, Kristien Wouters, Filip Van Den Eede, Lindsay Wilson, Andrew I.R. Maas, Cecilia Åkerlund, Krisztina Amrein, Nada Andelic, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Philippe Azouvi, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Iris Ceyisakar, Hans Clusmann, Mark Coburn, Jonathan Coles, Jamie D. Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Helen Dawes, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Đula Đilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubovic, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J. Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Koraropoulos, Lars-Owe Koskinen, Noémi Kovács, Ana Kowark, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Ana M. Castaño-León, Marc Maegele, Marek Majdan, Alex Manara, Geoffrey Manley, Costanza Martino, Hugues Maréchal, Julia Mattern, Catherine McMahon, Béla Melegh, David Menon, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Ancuta Negru, David Nelson, Virginia Newcombe, Daan Nieboer, József Nyirádi, Otesile Olubukola, Matej Oresic, Fabrizio Ortolano, Aarno Palotie, Paul M. Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Radoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Cecilie Roe, Olav Roise, Jonathan Rosand, Jeffrey V. Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Charlie Sewalt, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Robert Stevens, William Stewart, Ewout W. Steyerberg, Nino Stocchetti, Nina Sundström, Anneliese Synnot, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Olli Tenovuo, Alice Theadom, Matt Thomas, Dick Tibboel, Marjolein Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Andreas Unterberg, Peter Vajkoczy, Shirley Vallance, Egils Valeinis, Zoltán Vámos, Mathieu van der Jagt, Gregory Van der Steen, Joukje van der Naalt, Jeroen T.J.M. van Dijck, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Thijs Vande Vyvere, Roel P.J. van Wijk, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Nicole von Steinbüchel, Daphne Voormolen, Petar Vulekovic, Kevin K.W. Wang, Eveline Wiegers, Guy Williams, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Peter Ylén, Alexander Younsi, Frederick A. Zeiler, Veronika Zelinkova, Agate Ziverte, and Tommaso Zoerle

Subjects
Cognition, Head injury, Neuropsychology, Posttraumatic stress disorder, Stress, Neurology. Diseases of the nervous system, RC346-429
Abstract

Introduction: Neurocognitive problems associated with posttraumatic stress disorder (PTSD) can interact with impairment resulting from traumatic brain injury (TBI). Research question: We aimed to identify neurocognitive problems associated with probable PTSD following TBI in a civilian sample. Material and methods: The study is part of the CENTER-TBI project (Collaborative European Neurotrauma Effectiveness Research) that aims to better characterize TBI. For this cross-sectional study, we included patients of all severities aged over 15, and a Glasgow Outcome Score Extended (GOSE) above 3. Participants were assessed at six months post-injury on the PTSD Checklist-5 (PCL-5), the Trail Making Test (TMT), the Rey Auditory Verbal Learning Test (RAVLT) and the Cambridge Neuropsychological Test Automated Battery (CANTAB). Primary analysis was a complete case analysis. Regression analyses were performed to investigate the association between the PCL-5 and cognition. Results: Of the 1134 participants included in the complete case analysis, 13.5% screened positive for PTSD. Probable PTSD was significantly associated with higher TMT-(B-A) (OR ​= ​1.35, 95% CI: 1.14–1.60, p ​

Published
2022
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8. Maternal gluten, cereal, and dietary fiber intake during pregnancy and lactation and the risk of islet autoimmunity and type 1 diabetes in the child

Author

Anna, Eurén, Heikki, Hyöty, Kalle, Kurppa, Jutta, Laiho, Olli, Laitinen, Jussi, Lehtonen, Katri, Lindfors, Maria, Lönnrot, Johannes, Malkamäki, Noora, Nurminen, Matti, Nykter, Sami, Oikarinen, Leena, Puustinen, Amirbabak, Sioofy-Khojine, Keijo, Viiri, Daniel, Agardh, Andrén, Aronsson Carin, Markus, Lundgren, Iida, Mäkelä, Martin, Romantschuk, Laura, Soininen, Nicolai A, Lund-Blix, Maria, Magnus, Aino-Kaisa, Rantala, Lars, Stene, Ketil, Størdal, German, Tapia, Laura, Elo, Sini, Junttila, Riitta, Lahesmaa, Johanna, Lempainen, Robert, Moulder, Omid, Rasool, Tomi, Suomi, Jorma, Toppari, Ubaid, Ullah, Riitta, Veijola, Aleksandr, Peet, Kärt, Simre, Vallo, Tillmann, Elena, Bargagli, Francesco, Dotta, Laura, Nigi, Guido, Sebastiani, Leena, Hakola, Hannu, Kiviranta, Panu, Rantakokko, Suvi M, Virtanen, Ondrej, Cinek, Eva, Fronkova, Jaroslav, Havlik, Matthieu, Molinier, Juha, Pajula, Eija, Parmes, Juha, Pärkkä, Petri, Saviranta, Peter, Ylén, Alar, Aints, Anu, Bärenson, Anne, Kirss, Ivo, Laidmäe, Astrid, Oras, Aili, Tagoma, Raivo, Uibo, Tamara, Vorobjova, Loïc, Burr, Stefano, Cattaneo, Hui, Chai-Gao, Peter, Cristofollini, Silvia, Generelli, Samantha, Paoletti, Edith, Ruth, Gabriele, Berg, Wisnu, Wicaksono, Joseph, Petrosino, Rainer, Thiel, Schmidtmann, Daniel, Rosanna, Salo, Lauri, Häme, Alexander, Berler, Korina, Papadopoulou, Hans, Bisgaard, Klaus, Bonnelykke, Sarah, Brandt, Astrid, Sevelsted, Jakob, Stokholm, Jonathan, Thorsen, Mikael, Knip, Aki, Sinkkonen, Marja, Roslund, Hakola, Leena, Lund-Blix, Nicolai A., Takkinen, Hanna-Mari, Tapanainen, Heli, Niinistö, Sari, Korhonen, Tuuli E., Stene, Lars C., Hyöty, Heikki, Toppari, Jorma, Ilonen, Jorma, Knip, Mikael, Veijola, Riitta, and Virtanen, Suvi M.

Published
2024
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9. Predictors of Access to Rehabilitation in the Year Following Traumatic Brain Injury

