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2. Variation in Structure and Process of Care in Traumatic Brain Injury: Provider Profiles of European Neurotrauma Centers Participating in the CENTER-TBI Study

Author

Cnossen M. C., Polinder S., Lingsma H. F., Maas A. I. R., Menon D., Steyerberg E. W., Adams H., Alessandro M., Allanson J., Amrein K., Andaluz N., Andelic N., Andrea N., Andreassen L., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Baciu C., Bacon A., Badenes R., Baglin T., Bartels R., Barzo P., Bauerfeind U., Beer R., Belda F. J., Bellander B. -M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Borgen L. S., Bouzat P., Bragge P., Brazinova A., Brehar F., Brorsson C., Buki A., Bullinger M., Buckova V., Calappi E., Cameron P., Carbayo L. G., Carise E., Carpenter C., Castano-Leon A. M., Causin F., Chevallard G., Chieregato A., Citerio G., Coburn M. C., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Della Corte F., Depreitere B., Ding S., Dippel D., Dizdarevic K., Duliere G. -L., Dzeko A., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Feng J., Foks K., Fossi F., Francony G., Frantzen J., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gao G., Geleijns K., Ghuysen A., Giraud B., Glocker B., Gomez P. A., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Hadzic E., Haitsma I., Hartings J. A., Helbok R., Helseth E., Hertle D., Hill S., Hoedemaekers A., Hoefer S., Hutchinson P. J., Haberg A. K., Jacobs B., Janciak I., Janssens K., Jiang J., Jones K., Kalala J. -P., Kamnitsas K., Karan M., Karau J., Katila A., Kaukonen M., Keeling D., Kerforne T., Ketharanathan N., Kettunen J., Kivisaari R., Kolias A. G., Kolumban B., Kompanje E., Kondziella D., Koskinen L. -O., Kovacs N., Kalovits F., Lagares A., Lanyon L., Laureys S., Lauritzen M., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., Luddington R., Luijten-Arts C., MacDonald S., MacFayden C., Maegele M., Majdan M., Major S., Manara A., Manhes P., Manley G., Martin D., Martino C., Maruenda A., Marechal H., Mastelova D., Mattern J., McMahon C., Melegh B., Menovsky T., Morganti-Kossmann C., Mulazzi D., Mutschler M., Muhlan H., Negru A., Nelson D., Neugebauer E., Newcombe V., Noirhomme Q., Nyiradi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P. M., Patruno A., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Pichon N., Piilgaard H., Piippo A., Pili F. S., Pirinen M., Ples H., Pomposo I., Psota M., Pullens P., Puybasset L., Ragauskas A., Raj R., Rambadagalla M., Rehorcikova V., Rhodes J., Richardson S., Ripatti S., Rocka S., Rodier N., Roe C., Roise O., Roks G., Romegoux P., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rostalski T., Rueckert D. L., Ruiz De Arcaute F., Rusnak M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Pena P., Sanchez-Porras R., Sandor J., Santos E., Sasse N., Sasu L., Savo D., Schipper I., Schlosser B., Schmidt S., Schneider A., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Scholl M., Sir O., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E. L., Stanworth S., Stegemann K., Steinbuchel N., Stevens R., Stewart W., Stocchetti N., Sundstrom N., Synnot A., Szabo J., Soderberg J., Taccone F. S., Tamas V., Tanskanen P., Tascu A., Taylor M. S., Te Ao B., Tenovuo O., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J. -F. L., Tudora C. M., Vajkoczy P., Valeinis E., Van Hecke W., Van Praag D., Van Roost D., Van Vlierberghe E., Vande Vyvere T., Vanhaudenhuyse A., Vargiolu A., Vega E., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Vulekovic P., Vamos Z., Wade D., Wang K. K. W., Wang L., Wildschut E., Williams G., Willumsen L., Wilson A., Wilson L., Winkler M. K. L., Ylen P., Younsi A., Zaaroor M., Zhang Z., Zheng Z., Zumbo F., De Lange S., De Ruiter G. C. W., Den Boogert H., Van Dijck J., Van Essen T. A., Van Heugten C., Van Der Jagt M., Van Der Naalt J., CENTER-Tbi Invest Participants, Cnossen, M, Polinder, S, Lingsma, H, Maas, A, Menon, D, Steyerberg, E, Adams, H, Alessandro, M, Allanson, J, Amrein, K, Andaluz, N, Andelic, N, Andrea, N, Andreassen, L, Anke, A, Antoni, A, Ardon, H, Audibert, G, Auslands, K, Azouvi, P, Baciu, C, Bacon, A, Badenes, R, Baglin, T, Bartels, R, Barzo, P, Bauerfeind, U, Beer, R, Belda, F, Bellander, B, Belli, A, Bellier, R, Benali, H, Benard, T, Berardino, M, Beretta, L, Beynon, C, Bilotta, F, Binder, H, Biqiri, E, Blaabjerg, M, Borgen, L, Bouzat, P, Bragge, P, Brazinova, A, Brehar, F, Brorsson, C, Buki, A, Bullinger, M, Buckova, V, Calappi, E, Cameron, P, Carbayo, L, Carise, E, Carpenter, C, Castano-Leon, A, Causin, F, Chevallard, G, Chieregato, A, Citerio, G, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Damas, F, Damas, P, Dawes, H, De Keyser, V, Della Corte, F, Depreitere, B, Ding, S, Dippel, D, Dizdarevic, K, Duliere, G, Dzeko, A, Eapen, G, Engemann, H, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Feng, J, Foks, K, Fossi, F, Francony, G, Frantzen, J, Freo, U, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gao, G, Geleijns, K, Ghuysen, A, Giraud, B, Glocker, B, Gomez, P, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Hadzic, E, Haitsma, I, Hartings, J, Helbok, R, Helseth, E, Hertle, D, Hill, S, Hoedemaekers, A, Hoefer, S, Hutchinson, P, Haberg, A, Jacobs, B, Janciak, I, Janssens, K, Jiang, J, Jones, K, Kalala, J, Kamnitsas, K, Karan, M, Karau, J, Katila, A, Kaukonen, M, Keeling, D, Kerforne, T, Ketharanathan, N, Kettunen, J, Kivisaari, R, Kolias, A, Kolumban, B, Kompanje, E, Kondziella, D, Koskinen, L, Kovacs, N, Kalovits, F, Lagares, A, Lanyon, L, Laureys, S, Lauritzen, M, Lecky, F, Ledig, C, Lefering, R, Legrand, V, Lei, J, Levi, L, Lightfoot, R, Loeckx, D, Lozano, A, Luddington, R, Luijten-Arts, C, Macdonald, S, Macfayden, C, Maegele, M, Majdan, M, Major, S, Manara, A, Manhes, P, Manley, G, Martin, D, Martino, C, Maruenda, A, Marechal, H, Mastelova, D, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Morganti-Kossmann, C, Mulazzi, D, Mutschler, M, Muhlan, H, Negru, A, Nelson, D, Neugebauer, E, Newcombe, V, Noirhomme, Q, Nyiradi, J, Oddo, M, Oldenbeuving, A, Oresic, M, Ortolano, F, Palotie, A, Parizel, P, Patruno, A, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Pichon, N, Piilgaard, H, Piippo, A, Pili, F, Pirinen, M, Ples, H, Pomposo, I, Psota, M, Pullens, P, Puybasset, L, Ragauskas, A, Raj, R, Rambadagalla, M, Rehorcikova, V, Rhodes, J, Richardson, S, Ripatti, S, Rocka, S, Rodier, N, Roe, C, Roise, O, Roks, G, Romegoux, P, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rostalski, T, Rueckert, D, Ruiz De Arcaute, F, Rusnak, M, Sacchi, M, Sahakian, B, Sahuquillo, J, Sakowitz, O, Sala, F, Sanchez-Pena, P, Sanchez-Porras, R, Sandor, J, Santos, E, Sasse, N, Sasu, L, Savo, D, Schipper, I, Schlosser, B, Schmidt, S, Schneider, A, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Scholl, M, Sir, O, Skandsen, T, Smakman, L, Smeets, D, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stegemann, K, Steinbuchel, N, Stevens, R, Stewart, W, Stocchetti, N, Sundstrom, N, Synnot, A, Szabo, J, Soderberg, J, Taccone, F, Tamas, V, Tanskanen, P, Tascu, A, Taylor, M, Te Ao, B, Tenovuo, O, Teodorani, G, Theadom, A, Thomas, M, Tibboel, D, Tolias, C, Tshibanda, J, Tudora, C, Vajkoczy, P, Valeinis, E, Van Hecke, W, Van Praag, D, Van Roost, D, Van Vlierberghe, E, Vande Vyvere, T, Vanhaudenhuyse, A, Vargiolu, A, Vega, E, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Vizzino, G, Vleggeert-Lankamp, C, Volovici, V, Vulekovic, P, Vamos, Z, Wade, D, Wang, K, Wang, L, Wildschut, E, Williams, G, Willumsen, L, Wilson, A, Wilson, L, Winkler, M, Ylen, P, Younsi, A, Zaaroor, M, Zhang, Z, Zheng, Z, Zumbo, F, De Lange, S, De Ruiter, G, Den Boogert, H, Van