Author

Louis Jacob, Mélanie Cogné, Olli Tenovuo, Cecilie Røe, Nada Andelic, Marek Majdan, Jukka Ranta, Peter Ylen, Helen Dawes, Philippe Azouvi, Cecilia Åkerlund, Krisztina Amrein, Lasse Andreassen, Audny Anke, Anna Antoni, Gérard Audibert, Maria Luisa Azzolini, Ronald Bartels, Pál Barzó9, Romuald Beauvais, Ronny Beer, Bo-Michael Bellander, Antonio Belli, Habib Benali, Maurizio Berardino, Luigi Beretta, Morten Blaabjerg, Peter Bragge, Alexandra Brazinova, Vibeke Brinck, Joanne Brooker, Camilla Brorsson, Andras Buki, Monika Bullinger, Manuel Cabeleira, Alessio Caccioppola, Emiliana Calappi, Maria Rosa Calvi, Peter Cameron, Guillermo Carbayo Lozano, Marco Carbonara, Simona Cavallo, Giorgio Chevallard, Arturo Chieregato, Giuseppe Citerio, Iris Ceyisakar, Hans Clusmann, Mark Coburn, Jonathan Coles, Jamie D. Cooper, Marta Correia, Amra Čović, Nicola Curry, Endre Czeiter, Marek Czosnyka, Claire Dahyot-Fizelier, Paul Dark, Véronique De Keyser, Vincent Degos, Francesco Della Corte, Hugo den Boogert, Bart Depreitere, Đula Đilvesi, Abhishek Dixit, Emma Donoghue, Jens Dreier, Guy-Loup Dulière, Ari Ercole, Patrick Esser, Erzsébet Ezer, Martin Fabricius, Valery L. Feigin, Kelly Foks, Shirin Frisvold, Alex Furmanov, Pablo Gagliardo, Damien Galanaud, Dashiell Gantner, Guoyi Gao, Pradeep George, Alexandre Ghuysen, Lelde Giga, Ben Glocker, Jagoš Golubovic, Pedro A. Gomez, Johannes Gratz, Benjamin Gravesteijn, Francesca Grossi, Russell L. Gruen, Deepak Gupta, Juanita A. Haagsma, Iain Haitsma, Raimund Helbok, Eirik Helseth, Lindsay Horton, Jilske Huijben, Peter J. Hutchinson, Bram Jacobs, Stefan Jankowski, Mike Jarrett, Ji-yao Jiang, Faye Johnson, Kelly Jones, Mladen Karan, Angelos G. Kolias, Erwin Kompanje, Daniel Kondziella, Evgenios Koraropoulos, Lars-Owe Koskinen, Noémi Kovács, Ana Kowark, Alfonso Lagares, Linda Lanyon, Steven Laureys, Fiona Lecky, Didier Ledoux, Rolf Lefering, Valerie Legrand, Aurelie Lejeune, Leon Levi, Roger Lightfoot, Hester Lingsma, Andrew I.R. Maas, Ana M. Castaño-León, Marc Maegele, Alex Manara, Geoffrey Manley, Costanza Martino, Hugues Maréchal, Julia Mattern, Catherine McMahon, Béla Melegh, David Menon, Tomas Menovsky, Ana Mikolic, Benoit Misset, Visakh Muraleedharan, Lynnette Murray, Ancuta Negru, David Nelson, Virginia Newcombe, Daan Nieboer, József Nyirádi, Otesile Olubukola, Matej Oresic, Fabrizio Ortolano, Aarno Palotie, Paul M. Parizel, Jean-François Payen, Natascha Perera, Vincent Perlbarg, Paolo Persona, Wilco Peul, Anna Piippo-Karjalainen, Matti Pirinen, Horia Ples, Suzanne Polinder, Inigo Pomposo, Jussi P. Posti, Louis Puybasset, Andreea Radoi, Arminas Ragauskas, Rahul Raj, Malinka Rambadagalla, Jonathan Rhodes, Sylvia Richardson, Sophie Richter, Samuli Ripatti, Saulius Rocka, Olav Roise, Jonathan Rosand, Jeffrey V. Rosenfeld, Christina Rosenlund, Guy Rosenthal, Rolf Rossaint, Sandra Rossi, Daniel Rueckert, Martin Rusnák, Juan Sahuquillo, Oliver Sakowitz, Renan Sanchez-Porras, Janos Sandor, Nadine Schäfer, Silke Schmidt, Herbert Schoechl, Guus Schoonman, Rico Frederik Schou, Elisabeth Schwendenwein, Charlie Sewalt, Toril Skandsen, Peter Smielewski, Abayomi Sorinola, Emmanuel Stamatakis, Simon Stanworth, Robert Stevens, William Stewart, Ewout W. Steyerberg, Nino Stocchetti, Nina Sundström, Anneliese Synnot, Riikka Takala, Viktória Tamás, Tomas Tamosuitis, Mark Steven Taylor, Braden Te Ao, Alice Theadom, Matt Thomas, Dick Tibboel, Marjolein Timmers, Christos Tolias, Tony Trapani, Cristina Maria Tudora, Peter Vajkoczy, Shirley Vallance, Egils Valeinis, Zoltán Vámos, Mathieu van der Jagt, Gregory Van der Steen, Joukje van der Naalt, Jeroen T.J.M. van Dijck, Thomas A. van Essen, Wim Van Hecke, Caroline van Heugten, Dominique Van Praag, Thijs Vande Vyvere, Roel P. J. van Wijk, Alessia Vargiolu, Emmanuel Vega, Kimberley Velt, Jan Verheyden, Paul M. Vespa, Anne Vik, Rimantas Vilcinis, Victor Volovici, Nicole von Steinbüchel, Daphne Voormolen, Petar Vulekovic, Kevin K.W. Wang, Eveline Wiegers, Guy Williams, Lindsay Wilson, Stefan Winzeck, Stefan Wolf, Zhihui Yang, Alexander Younsi, Frederick A. Zeiler, Veronika Zelinkova, Agate Ziverte, Tommaso Zoerle, Molecular Neuroscience and Ageing Research (MOLAR), Centre of Excellence in Complex Disease Genetics, Research Programs Unit, Aarno Palotie / Principal Investigator, Institute for Molecular Medicine Finland, Genomics of Neurological and Neuropsychiatric Disorders, HUS Neurocenter, Neurokirurgian yksikkö, Helsinki Institute for Information Technology, Statistical and population genetics, Department of Mathematics and Statistics, Biostatistics Helsinki, Clinicum, Helsinki University Hospital Area, Samuli Olli Ripatti / Principal Investigator, Complex Disease Genetics, Jacob, L., Cogne, M., Tenovuo, O., Roe, C., Andelic, N., Majdan, M., Ranta, J., Ylen, P., Dawes, H., Azouvi P., (CENTER-TBI Participants and Investigators), Beretta, Luigi, Jacob, L, Cogne, M, Tenovuo, O, Roe, C, Andelic, N, Majdan, M, Ranta, J, Ylen, P, Dawes, H, Azouvi, P, Akerlund, C, Amrein, K, Andreassen, L, Anke, A, Antoni, A, Audibert, G, Azzolini, M, Bartels, R, Barzo9, P, Beauvais, R, Beer, R, Bellander, B, Belli, A, Benali, H, Berardino, M, Beretta, L, Blaabjerg, M, Bragge, P, Brazinova, A, Brinck, V, Brooker, J, Brorsson, C, Buki, A, Bullinger, M, Cabeleira, M, Caccioppola, A, Calappi, E, Calvi, M, Cameron, P, Carbayo Lozano, G, Carbonara, M, Cavallo, S, Chevallard, G, Chieregato, A, Citerio, G, Ceyisakar, I, Clusmann, H, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Dark, P, De Keyser, V, Degos, V, Della Corte, F, den Boogert, H, Depreitere, B, Dilvesi, D, Dixit, A, Donoghue, E, Dreier, J, Duliere, G, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Foks, K, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gantner, D, Gao, G, George, P, Ghuysen, A, Giga, L, Glocker, B, Golubovic, J, Gomez, P, Gratz, J, Gravesteijn, B, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Haitsma, I, Helbok, R, Helseth, E, Horton, L, Huijben, J, Hutchinson, P, Jacobs, B, Jankowski, S, Jarrett, M, Jiang, J, Johnson, F, Jones, K, Karan, M, Kolias, A, Kompanje, E, Kondziella, D, Koraropoulos, E, Koskinen, L, Kovacs, N, Kowark, A, Lagares, A, Lanyon, L, Laureys, S, Lecky, F, Ledoux, D, Lefering, R, Legrand, V, Lejeune, A, Levi, L, Lightfoot, R, Lingsma, H, Maas, A, Castano-Leon, A, Maegele, M, Manara, A, Manley, G, Martino, C, Marechal, H, Mattern, J, Mcmahon, C, Melegh, B, Menon, D, Menovsky, T, Mikolic, A, Misset, B, Muraleedharan, V, Murray, L, Negru, A, Nelson, D, Newcombe, V, Nieboer, D, Nyiradi, J, Olubukola, O, Oresic, M, Ortolano, F, Palotie, A, Parizel, P, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Piippo-Karjalainen, A, Pirinen, M, Ples, H, Polinder, S, Pomposo, I, Posti, J, Puybasset, L, Radoi, A, Ragauskas, A, Raj, R, Rambadagalla, M, Rhodes, J, Richardson, S, Richter, S, Ripatti, S, Rocka, S, Roise, O, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rueckert, D, Rusnak, M, Sahuquillo, J, Sakowitz, O, Sanchez-Porras, R, Sandor, J, Schafer, N, Schmidt, S, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Sewalt, C, Skandsen, T, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stevens, R, Stewart, W, Steyerberg, E, Stocchetti, N, Sundstrom, N, Synnot, A, Takala, R, Tamas, V, Tamosuitis, T, Taylor, M, Te Ao, B, Theadom, A, Thomas, M, Tibboel, D, Timmers, M, Tolias, C, Trapani, T, Tudora, C, Vajkoczy, P, Vallance, S, Valeinis, E, Vamos, Z, van der Jagt, M, Van der Steen, G, van der Naalt, J, van Dijck, J, van Essen, T, Van Hecke, W, van Heugten, C, Van Praag, D, Vande Vyvere, T, van Wijk, R, Vargiolu, A, Vega, E, Velt, K, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Volovici, V, von Steinbuchel, N, Voormolen, D, Vulekovic, P, Wang, K, Wiegers, E, Williams, G, Wilson, L, Winzeck, S, Wolf, S, Yang, Z, Younsi, A, Zeiler, F, Zelinkova, V, Ziverte, A, Zoerle, T, Université de Versailles Saint-Quentin-en-Yvelines (UVSQ), Oslo University Hospital [Oslo], Oxford Brookes University, European Commission, EC: 602150, The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: Data used in preparation of this article were obtained in the context of CENTER-TBI, a large collaborative project with the support of the European Union 7th Framework program (EC Grant 602150). Additional funding was obtained from the Hannelore Kohl Stiftung (Germany), from OneMind (USA), and from Integra LifeSciences Corporation (USA). Data for the CENTER-TBI study were collected through the Quesgen e-CRF (Quesgen Systems Inc, USA), hosted on the INCF platform and extracted via the INCF Neurobot tool (INCF, Sweden). The funder had no role in the study design, collection, analysis, and interpretation of the data, writing of the report, and the decision to submit the article for publication., European Project: 602150,EC:FP7:HEALTH,FP7-HEALTH-2013-INNOVATION-1,CENTER-TBI(2013), Section Neuropsychology, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, RS: FPN NPPP I, and Psychiatrie & Neuropsychologie