Dijck, J, Van Essen, T, Van Heugten, C, Van Der Jagt, M, Van Der Naalt, J, Cnossen, M. C., Polinder, S., Lingsma, H. F., Maas, A. I. R., Menon, D., Steyerberg, E. W., Adams, H., Alessandro, M., Allanson, J., Amrein, K., Andaluz, N., Andelic, N., Andrea, N., Andreassen, L., Anke, A., Antoni, A., Ardon, H., Audibert, G., Auslands, K., Azouvi, P., Baciu, C., Bacon, A., Badenes, R., Baglin, T., Bartels, R., Barzo, P., Bauerfeind, U., Beer, R., Belda, F. J., Bellander, B. -M., Belli, A., Bellier, R., Benali, H., Benard, T., Berardino, M., Beretta, L., Beynon, C., Bilotta, F., Binder, H., Biqiri, E., Blaabjerg, M., Borgen, L. S., Bouzat, P., Bragge, P., Brazinova, A., Brehar, F., Brorsson, C., Buki, A., Bullinger, M., Buckova, V., Calappi, E., Cameron, P., Carbayo, L. G., Carise, E., Carpenter, C., Castano-Leon, A. M., Causin, F., Chevallard, G., Chieregato, A., Citerio, G., Coburn, M. C., Coles, J., Cooper, J. D., Correia, M., Covic, A., Curry, N., Czeiter, E., Czosnyka, M., Dahyot-Fizelier, C., Damas, F., Damas, P., Dawes, H., De Keyser, V., Della Corte, F., Depreitere, B., Ding, S., Dippel, D., Dizdarevic, K., Duliere, G. -L., Dzeko, A., Eapen, G., Engemann, H., Ercole, A., Esser, P., Ezer, E., Fabricius, M., Feigin, V. L., Feng, J., Foks, K., Fossi, F., Francony, G., Frantzen, J., Freo, U., Frisvold, S., Furmanov, A., Gagliardo, P., Galanaud, D., Gao, G., Geleijns, K., Ghuysen, A., Giraud, B., Glocker, B., Gomez, P. A., Grossi, F., Gruen, R. L., Gupta, D., Haagsma, J. A., Hadzic, E., Haitsma, I., Hartings, J. A., Helbok, R., Helseth, E., Hertle, D., Hill, S., Hoedemaekers, A., Hoefer, S., Hutchinson, P. J., Haberg, A. K., Jacobs, B., Janciak, I., Janssens, K., Jiang, J., Jones, K., Kalala, J. -P., Kamnitsas, K., Karan, M., Karau, J., Katila, A., Kaukonen, M., Keeling, D., Kerforne, T., Ketharanathan, N., Kettunen, J., Kivisaari, R., Kolias, A. G., Kolumban, B., Kompanje, E., Kondziella, D., Koskinen, L. -O., Kovacs, N., Kalovits, F., Lagares, A., Lanyon, L., Laureys, S., Lauritzen, M., Lecky, F., Ledig, C., Lefering, R., Legrand, V., Lei, J., Levi, L., Lightfoot, R., Lingsma, H., Loeckx, D., Lozano, A., Luddington, R., Luijten-Arts, C., Macdonald, S., Macfayden, C., Maegele, M., Majdan, M., Major, S., Manara, A., Manhes, P., Manley, G., Martin, D., Martino, C., Maruenda, A., Marechal, H., Mastelova, D., Mattern, J., Mcmahon, C., Melegh, B., Menovsky, T., Morganti-Kossmann, C., Mulazzi, D., Mutschler, M., Muhlan, H., Negru, A., Nelson, D., Neugebauer, E., Newcombe, V., Noirhomme, Q., Nyiradi, J., Oddo, M., Oldenbeuving, A., Oresic, M., Ortolano, F., Palotie, A., Parizel, P. M., Patruno, A., Payen, J. -F., Perera, N., Perlbarg, V., Persona, P., Peul, W., Pichon, N., Piilgaard, H., Piippo, A., Pili, F. S., Pirinen, M., Ples, H., Pomposo, I., Psota, M., Pullens, P., Puybasset, L., Ragauskas, A., Raj, R., Rambadagalla, M., Rehorcikova, V., Rhodes, J., Richardson, S., Ripatti, S., Rocka, S., Rodier, N., Roe, C., Roise, O., Roks, G., Romegoux, P., Rosand, J., Rosenfeld, J., Rosenlund, C., Rosenthal, G., Rossaint, R., Rossi, S., Rostalski, T., Rueckert, D. L., Ruiz De Arcaute, F., Rusnak, M., Sacchi, M., Sahakian, B., Sahuquillo, J., Sakowitz, O., Sala, F., Sanchez-Pena, P., Sanchez-Porras, R., Sandor, J., Santos, E., Sasse, N., Sasu, L., Savo, D., Schipper, I., Schlosser, B., Schmidt, S., Schneider, A., Schoechl, H., Schoonman, G., Schou, R. F., Schwendenwein, E., Scholl, M., Sir, O., Skandsen, T., Smakman, L., Smeets, D., Smielewski, P., Sorinola, A., Stamatakis, E. L., Stanworth, S., Stegemann, K., Steinbuchel, N., Stevens, R., Stewart, W., Stocchetti, N., Sundstrom, N., Synnot, A., Szabo, J., Soderberg, J., Taccone, F. S., Tamas, V., Tanskanen, P., Tascu, A., Taylor, M. S., Te Ao, B., Tenovuo, O., Teodorani, G., Theadom, A., Thomas, M., Tibboel, D., Tolias, C., Tshibanda, J. -F. L., Tudora, C. M., Vajkoczy, P., Valeinis, E., Van Hecke, W., Van Praag, D., Van Roost, D., Van Vlierberghe, E., Vande Vyvere, T., Vanhaudenhuyse, A., Vargiolu, A., Vega, E., Verheyden, J., Vespa, P. M., Vik, A., Vilcinis, R., Vizzino, G., Vleggeert-Lankamp, C., Volovici, V., Vulekovic, P., Vamos, Z., Wade, D., Wang, K. K. W., Wang, L., Wildschut, E., Williams, G., Willumsen, L., Wilson, A., Wilson, L., Winkler, M. K. L., Ylen, P., Younsi, A., Zaaroor, M., Zhang, Z., Zheng, Z., Zumbo, F., De Lange, S., De Ruiter, G. C. W., Den Boogert, H., Van Dijck, J., Van Essen, T. A., Van Heugten, C., Van Der Jagt, M., Van Der Naalt, J., Commission of the European Communities, Molecular Neuroscience and Ageing Research (MOLAR), Menon, David [0000-0002-3228-9692], Apollo - University of Cambridge Repository, and Public Health

Subjects
Questionnaires, Comparative Effectiveness Research, Critical Care and Emergency Medicine, Medical Doctors, Neurologi, Health Care Providers, CENTER-TBI Investigators and Participants, lcsh:Medicine, Poison control, Occupational safety and health, Diagnostic Radiology, Geographical Locations, 0302 clinical medicine, Trauma Centers, Surveys and Questionnaires, Brain Injuries, Traumatic, Medicine and Health Sciences, Brain Damage, Longitudinal Studies, Prospective Studies, Israel, lcsh:Science, Tomography, Trauma Medicine, Multidisciplinary, Radiology and Imaging, traumatic brain injury, Trauma center, Hospitals, 3. Good health, Europe, Hospitalization, Professions, Intensive Care Units, Neurology, Research Design, Intracranial pressure monitoring, Medical emergency, Engineering sciences. Technology, Research Article, medicine.medical_specialty, Imaging Techniques, Traumatic brain injury, General Science & Technology, Concordance, Comparative effectiveness research, Neuroimaging, Research and Analysis Methods, 03 medical and health sciences, Diagnostic Medicine, Physicians, Injury prevention, MD Multidisciplinary, medicine, Humans, Treatment Guidelines, Survey Research, Health Care Policy, business.industry, lcsh:R, Biology and Life Sciences, 030208 emergency & critical care medicine, Length of Stay, medicine.disease, ta3124, Computed Axial Tomography, Health Care, Health Care Facilities, Family medicine, People and Places, lcsh:Q, Population Groupings, business, 030217 neurology & neurosurgery, Neuroscience
Abstract

© 2016 Cnossen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Introduction: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Methods: We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. Results: All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. Conclusion: Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches.

Published
2020
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3. Variation in structure and process of care in traumatic brain injury: Provider profiles of European Neurotrauma Centers participating in the CENTER-TBI study

Author

Cnossen, M, Polinder, S, Lingsma, H, Maas, A, Menon, D, Steyerberg, E, Adams, H, Alessandro, M, Allanson, J, Amrein, K, Andaluz, N, Andelic, N, Andrea, N, Andreassen, L, Anke, A, Antoni, A, Ardon, H, Audibert, G, Auslands, K, Azouvi, P, Baciu, C, Bacon, A, Badenes, R, Baglin, T, Bartels, R, Barzo, P, Bauerfeind, U, Beer, R, Belda, F, Bellander, B, Belli, A, Bellier, R, Benali, H, Benard, T, Berardino, M, Beretta, L, Beynon, C, Bilotta, F, Binder, H, Biqiri, E, Blaabjerg, M, Borgen, L, Bouzat, P, Bragge, P, Brazinova, A, Brehar, F, Brorsson, C, Buki, A, Bullinger, M, Buckova, V, Calappi, E, Cameron, P, Carbayo, L, Carise, E, Carpenter, C, Castano-Leon, A, Causin, F, Chevallard, G, Chieregato, A, Citerio, G, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Damas, F, Damas, P, Dawes, H, De Keyser, V, Della