Subjects
Male, 030506 rehabilitation, Neurology, predictive factors, IMPACT, medicine.medical_treatment, CENTER-TBI, Health Services Accessibility, 3124 Neurology and psychiatry, predictive factor, Injury Severity Score, 0302 clinical medicine, Brain Injuries, Traumatic, Epidemiology, EPIDEMIOLOGY, Prospective Studies, rehabilitation, OUTCOMES, Rehabilitation, traumatic brain injury, Neurological Rehabilitation, General Medicine, Middle Aged, RECOVERY, Prognosis, 3. Good health, Hospitalization, Europe, Educational Status, international prospective study, Female, HEALTH, 0305 other medical science, Adult, Employment, medicine.medical_specialty, Traumatic brain injury, 03 medical and health sciences, Sex Factors, medicine, Humans, Glasgow Coma Scale, business.industry, [SCCO.NEUR]Cognitive science/Neuroscience, MORTALITY, 3112 Neurosciences, PATHWAYS, CARE, medicine.disease, Multicenter study, Emergency medicine, MODERATE, business, 030217 neurology & neurosurgery
Abstract

BackgroundAlthough rehabilitation is beneficial for individuals with traumatic brain injury (TBI), a significant proportion of them do not receive adequate rehabilitation after acute care.ObjectiveTherefore, the goal of this prospective and multicenter study was to investigate predictors of access to rehabilitation in the year following injury in patients with TBI.MethodsData from a large European study (CENTER-TBI), including TBIs of all severities between December 2014 and December 2017 were used (N = 4498 patients). Participants were dichotomized into those who had and those who did not have access to rehabilitation in the year following TBI. Potential predictors included sociodemographic factors, psychoactive substance use, preinjury medical history, injury-related factors, and factors related to medical care, complications, and discharge.ResultsIn the year following traumatic injury, 31.4% of patients received rehabilitation services. Access to rehabilitation was positively and significantly predicted by female sex (odds ratio [OR] = 1.50), increased number of years of education completed (OR = 1.05), living in Northern (OR = 1.62; reference: Western Europe) or Southern Europe (OR = 1.74), lower prehospital Glasgow Coma Scale score (OR = 1.03), higher Injury Severity Score (OR = 1.01), intracranial (OR = 1.33) and extracranial (OR = 1.99) surgery, and extracranial complication (OR = 1.75). On contrast, significant negative predictors were lack of preinjury employment (OR = 0.80), living in Central and Eastern Europe (OR = 0.42), and admission to hospital ward (OR = 0.47; reference: admission to intensive care unit) or direct discharge from emergency room (OR = 0.24).ConclusionsBased on these findings, there is an urgent need to implement national and international guidelines and strategies for access to rehabilitation after TBI.

Published
2020
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10. Correction to

Author

Marina Zeldovich, Paul M. Parizel, Thomas Van Essen, Daniel Kondziella, Guy Williams, Juan Sahuquillo, Oliver Sakowitz, Maria Luisa Azzolini, Francesco Della Corte, Joukje Van der Naalt, Benjamin Gravesteijn, Peter Ylen, Ana M Castaño-Leon, Thijs Vande Vyvere, Willem Cornelis Peul, Giuseppe Citerio, Victor Volovici, Jussi Posti, Renán Sánchez-Porras, Didier Ledoux, Peter Hutchinson, Sandra Rossi, Pedro Gomez, Virginia Newcombe, William Stewart, Jonathan Coles, Frederick Zeiler, Paul Dark, Alfonso Lagares, Arminas Ragauskas, Johannes Gratz, Emmanuel Andreas Stamatakis, Andelic, Nada, Røe, Cecilie, Brunborg, Cathrine, Zeldovich, Marina, Løvstad, Marianne, Løke, Daniel, Borgen, Ida M, Voormolen, Daphne C, Howe, Emilie I, Forslund, Marit V, Dahl, Hilde M, von Steinbuechel, Nicole (CENTER-TBI participants investigators), and Beretta, Luigi

Subjects
Sleep Wake Disorders, medicine.medical_specialty, Traumatic brain injury, Emotions, Correction, Mistake, medicine.disease, Given name, Neurology, Brain Injuries, Brain Injuries, Traumatic, medicine, Humans, Center (algebra and category theory), Female, Neurology (clinical), Psychology, Psychiatry, Author name, Fatigue, Neuroradiology
Abstract

BackgroundFatigue is one of the most commonly reported subjective symptoms following traumatic brain injury (TBI). The aims were to assess frequency of fatigue over the first 6 months after TBI, and examine whether fatigue changes could be predicted by demographic characteristics, injury severity and comorbidities.MethodsPatients with acute TBI admitted to 65 trauma centers were enrolled in the study Collaborative European NeuroTrauma Effectiveness Research in TBI (CENTER-TBI). Subjective fatigue was measured by single item on the Rivermead Post-Concussion Symptoms Questionnaire (RPQ), administered at baseline, three and 6 months postinjury. Patients were categorized by clinical care pathway: admitted to an emergency room (ER), a ward (ADM) or an intensive care unit (ICU). Injury severity, preinjury somatic- and psychiatric conditions, depressive and sleep problems were registered at baseline. For prediction of fatigue changes, descriptive statistics and mixed effect logistic regression analysis are reported.ResultsFatigue was experienced by 47% of patients at baseline, 48% at 3 months and 46% at 6 months. Patients admitted to ICU had a higher probability of experiencing fatigue than those in ER and ADM strata. Females and individuals with lower age, higher education, more severe intracranial injury, preinjury somatic and psychiatric conditions, sleep disturbance and feeling depressed postinjury had a higher probability of fatigue.ConclusionA high and stable frequency of fatigue was found during the first 6 months after TBI. Specific socio-demographic factors, comorbidities and injury severity characteristics were predictors of fatigue in this study.

Published
2021
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11. Correction to: Variation in neurosurgical management of traumatic brain injury: a survey in 68 centers participating in the CENTER-TBI study

Author

Braden Te Ao, R.H.M.A. Bartels, Paul M. Parizel, Thomas Van Essen, Marco Carbonara, Daniel Kondziella, Guy Williams, Maria A. Poca, Kevin Wang, Juan Sahuquillo, Oliver Sakowitz, Maria Luisa Azzolini, Rafael Badenes, Joukje Van der Naalt, Johnny Collett, Lars Wessels, Mathieu Van der Jagt, Steven Laureys, Peter Ylen, Ana M Castaño-Leon, Emma Donoghue, Nada Andelic, Ari Ercole, Valery L. Feigin, Thijs Vande Vyvere, Willem Cornelis Peul, Anneliese Synnot, Vanni Agnoletti, Stephen Macdonald, Antonio Belli, Morten Blaabjerg, David Nelson, Giuseppe Citerio, Victor Volovici, Rahul Raj, Linda Lanyon, Edgar Santos, Jussi Posti, Renán Sánchez-Porras, Andreea Rădoi, Sandra Rossi, Peter Bragge, Pedro Gomez, Virginia Newcombe, William Stewart, Diederik Dippel, Carmen Vleggeert-Lankamp, Helen Dawes, Matej Oresic, Didier Herman MARTIN, Alfonso Lagares, Schipper Inger, Arminas Ragauskas, Dashiell Gantner, Derick Wade, Bart Depreitere, and Emmanuel Andreas Stamatakis

Subjects
030506 rehabilitation, medicine.medical_specialty, Decompressive Craniectomy, genetic structures, Traumatic brain injury, Clinical Decision-Making, 03 medical and health sciences, 0302 clinical medicine, Trauma Centers, Surveys and Questionnaires, Brain Injuries, Traumatic, medicine, Humans, Neuroradiology, Monitoring, Physiologic, business.industry, Correction, medicine.disease, eye diseases, Europe, Neurosurgeons, Physical therapy, Surgery, Neurology (clinical), Neurosurgery, 0305 other medical science, business, 030217 neurology & neurosurgery
Abstract

Neurosurgical management of traumatic brain injury (TBI) is challenging, with only low-quality evidence. We aimed to explore differences in neurosurgical strategies for TBI across Europe.A survey was sent to 68 centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The questionnaire contained 21 questions, including the decision when to operate (or not) on traumatic acute subdural hematoma (ASDH) and intracerebral hematoma (ICH), and when to perform a decompressive craniectomy (DC) in raised intracranial pressure (ICP).The survey was completed by 68 centers (100%). On average, 10 neurosurgeons work in each trauma center. In all centers, a neurosurgeon was available within 30 min. Forty percent of responders reported a thickness or volume threshold for evacuation of an ASDH. Most responders (78%) decide on a primary DC in evacuating an ASDH during the operation, when swelling is present. For ICH, 3% would perform an evacuation directly to prevent secondary deterioration and 66% only in case of clinical deterioration. Most respondents (91%) reported to consider a DC for refractory high ICP. The reported cut-off ICP for DC in refractory high ICP, however, differed: 60% uses 25 mmHg, 18% 30 mmHg, and 17% 20 mmHg. Treatment strategies varied substantially between regions, specifically for the threshold for ASDH surgery and DC for refractory raised ICP. Also within center variation was present: 31% reported variation within the hospital for inserting an ICP monitor and 43% for evacuating mass lesions.Despite a homogeneous organization, considerable practice variation exists of neurosurgical strategies for TBI in Europe. These results provide an incentive for comparative effectiveness research to determine elements of effective neurosurgical care.

Published
2019
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12. Machine Learning for Prediction of Mortality and Unfavorable Outcome in Traumatic Brain Injury:A CENTER-TBI Study

Author

Daniel Kondziella, Guy Williams, Maria Luisa Azzolini, Joukje Van der Naalt, Benjamin Gravesteijn, Peter Ylen, Willem Cornelis Peul, Victor Volovici, Frederick Zeiler, Alfonso Lagares, Johannes Gratz, and Emmanuel Andreas Stamatakis

Subjects
business.industry, Context (language use), Regression analysis, Machine learning, computer.software_genre, Logistic regression, Support vector machine, Clinical trial, Medicine, media_common.cataloged_instance, Artificial intelligence, Gradient boosting, European union, business, computer, Predictive modelling, media_common
Abstract

Background: Prediction of outcome in traumatic brain injury is important for risk-stratification of patients. Most prediction models were thus far based on traditional statistical techniques. We aimed to explore the added value of common machine learning algorithms (ML) for prediction of outcome for moderate and severe traumatic brain injury. Methods: We performed logistic regression (LR), lasso regression, and ridge regression with key baseline predictors in the IMPACT database (15 studies, n=11,022). ML algorithms included support vector machines, random forests, gradient boosting machines, and artificial neural networks, and were trained using the same predictors. Regression and ML algorithms were all trained to optimize the log-likelihood. We performed cross-validation by leaving out each study once. The algorithms were further validated externally on the recent CENTER-TBI study (patients with GCS

Published
2019
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13. A system dynamics model for evaluating the impact of public investments in a data-driven precision medicine ecosystem

Author

Jaakko Lähteenmäki, Sampsa Ruutu, Peter Ylen, and Mark van Gils

Subjects
ecosystem, precision medicine, data-driven, system dynamics, simulation
Abstract

Precision medicine is fueled by data and biosample collections produced in healthcare settings. Efficient exploitation of these data requires investments in setting up the infrastructures for secondary use of data and in supporting related R&D activities. This paper presents an ecosystem model for evaluating the impact of public investments on the business activities of companies and the resulting societal and economic benefits.