Corte, F, Depreitere, B, Ding, S, Dippel, D, Dizdarevic, K, Duliere, G, Dzeko, A, Eapen, G, Engemann, H, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Feng, J, Foks, K, Fossi, F, Francony, G, Frantzen, J, Freo, U, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gao, G, Geleijns, K, Ghuysen, A, Giraud, B, Glocker, B, Gomez, P, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Hadzic, E, Haitsma, I, Hartings, J, Helbok, R, Helseth, E, Hertle, D, Hill, S, Hoedemaekers, A, Hoefer, S, Hutchinson, P, Haberg, A, Jacobs, B, Janciak, I, Janssens, K, Jiang, J, Jones, K, Kalala, J, Kamnitsas, K, Karan, M, Karau, J, Katila, A, Kaukonen, M, Keeling, D, Kerforne, T, Ketharanathan, N, Kettunen, J, Kivisaari, R, Kolias, A, Kolumban, B, Kompanje, E, Kondziella, D, Koskinen, L, Kovacs, N, Kalovits, F, Lagares, A, Lanyon, L, Laureys, S, Lauritzen, M, Lecky, F, Ledig, C, Lefering, R, Legrand, V, Lei, J, Levi, L, Lightfoot, R, Loeckx, D, Lozano, A, Luddington, R, Luijten-Arts, C, Macdonald, S, Macfayden, C, Maegele, M, Majdan, M, Major, S, Manara, A, Manhes, P, Manley, G, Martin, D, Martino, C, Maruenda, A, Marechal, H, Mastelova, D, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Morganti-Kossmann, C, Mulazzi, D, Mutschler, M, Muhlan, H, Negru, A, Nelson, D, Neugebauer, E, Newcombe, V, Noirhomme, Q, Nyiradi, J, Oddo, M, Oldenbeuving, A, Oresic, M, Ortolano, F, Palotie, A, Parizel, P, Patruno, A, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Pichon, N, Piilgaard, H, Piippo, A, Pili, F, Pirinen, M, Ples, H, Pomposo, I, Psota, M, Pullens, P, Puybasset, L, Ragauskas, A, Raj, R, Rambadagalla, M, Rehorcikova, V, Rhodes, J, Richardson, S, Ripatti, S, Rocka, S, Rodier, N, Roe, C, Roise, O, Roks, G, Romegoux, P, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rostalski, T, Rueckert, D, Ruiz De Arcaute, F, Rusnak, M, Sacchi, M, Sahakian, B, Sahuquillo, J, Sakowitz, O, Sala, F, Sanchez-Pena, P, Sanchez-Porras, R, Sandor, J, Santos, E, Sasse, N, Sasu, L, Savo, D, Schipper, I, Schlosser, B, Schmidt, S, Schneider, A, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Scholl, M, Sir, O, Skandsen, T, Smakman, L, Smeets, D, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stegemann, K, Steinbuchel, N, Stevens, R, Stewart, W, Stocchetti, N, Sundstrom, N, Synnot, A, Szabo, J, Soderberg, J, Taccone, F, Tamas, V, Tanskanen, P, Tascu, A, Taylor, M, Te Ao, B, Tenovuo, O, Teodorani, G, Theadom, A, Thomas, M, Tibboel, D, Tolias, C, Tshibanda, J, Tudora, C, Vajkoczy, P, Valeinis, E, Van Hecke, W, Van Praag, D, Van Roost, D, Van Vlierberghe, E, Vande Vyvere, T, Vanhaudenhuyse, A, Vargiolu, A, Vega, E, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Vizzino, G, Vleggeert-Lankamp, C, Volovici, V, Vulekovic, P, Vamos, Z, Wade, D, Wang, K, Wang, L, Wildschut, E, Williams, G, Willumsen, L, Wilson, A, Wilson, L, Winkler, M, Ylen, P, Younsi, A, Zaaroor, M, Zhang, Z, Zheng, Z, Zumbo, F, De Lange, S, De Ruiter, G, Den Boogert, H, Van Dijck, J, Van Essen, T, Van Heugten, C, Van Der Jagt, M, Van Der Naalt, J, Cnossen M. C., Polinder S., Lingsma H. F., Maas A. I. R., Menon D., Steyerberg E. W., Adams H., Alessandro M., Allanson J., Amrein K., Andaluz N., Andelic N., Andrea N., Andreassen L., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Baciu C., Bacon A., Badenes R., Baglin T., Bartels R., Barzo P., Bauerfeind U., Beer R., Belda F. J., Bellander B. -M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Borgen L. S., Bouzat P., Bragge P., Brazinova A., Brehar F., Brorsson C., Buki A., Bullinger M., Buckova V., Calappi E., Cameron P., Carbayo L. G., Carise E., Carpenter C., Castano-Leon A. M., Causin F., Chevallard G., Chieregato A., Citerio G., Coburn M. C., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Della Corte F., Depreitere B., Ding S., Dippel D., Dizdarevic K., Duliere G. -L., Dzeko A., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Feng J., Foks K., Fossi F., Francony G., Frantzen J., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gao G., Geleijns K., Ghuysen A., Giraud B., Glocker B., Gomez P. A., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Hadzic E., Haitsma I., Hartings J. A., Helbok R., Helseth E., Hertle D., Hill S., Hoedemaekers A., Hoefer S., Hutchinson P. J., Haberg A. K., Jacobs B., Janciak I., Janssens K., Jiang J., Jones K., Kalala J. -P., Kamnitsas K., Karan M., Karau J., Katila A., Kaukonen M., Keeling D., Kerforne T., Ketharanathan N., Kettunen J., Kivisaari R., Kolias A. G., Kolumban B., Kompanje E., Kondziella D., Koskinen L. -O., Kovacs N., Kalovits F., Lagares A., Lanyon L., Laureys S., Lauritzen M., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., Luddington R., Luijten-Arts C., MacDonald S., MacFayden C., Maegele M., Majdan M., Major S., Manara A., Manhes P., Manley G., Martin D., Martino C., Maruenda A., Marechal H., Mastelova D., Mattern J., McMahon C., Melegh B., Menovsky T., Morganti-Kossmann C., Mulazzi D., Mutschler M., Muhlan H., Negru A., Nelson D., Neugebauer E., Newcombe V., Noirhomme Q., Nyiradi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P. M., Patruno A., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Pichon N., Piilgaard H., Piippo A., Pili F. S., Pirinen M., Ples H., Pomposo I., Psota M., Pullens P., Puybasset L., Ragauskas A., Raj R., Rambadagalla M., Rehorcikova V., Rhodes J., Richardson S., Ripatti S., Rocka S., Rodier N., Roe C., Roise O., Roks G., Romegoux P., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rostalski T., Rueckert D. L., Ruiz De Arcaute F., Rusnak M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Pena P., Sanchez-Porras R., Sandor J., Santos E., Sasse N., Sasu L., Savo D., Schipper I., Schlosser B., Schmidt S., Schneider A., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Scholl M., Sir O., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E. L., Stanworth S., Stegemann K., Steinbuchel N., Stevens R., Stewart W., Stocchetti N., Sundstrom N., Synnot A., Szabo J., Soderberg J., Taccone F. S., Tamas V., Tanskanen P., Tascu A., Taylor M. S., Te Ao B., Tenovuo O., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J. -F. L., Tudora C. M., Vajkoczy P., Valeinis E., Van Hecke W., Van Praag D., Van Roost D., Van Vlierberghe E., Vande Vyvere T., Vanhaudenhuyse A., Vargiolu A., Vega E., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Vulekovic P., Vamos Z., Wade D., Wang K. K. W., Wang L., Wildschut E., Williams G., Willumsen L., Wilson A., Wilson L., Winkler M. K. L., Ylen P., Younsi A., Zaaroor M., Zhang Z., Zheng Z., Zumbo F., De Lange S., De Ruiter G. C. W., Den Boogert H., Van Dijck J., Van Essen T. A., Van Heugten C., Van Der Jagt M., Van Der Naalt J., Cnossen, M, Polinder, S, Lingsma, H, Maas, A, Menon, D, Steyerberg, E, Adams, H, Alessandro, M, Allanson, J, Amrein, K, Andaluz, N, Andelic, N, Andrea, N, Andreassen, L, Anke, A, Antoni, A, Ardon, H, Audibert, G, Auslands, K, Azouvi, P, Baciu, C, Bacon, A, Badenes, R, Baglin, T, Bartels, R, Barzo, P, Bauerfeind, U, Beer, R, Belda, F, Bellander, B, Belli, A, Bellier, R, Benali, H, Benard, T, Berardino, M, Beretta, L, Beynon, C, Bilotta, F, Binder, H, Biqiri, E, Blaabjerg, M, Borgen, L, Bouzat, P, Bragge, P, Brazinova, A, Brehar, F, Brorsson, C, Buki, A, Bullinger, M, Buckova, V, Calappi, E, Cameron, P, Carbayo, L, Carise, E, Carpenter, C, Castano-Leon, A, Causin, F, Chevallard, G, Chieregato, A, Citerio, G, Coburn, M, Coles, J, Cooper, J, Correia, M, Covic, A, Curry, N, Czeiter, E, Czosnyka, M, Dahyot-Fizelier, C, Damas, F, Damas, P, Dawes, H, De Keyser, V, Della