Published
2019

14. Variation in neurosurgical management of traumatic brain injury: a survey in 68 centers participating in the CENTER-TBI study

Author

van Essen, Thomas A., den Boogert, Hugo F., Cnossen, Maryse C., de Ruiter, Godard C. W., Haitsma, Iain, Polinder, Suzanne, Steyerberg, Ewout W., Menon, David, Maas, Andrew I. R., Lingsma, Hester F., Peul, Wilco C., Cecilia, Ackerlund, Hadie, Adams, Vanni, Agnoletti, Judith, Allanson, Krisztina, Amrein, Norberto, Andaluz, Nada, Andelic, Lasse, Andreassen, Azasevac, Antun, Audny, Anke, Anna, Antoni, Hilko, Ardon, Gerard, Audibert, Kaspars, Auslands, Philippe, Azouvi, Luisa, Azzolini Maria, Camelia, Baciu, Rafael, Badenes, Ronald, Bartels, Pal, Barzo, Ursula, Bauerfeind, Romuald, Beauvais, Ronny, Beer, Francisco Javier, Belda, Bo-Michael, Bellander, Antonio, Belli, Remy, Bellier, Habib, Benali, Thierry, Benard, Maurizio, Berardino, Luigi, Beretta, Christopher, Beynon, Federico, Bilotta, Harald, Binder, Erta, Biqiri, Morten, Blaabjerg, Hugo, den Boogert, Pierre, Bouzat, Peter, Bragge, Alexandra, Brazinova, Vibeke, Brinck, Joanne, Brooker, Camilla, Brorsson, Andras, Buki, Monika, Bullinger, Emiliana, Calappi, Rosa, Calvi Maria, Peter, Cameron, Lozano Guillermo, Carbayo, Marco, Carbonara, Elsa, Carise, Carpenter, K., Ana M, Castano-Leon, Francesco, Causin, Giorgio, Chevallard, Arturo, Chieregato, Giuseppe, Citerio, Maryse, Cnossen, Mark, Coburn, Jonathan, Coles, Lizzie, Coles-Kemp, Johnny, Collett, Jamie, Cooper D., Marta, Correia, Amra, Covic, Nicola, Curry, Endre, Czeiter, Marek, Czosnyka, Claire, Dahyot-Fizelier, Francois, Damas, Pierre, Damas, Helen, Dawes, Veronique, De Keyser, Francesco, Della Corte, Bart, Depreitere, Godard, de Ruiter C. W., Dula, Dilvesi, Diederik, Dippel, Abhishek, Dixit, Emma, Donoghue, Jens, Dreier, Guy-Loup, Duliere, George, Eapen, Heiko, Engemann, Ari, Ercole, Patrick, Esser, Erzsebet, Ezer, Martin, Fabricius, Valery, Feigin L., Kelly, Foks, Francesca, Fossi, Gilles, Francony, Ulderico, Freo, Shirin, Frisvold, Alex, Furmanov, Pablo, Gagliardo, Damien, Galanaud, Dashiell, Gantner, Karin, Geleijns, Pradeep, George, Alexandre, Ghuysen, Lelde, Giga, Benoit, Giraud, Ben, Glocker, Jagos, Golubovic, Pedro, Gomez A., Francesca, Grossi, Russell, Gruen L., Deepak, Gupta, Juanita, Haagsma A., Iain, Haitsma, Jed, Hartings A., Raimund, Helbok, Eirik, Helseth, Daniel, Hertle, Astrid, Hoedemaekers, Stefan, Hoefer, Lindsay, Horton, Jilske, Huijben, Peter, Hutchinson J., Kristine, Haberg Asta, Bram, Jacobs, Stefan, Jankowski, Mike, Jarrett, Bojan, Jelaca, Kelly, Jones, Konstantinos, Kamnitsas, Mladen, Karan, Ari, Katila, Maija, Kaukonen, Thomas, Kerforne, Riku, Kivisaari, Angelos, Kolias G., Balint, Kolumban, Erwin, Kompanje, Ksenija, Kolundzija, Daniel, Kondziella, Lars-Owe, Koskinen, Noemi, Kovacs, Alfonso, Lagares, Linda, Lanyon, Steven, Laureys, Fiona, Lecky, Christian, Ledig, Rolf, Lefering, Valerie, Legrand, Jin, Lei, Leon, Levi, Roger, Lightfoot, Hester, Lingsma, Dirk, Loeckx, Angels, Lozano, Andrew, Maas I. R., Stephen, MacDonald, Marc, Maegele, Marek, Majdan, Sebastian, Major, Alex, Manara, Geoffrey, Manley, Didier, Martin, Francisco, Martin Leon, Costanza, Martino, Armando, Maruenda, Hugues, Marechal, Alessandro, Masala, Julia, Mattern, Charles, McFadyen, Catherine, McMahon, Bela, Melegh, David, Menon, Tomas, Menovsky, Cristina, Morganti-Kossmann, Davide, Mulazzi, Visakh, Muraleedharan, Lynnette, Murray, Holger, Muehlan, Nandesh, Nair, Ancuta, Negru, David, Nelson, Virginia, Newcombe, Daan, Nieboer, Quentin, Noirhomme, Jozsef, Nyiradi, Mauro, Oddo, Annemarie, Oldenbeuving, Matej, Oresic, Fabrizio, Ortolano, Aarno, Palotie, Paul, Parizel M., Adriana, Patruno, Jean-Francois, Payen, Natascha, Perera, Vincent, Perlbarg, Paolo, Persona, Anna, Piippo-Karjalainen, Sebastien, Pili Floury, Matti, Pirinen, Horia, Ples, Maria Antonia, Poca, Suzanne, Polinder, Inigo, Pomposo, Jussi, Posti, Louis, Puybasset, Andreea, Radoi, Arminas, Ragauskas, Rahul, Raj, Malinka, Rambadagalla, Ruben, Real, Veronika, Rehorcikova, Jonathan, Rhodes, Samuli, Ripatti, Saulius, Rocka, Cecilie, Roe, Olav, Roise, Gerwin, Roks, Jonathan, Rosand, Jeffrey, Rosenfeld, Christina, Rosenlund, Guy, Rosenthal, Rolf, Rossaint, Sandra, Rossi, Daniel, Rueckert, Martin, Rusnak, Marco, Sacchi, Barbara, Sahakian, Juan, Sahuquillo, Oliver, Sakowitz, Francesca, Sala, Renan, Sanchez-Porras, Janos, Sandor, Edgar, Santos, Luminita, Sasu, Davide, Savo, Nadine, Schaeffer, Inger, Schipper, Barbara, Schloesser, Silke, Schmidt, Herbert, Schoechl, Guus, Schoonman, Frederik, Schou Rico, Elisabeth, Schwendenwein, Michael, Schoell, Ozcan, Sir, Toril, Skandsen, Lidwien, Smakman, Dirk, Smeets, Peter, Smielewski, Abayomi, Sorinola, Emmanuel, Stamatakis, Simon, Stanworth, Nicole, Steinbuechel, Ana, Stevanovic, Robert, Stevens, William, Stewart, Ewout, Steyerberg W., Nino, Stocchetti, Nina, Sundstrom, Anneliese, Synnot, Fabio Silvio, Taccone, Riikka, Takala, Viktoria, Tamas, Paivi, Tanskanen, Steven, Taylor Mark, Braden, Te Ao, Olli, Tenovuo, Ralph, Telgmann, Guido, Teodorani, Alice, Theadom, Matt, Thomas, Dick, Tibboel, Christos, Tolias, Luaba, Tshibanda Jean-Flory, Tony, Trapani, Maria, Tudora Cristina, Peter, Vajkoczy, Shirley, Vallance, Egils, Valeinis, Gregory, Van der Steen, Mathieu, Van der Jagt, Joukje, Van der Naalt, Jeroen, van Dijck T. J. M., Thomas, Van Essen A., Wim, Van Hecke, Caroline, van Heugten, Dominique, Van Praag, Thijs, Vande Vyvere, Julia, Van Waesberghe, Audrey, Vanhaudenhuyse, Alessia, Vargiolu, Emmanuel, Vega, Kimberley, Velt, Jan, Verheyden, Paul, Vespa M., Anne, Vik, Rimantas, Vilcinis, Giacinta, Vizzino, Carmen, Vleggeert-Lankamp, Victor, Volovici, Daphne, Voormolen, Peter, Vulekovic, Zoltan, Vamos, Derick, Wade, Kevin, Wang K. W., Lei, Wang, Lars, Wessels, Eno, Wildschut, Guy, Williams, Lindsay, Wilson, Maren, Winkler