Corte, F, Depreitere, B, Ding, S, Dippel, D, Dizdarevic, K, Duliere, G, Dzeko, A, Eapen, G, Engemann, H, Ercole, A, Esser, P, Ezer, E, Fabricius, M, Feigin, V, Feng, J, Foks, K, Fossi, F, Francony, G, Frantzen, J, Freo, U, Frisvold, S, Furmanov, A, Gagliardo, P, Galanaud, D, Gao, G, Geleijns, K, Ghuysen, A, Giraud, B, Glocker, B, Gomez, P, Grossi, F, Gruen, R, Gupta, D, Haagsma, J, Hadzic, E, Haitsma, I, Hartings, J, Helbok, R, Helseth, E, Hertle, D, Hill, S, Hoedemaekers, A, Hoefer, S, Hutchinson, P, Haberg, A, Jacobs, B, Janciak, I, Janssens, K, Jiang, J, Jones, K, Kalala, J, Kamnitsas, K, Karan, M, Karau, J, Katila, A, Kaukonen, M, Keeling, D, Kerforne, T, Ketharanathan, N, Kettunen, J, Kivisaari, R, Kolias, A, Kolumban, B, Kompanje, E, Kondziella, D, Koskinen, L, Kovacs, N, Kalovits, F, Lagares, A, Lanyon, L, Laureys, S, Lauritzen, M, Lecky, F, Ledig, C, Lefering, R, Legrand, V, Lei, J, Levi, L, Lightfoot, R, Loeckx, D, Lozano, A, Luddington, R, Luijten-Arts, C, Macdonald, S, Macfayden, C, Maegele, M, Majdan, M, Major, S, Manara, A, Manhes, P, Manley, G, Martin, D, Martino, C, Maruenda, A, Marechal, H, Mastelova, D, Mattern, J, Mcmahon, C, Melegh, B, Menovsky, T, Morganti-Kossmann, C, Mulazzi, D, Mutschler, M, Muhlan, H, Negru, A, Nelson, D, Neugebauer, E, Newcombe, V, Noirhomme, Q, Nyiradi, J, Oddo, M, Oldenbeuving, A, Oresic, M, Ortolano, F, Palotie, A, Parizel, P, Patruno, A, Payen, J, Perera, N, Perlbarg, V, Persona, P, Peul, W, Pichon, N, Piilgaard, H, Piippo, A, Pili, F, Pirinen, M, Ples, H, Pomposo, I, Psota, M, Pullens, P, Puybasset, L, Ragauskas, A, Raj, R, Rambadagalla, M, Rehorcikova, V, Rhodes, J, Richardson, S, Ripatti, S, Rocka, S, Rodier, N, Roe, C, Roise, O, Roks, G, Romegoux, P, Rosand, J, Rosenfeld, J, Rosenlund, C, Rosenthal, G, Rossaint, R, Rossi, S, Rostalski, T, Rueckert, D, Ruiz De Arcaute, F, Rusnak, M, Sacchi, M, Sahakian, B, Sahuquillo, J, Sakowitz, O, Sala, F, Sanchez-Pena, P, Sanchez-Porras, R, Sandor, J, Santos, E, Sasse, N, Sasu, L, Savo, D, Schipper, I, Schlosser, B, Schmidt, S, Schneider, A, Schoechl, H, Schoonman, G, Schou, R, Schwendenwein, E, Scholl, M, Sir, O, Skandsen, T, Smakman, L, Smeets, D, Smielewski, P, Sorinola, A, Stamatakis, E, Stanworth, S, Stegemann, K, Steinbuchel, N, Stevens, R, Stewart, W, Stocchetti, N, Sundstrom, N, Synnot, A, Szabo, J, Soderberg, J, Taccone, F, Tamas, V, Tanskanen, P, Tascu, A, Taylor, M, Te Ao, B, Tenovuo, O, Teodorani, G, Theadom, A, Thomas, M, Tibboel, D, Tolias, C, Tshibanda, J, Tudora, C, Vajkoczy, P, Valeinis, E, Van Hecke, W, Van Praag, D, Van Roost, D, Van Vlierberghe, E, Vande Vyvere, T, Vanhaudenhuyse, A, Vargiolu, A, Vega, E, Verheyden, J, Vespa, P, Vik, A, Vilcinis, R, Vizzino, G, Vleggeert-Lankamp, C, Volovici, V, Vulekovic, P, Vamos, Z, Wade, D, Wang, K, Wang, L, Wildschut, E, Williams, G, Willumsen, L, Wilson, A, Wilson, L, Winkler, M, Ylen, P, Younsi, A, Zaaroor, M, Zhang, Z, Zheng, Z, Zumbo, F, De Lange, S, De Ruiter, G, Den Boogert, H, Van Dijck, J, Van Essen, T, Van Heugten, C, Van Der Jagt, M, Van Der Naalt, J, Cnossen M. C., Polinder S., Lingsma H. F., Maas A. I. R., Menon D., Steyerberg E. W., Adams H., Alessandro M., Allanson J., Amrein K., Andaluz N., Andelic N., Andrea N., Andreassen L., Anke A., Antoni A., Ardon H., Audibert G., Auslands K., Azouvi P., Baciu C., Bacon A., Badenes R., Baglin T., Bartels R., Barzo P., Bauerfeind U., Beer R., Belda F. J., Bellander B. -M., Belli A., Bellier R., Benali H., Benard T., Berardino M., Beretta L., Beynon C., Bilotta F., Binder H., Biqiri E., Blaabjerg M., Borgen L. S., Bouzat P., Bragge P., Brazinova A., Brehar F., Brorsson C., Buki A., Bullinger M., Buckova V., Calappi E., Cameron P., Carbayo L. G., Carise E., Carpenter C., Castano-Leon A. M., Causin F., Chevallard G., Chieregato A., Citerio G., Coburn M. C., Coles J., Cooper J. D., Correia M., Covic A., Curry N., Czeiter E., Czosnyka M., Dahyot-Fizelier C., Damas F., Damas P., Dawes H., De Keyser V., Della Corte F., Depreitere B., Ding S., Dippel D., Dizdarevic