K. L., Stefan, Wolf, Peter, Ylen, Alexander, Younsi, Menashe, Zaaroor, Yang, Zhihui, Agate, Ziverte, Fabrizio, Zumbo, van Essen, Thomas A., den Boogert, Hugo F., Cnossen, Maryse C., de Ruiter, Godard C. W., Haitsma, Iain, Polinder, Suzanne, Steyerberg, Ewout W., Menon, David, Maas, Andrew I. R., Lingsma, Hester F., Peul, Wilco C., Cecilia, Ackerlund, Hadie, Adams, Vanni, Agnoletti, Judith, Allanson, Krisztina, Amrein, Norberto, Andaluz, Nada, Andelic, Lasse, Andreassen, Azasevac, Antun, Audny, Anke, Anna, Antoni, Hilko, Ardon, Gerard, Audibert, Kaspars, Auslands, Philippe, Azouvi, Luisa, Azzolini Maria, Camelia, Baciu, Rafael, Badenes, Ronald, Bartels, Pal, Barzo, Ursula, Bauerfeind, Romuald, Beauvais, Ronny, Beer, Francisco Javier, Belda, Bo-Michael, Bellander, Antonio, Belli, Remy, Bellier, Habib, Benali, Thierry, Benard, Maurizio, Berardino, Luigi, Beretta, Christopher, Beynon, Federico, Bilotta, Harald, Binder, Erta, Biqiri, Morten, Blaabjerg, Hugo, den Boogert, Pierre, Bouzat, Peter, Bragge, Alexandra, Brazinova, Vibeke, Brinck, Joanne, Brooker, Camilla, Brorsson, Andras, Buki, Monika, Bullinger, Emiliana, Calappi, Rosa, Calvi Maria, Peter, Cameron, Lozano Guillermo, Carbayo, Marco, Carbonara, Elsa, Carise, Carpenter, K., Ana M, Castano-Leon, Francesco, Causin, Giorgio, Chevallard, Arturo, Chieregato, Giuseppe, Citerio, Maryse, Cnossen, Mark, Coburn, Jonathan, Coles, Lizzie, Coles-Kemp, Johnny, Collett, Jamie, Cooper D., Marta, Correia, Amra, Covic, Nicola, Curry, Endre, Czeiter, Marek, Czosnyka, Claire, Dahyot-Fizelier, Francois, Damas, Pierre, Damas, Helen, Dawes, Veronique, De Keyser, Francesco, Della Corte, Bart, Depreitere, Godard, de Ruiter C. W., Dula, Dilvesi, Diederik, Dippel, Abhishek, Dixit, Emma, Donoghue, Jens, Dreier, Guy-Loup, Duliere, George, Eapen, Heiko, Engemann, Ari, Ercole, Patrick, Esser, Erzsebet, Ezer, Martin, Fabricius, Valery, Feigin L., Kelly, Foks, Francesca, Fossi, Gilles, Francony, Ulderico, Freo, Shirin, Frisvold, Alex, Furmanov, Pablo, Gagliardo, Damien, Galanaud, Dashiell, Gantner, Karin, Geleijns, Pradeep, George, Alexandre, Ghuysen, Lelde, Giga, Benoit, Giraud, Ben, Glocker, Jagos, Golubovic, Pedro, Gomez A., Francesca, Grossi, Russell, Gruen L., Deepak, Gupta, Juanita, Haagsma A., Iain, Haitsma, Jed, Hartings A., Raimund, Helbok, Eirik, Helseth, Daniel, Hertle, Astrid, Hoedemaekers, Stefan, Hoefer, Lindsay, Horton, Jilske, Huijben, Peter, Hutchinson J., Kristine, Haberg Asta, Bram, Jacobs, Stefan, Jankowski, Mike, Jarrett, Bojan, Jelaca, Kelly, Jones, Konstantinos, Kamnitsas, Mladen, Karan, Ari, Katila, Maija, Kaukonen, Thomas, Kerforne, Riku, Kivisaari, Angelos, Kolias G., Balint, Kolumban, Erwin, Kompanje, Ksenija, Kolundzija, Daniel, Kondziella, Lars-Owe, Koskinen, Noemi, Kovacs, Alfonso, Lagares, Linda, Lanyon, Steven, Laureys, Fiona, Lecky, Christian, Ledig, Rolf, Lefering, Valerie, Legrand, Jin, Lei, Leon, Levi, Roger, Lightfoot, Hester, Lingsma, Dirk, Loeckx, Angels, Lozano, Andrew, Maas I. R., Stephen, MacDonald, Marc, Maegele, Marek, Majdan, Sebastian, Major, Alex, Manara, Geoffrey, Manley, Didier, Martin, Francisco, Martin Leon, Costanza, Martino, Armando, Maruenda, Hugues, Marechal, Alessandro, Masala, Julia, Mattern, Charles, McFadyen, Catherine, McMahon, Bela, Melegh, David, Menon, Tomas, Menovsky, Cristina, Morganti-Kossmann, Davide, Mulazzi, Visakh, Muraleedharan, Lynnette, Murray, Holger, Muehlan, Nandesh, Nair, Ancuta, Negru, David, Nelson, Virginia, Newcombe, Daan, Nieboer, Quentin, Noirhomme, Jozsef, Nyiradi, Mauro, Oddo, Annemarie, Oldenbeuving, Matej, Oresic, Fabrizio, Ortolano, Aarno, Palotie, Paul, Parizel M., Adriana, Patruno, Jean-Francois, Payen, Natascha, Perera, Vincent, Perlbarg, Paolo, Persona, Anna, Piippo-Karjalainen, Sebastien, Pili Floury, Matti, Pirinen, Horia, Ples, Maria Antonia, Poca, Suzanne, Polinder, Inigo, Pomposo, Jussi, Posti, Louis, Puybasset, Andreea, Radoi, Arminas, Ragauskas, Rahul, Raj, Malinka, Rambadagalla, Ruben, Real, Veronika, Rehorcikova, Jonathan, Rhodes, Samuli, Ripatti, Saulius, Rocka, Cecilie, Roe, Olav, Roise, Gerwin, Roks, Jonathan, Rosand, Jeffrey, Rosenfeld, Christina, Rosenlund, Guy, Rosenthal, Rolf, Rossaint, Sandra, Rossi, Daniel, Rueckert, Martin, Rusnak, Marco, Sacchi, Barbara, Sahakian, Juan, Sahuquillo, Oliver, Sakowitz, Francesca, Sala, Renan, Sanchez-Porras, Janos, Sandor, Edgar, Santos, Luminita, Sasu, Davide, Savo, Nadine, Schaeffer, Inger, Schipper, Barbara, Schloesser, Silke, Schmidt, Herbert, Schoechl, Guus, Schoonman, Frederik, Schou Rico, Elisabeth, Schwendenwein, Michael, Schoell, Ozcan, Sir, Toril, Skandsen, Lidwien, Smakman, Dirk, Smeets, Peter, Smielewski, Abayomi, Sorinola, Emmanuel, Stamatakis, Simon, Stanworth, Nicole, Steinbuechel, Ana, Stevanovic, Robert, Stevens, William, Stewart, Ewout, Steyerberg W., Nino, Stocchetti, Nina, Sundstrom, Anneliese, Synnot, Fabio Silvio, Taccone, Riikka, Takala, Viktoria, Tamas, Paivi, Tanskanen, Steven, Taylor Mark, Braden, Te Ao, Olli, Tenovuo, Ralph, Telgmann, Guido, Teodorani, Alice, Theadom, Matt, Thomas, Dick, Tibboel, Christos, Tolias, Luaba, Tshibanda Jean-Flory, Tony, Trapani, Maria, Tudora Cristina, Peter, Vajkoczy, Shirley, Vallance, Egils, Valeinis, Gregory, Van der Steen, Mathieu, Van der Jagt, Joukje, Van der Naalt, Jeroen, van Dijck T. J. M., Thomas, Van Essen A., Wim, Van Hecke, Caroline, van Heugten, Dominique, Van Praag, Thijs, Vande Vyvere, Julia, Van Waesberghe, Audrey, Vanhaudenhuyse, Alessia, Vargiolu, Emmanuel, Vega, Kimberley, Velt, Jan, Verheyden, Paul, Vespa M., Anne, Vik, Rimantas, Vilcinis, Giacinta, Vizzino, Carmen, Vleggeert-Lankamp, Victor, Volovici, Daphne, Voormolen, Peter, Vulekovic, Zoltan, Vamos, Derick, Wade, Kevin, Wang K. W., Lei, Wang, Lars, Wessels, Eno, Wildschut, Guy, Williams, Lindsay, Wilson, Maren, Winkler K. L., Stefan, Wolf, Peter, Ylen, Alexander, Younsi, Menashe, Zaaroor, Yang, Zhihui, Agate, Ziverte, and Fabrizio, Zumbo

Abstract

BackgroundNeurosurgical management of traumatic brain injury (TBI) is challenging, with only low-quality evidence. We aimed to explore differences in neurosurgical strategies for TBI across Europe.MethodsA survey was sent to 68 centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. The questionnaire contained 21 questions, including the decision when to operate (or not) on traumatic acute subdural hematoma (ASDH) and intracerebral hematoma (ICH), and when to perform a decompressive craniectomy (DC) in raised intracranial pressure (ICP).ResultsThe survey was completed by 68 centers (100%). On average, 10 neurosurgeons work in each trauma center. In all centers, a neurosurgeon was available within 30min. Forty percent of responders reported a thickness or volume threshold for evacuation of an ASDH. Most responders (78%) decide on a primary DC in evacuating an ASDH during the operation, when swelling is present. For ICH, 3% would perform an evacuation directly to prevent secondary deterioration and 66% only in case of clinical deterioration. Most respondents (91%) reported to consider a DC for refractory high ICP. The reported cut-off ICP for DC in refractory high ICP, however, differed: 60% uses 25mmHg, 18% 30mmHg, and 17% 20mmHg. Treatment strategies varied substantially between regions, specifically for the threshold for ASDH surgery and DC for refractory raised ICP. Also within center variation was present: 31% reported variation within the hospital for inserting an ICP monitor and 43% for evacuating mass lesions.ConclusionDespite a homogeneous organization, considerable practice variation exists of neurosurgical strategies for TBI in Europe. These results provide an incentive for comparative effectiveness research to determine elements of effective neurosurgical care.

Published
2019

16. System dynamics-modelling as a tool to foster innovation orchestration in the context of data-driven policy making

Author

Minna Pikkarainen, Marika Iivari, Francis Gomes, J., Peter Ylen, Jukka Ranta, Pia Hurmelinna-Laukkanen, Huizingh, Koos, Bitran, Ian, Conn, Steffen, Kokshina, Olga, Torkkeli, Marko, and Tynnhammar, Marcus

Subjects
SDG 3 - Good Health and Well-being
Abstract

The decisions of public health policies have great impact on our society and citizens. These decisions made policy makers are typically driven by various types of continuously changing and interlinked determinants, such as economic, social, political and technological factors. In this dynamic situation, it is not possible forone person to understand the whole system, and all cause effect relations. Thus, we need a data-driven decision support tool - an innovation which will help policy makers to evaluate and orchestrate networks for better health and wellbeing in the society. This paper looks at the potential of system dynamics (SD) modeling as a tool for policy level innovation orchestration. In the paper, it isshown how orchestration of a network contributes to implementing an innovative data-driven decision support system for policy makers with the use of system dynamics modeling that makes visible all those causes and effects of systemic challenges.

Published
2017

17. Accelerating innovation with service dominant logic

Author

Marja Toivonen and Peter Ylen

Abstract

In recent decades, innovation has been considered a crucial factor in the fostering of business growth and societal welfare. This emphasis is linked to the increasing rate of change and the significance of knowledge in modern economies. At the beginning of the 'knowledge economy' discussion in the 1990s, strengthening the knowledge base was seen as a central task. Today, learning is the core aim: what matters is not so much the knowledge possessed by agents and organisations at a certain point in time as the capability of rapid learning. This focus brings new knowledge and innovation to the fore - the knowledge economy is fundamentally an innovation driven economy [1]. On the other hand, businesses, other organisations, and policymakers face many challenges when they implement the innovation-driven view. Slowness and lack of radical thoughts are among the most typical concerns. Several researchers have linked these problems to overly narrow, science based thoughts about the nature of innovation and suggested that a more efficient approach can be achieved when innovation is seen as intertwined and co-evolving with practical activities. 'Learning-by-doing', 'learning-by-using', and 'learning-by-interacting' have been highlighted as essential in the emergence of innovations [2]. This 'broad view of innovation' - meaning in many respects a return to the original theory of Schumpeter (1934) - has been influential among innovation scholars, but less among practitioners. One apparent bottleneck is the lack of such alternative innovation models as would provide a credible alternative to the process model in which innovations are pursued on the basis of in-house R&D activities. We propose that one approach for addressing these challenges is to analyse how service-dominant logic (SDL) contributes to the building of an alternative innovation model. We have selected this approach as our starting point for four reasons. First, it is applicable in all kinds of companies and other organisations, in both manufacturing and service sectors. Second, it summarises several approaches that have pursued a broader perspective outside the dyad of the producer and the customer. Third, it is in line with the broad view of innovation. Fourth, it fosters a radically new way of thinking about the principles of economic activity. From the standpoint of innovation, the core benefit of SDL is that it focuses on complex and dynamic systems of actors that relationally co-create value and, at the same time, jointly provide the context through which 'value' gains its collective and individual assessment [3].

Published
2013

18. Dynamic model of electronic invoicing adoption

Author

Tero Jokinen, Heikki Nikali, and Peter Ylen

Subjects
ComputingMethodologies_DOCUMENTANDTEXTPROCESSING
Abstract

Traditional paper invoicing is in the process of being replaced for the major part by electronic invoicing, as it is comparatively outdated. Considering the advantages of electronic invoicing the adoption rate of the service has been surprisingly slow among billers and their customers in Finland. Nevertheless, as more and more companies and consumers adopt electronic invoicing, service providers compete for market shares. The service provider that comprehends and makes the best use of the features of the market's dynamics has an advantage over its competitors. We used system dynamics modelling to understand the dynamics of electronic invoicing adoption in Finland.

Published
2011

19. Simulation of a distributed design project

Author

Sampsa Ruutu, Peter Ylen, Laine, M., Lyneis, James M., and Richardson, George P.

Subjects
decision support, design service, system dynamics, simulation, distributed project
Abstract

Dissemination of system dynamics to project management practitioners is not as widespread as its use for project management theory building within the system dynamics community. This article presents a decision support and training project model built for a global consulting and engineering company. The simulation model comprises the most important work phases within the detail engineering phase of a large investment project in three offices. The model was validated using data from several past projects and in workshops with the company. A user interface was built to aid dissemination and use of the model. The purpose of the model is the bottleneck analysis and simulation of an ongoing engineering project, as well as the simulation of quality, scheduling, and profitability issues when outsourcing parts of the detail plant engineering.

Published
2011

20. Open Source System Dynamics with Simantics and OpenModelica

Author

Teemu Lempinen, Sampsa Ruutu, Tommi Karhela, and Peter Ylen

Subjects
Simantics, system dynamics, OpenModelica, Open source
Abstract

We will introduce a new system dynamic modelling and simulation environment based on open source components. The development was initiated by a group of active system dynamics modellers who had needs and ideas for an open toolset. The new needs for features like hierarchical modules, module libraries, collaborative model development and efficient model communication in system dynamics together with the development of open source modelling framework Simantics and simulation environment OpenModelica have driven us to start developing an open source modelling and simulation software for system dynamics. In this paper we discuss how current open source components can be used to build a comprehensive tool for system dynamics modelling and what impact open source could have on system dynamics modelling. Even though the development is still on its early stages, the open source components have enabled us to rapidly develop a tool capable of hierarchical modelling, simulation and some basic result and model analysis. When using open source, the modelling software becomes more affordable and distribution of models becomes easier, modelling software can be adapted to individual needs and models can be used and validated by all stakeholders

Published
2011

24. Dynamic modeling of maintenance strategies

Author

Tero Jokinen, Peter Ylen, and Zupančič, Borut

Subjects
maintenance strategy, System dynamics, simulation
Abstract

Maintenance strategy formulation is difficult because different systems, such as production control and maintenance, are integrated and highly interdependent. Dividing the problem into smaller sub-problems helps only in short term. The longer the time span over which the system is examined, the more significant the interactions become. Considering the whole system, problems of maintenance strategy formulation are complex. This paper presents a system dynamics simulation model for the maintenance of a generic process plant. The model describes the maintenance activity and its interactions with other parts of the organization. With the help of the simulations and the causal diagram of system’s feedback structure it is possible to clarify the role of the maintenance in the organization. When the role is clear, it is easier to set goals and to plan maintenance strategy so that they serve best the needs of the corporate. The strategies were evaluated with different performance measures. Additionally, strategies’ sensitivity to different uncertain variables and assumptions were tested.

25. Automaatio liiketoimintaprosessien tukena

Author

Peter Ylen, Olli Ventä, Teemu Tommila, Jari Lappalainen, Juhani Hirvonen, Tommi Karhela, Matti Paljakka, Hannu Lehtinen, Juhani Heilala, Janne Peltonen, Timo Malm, Janne Valkonen, Paavo Voho, and Paula Savioja

26. A System Dynamics Model of Data-Driven Precision Medicine Ecosystem

Author

Peter Ylen, Jaakko Lähteenmäki, and Tomi Sorasalmi

Subjects
biobank, system dynamics, healthcare
Abstract

Biobanking and secondary use of healthcare data enable considerable improvement to healthcare through personalized medicine including innovative therapies, pharmaceuticals, medical technology, and healthcare processes tailored for the needs of individuals. The data-driven precision medicine ecosystem requires contributions from a large variety of stakeholders as well as public investments to boost ecosystem growth. This paper introduces a system dynamics model describing mechanisms for biobank data and biosample accumulation and the related impact to pharmaceutical R&D projects. The preliminary simulation results reflect the important role of public funding of the infrastructure needed for biobank and register data exploitation as well as setting up services to attract more donors. Large public-private precision medicine projects, such as the FinnGen project are in a key role. Further work is needed to improve the ecosystem model precision especially in taking into account the differences between pharmaceutical R&D projects and their data exploitation needs.

28. Exploring values-based co-innovation in ecosystems through system dynamic group modelling

Author

Katri Valkokari, Peter Ylen, Henri Wiman, and Markus Jähi

Subjects
Values-based innovation, future-orientated values, co-innovation, innovation ecosystem, systemic innovation, system dynamics, group modelling, sustainable future, stakeholders
Abstract

By drawing on an ecosystem approach, this paper aims to bridge the gap between the dynamics of collaborative innovation processes and multiple future-orientated value(s). Our study indicates that the system dynamic group modelling process was well-suited to understanding the transition towards a circular, bio-based plastics ecosystem. Due to systemic innovation, the transition is rather time consuming and includes variety of actors. In other words, system dynamic ecosystem approach can serve as a mean to solve wicked problems stemming from the conflicting views of various stakeholders. Based on the findings of our study, we suggest that managers should also look for conflicting interests, purposes and value destruction in order to enhance an ecosystem’s values-based innovation process

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