K., Duliere G. -L., Dzeko A., Eapen G., Engemann H., Ercole A., Esser P., Ezer E., Fabricius M., Feigin V. L., Feng J., Foks K., Fossi F., Francony G., Frantzen J., Freo U., Frisvold S., Furmanov A., Gagliardo P., Galanaud D., Gao G., Geleijns K., Ghuysen A., Giraud B., Glocker B., Gomez P. A., Grossi F., Gruen R. L., Gupta D., Haagsma J. A., Hadzic E., Haitsma I., Hartings J. A., Helbok R., Helseth E., Hertle D., Hill S., Hoedemaekers A., Hoefer S., Hutchinson P. J., Haberg A. K., Jacobs B., Janciak I., Janssens K., Jiang J., Jones K., Kalala J. -P., Kamnitsas K., Karan M., Karau J., Katila A., Kaukonen M., Keeling D., Kerforne T., Ketharanathan N., Kettunen J., Kivisaari R., Kolias A. G., Kolumban B., Kompanje E., Kondziella D., Koskinen L. -O., Kovacs N., Kalovits F., Lagares A., Lanyon L., Laureys S., Lauritzen M., Lecky F., Ledig C., Lefering R., Legrand V., Lei J., Levi L., Lightfoot R., Lingsma H., Loeckx D., Lozano A., Luddington R., Luijten-Arts C., MacDonald S., MacFayden C., Maegele M., Majdan M., Major S., Manara A., Manhes P., Manley G., Martin D., Martino C., Maruenda A., Marechal H., Mastelova D., Mattern J., McMahon C., Melegh B., Menovsky T., Morganti-Kossmann C., Mulazzi D., Mutschler M., Muhlan H., Negru A., Nelson D., Neugebauer E., Newcombe V., Noirhomme Q., Nyiradi J., Oddo M., Oldenbeuving A., Oresic M., Ortolano F., Palotie A., Parizel P. M., Patruno A., Payen J. -F., Perera N., Perlbarg V., Persona P., Peul W., Pichon N., Piilgaard H., Piippo A., Pili F. S., Pirinen M., Ples H., Pomposo I., Psota M., Pullens P., Puybasset L., Ragauskas A., Raj R., Rambadagalla M., Rehorcikova V., Rhodes J., Richardson S., Ripatti S., Rocka S., Rodier N., Roe C., Roise O., Roks G., Romegoux P., Rosand J., Rosenfeld J., Rosenlund C., Rosenthal G., Rossaint R., Rossi S., Rostalski T., Rueckert D. L., Ruiz De Arcaute F., Rusnak M., Sacchi M., Sahakian B., Sahuquillo J., Sakowitz O., Sala F., Sanchez-Pena P., Sanchez-Porras R., Sandor J., Santos E., Sasse N., Sasu L., Savo D., Schipper I., Schlosser B., Schmidt S., Schneider A., Schoechl H., Schoonman G., Schou R. F., Schwendenwein E., Scholl M., Sir O., Skandsen T., Smakman L., Smeets D., Smielewski P., Sorinola A., Stamatakis E. L., Stanworth S., Stegemann K., Steinbuchel N., Stevens R., Stewart W., Stocchetti N., Sundstrom N., Synnot A., Szabo J., Soderberg J., Taccone F. S., Tamas V., Tanskanen P., Tascu A., Taylor M. S., Te Ao B., Tenovuo O., Teodorani G., Theadom A., Thomas M., Tibboel D., Tolias C., Tshibanda J. -F. L., Tudora C. M., Vajkoczy P., Valeinis E., Van Hecke W., Van Praag D., Van Roost D., Van Vlierberghe E., Vande Vyvere T., Vanhaudenhuyse A., Vargiolu A., Vega E., Verheyden J., Vespa P. M., Vik A., Vilcinis R., Vizzino G., Vleggeert-Lankamp C., Volovici V., Vulekovic P., Vamos Z., Wade D., Wang K. K. W., Wang L., Wildschut E., Williams G., Willumsen L., Wilson A., Wilson L., Winkler M. K. L., Ylen P., Younsi A., Zaaroor M., Zhang Z., Zheng Z., Zumbo F., De Lange S., De Ruiter G. C. W., Den Boogert H., Van Dijck J., Van Essen T. A., Van Heugten C., Van Der Jagt M., and Van Der Naalt J.

Abstract

Introduction: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Methods: We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. Results: All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. Conclusion: Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches.

Published
2016

4. Variation in structure and process of care in traumatic brain injury: Provider profiles of European Neurotrauma Centers participating in the CENTER-TBI study

Author

Cnossen, M.C. (Maryse), Polinder, S. (Suzanne), Lingsma, H.F. (Hester F.), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Steyerberg, E.W. (Ewout), Adams, H. (Hadie), Alessandro, M. (Masala), Allanson, J.E. (Judith), Amrein, K. (Krisztina), Andaluz, N. (Norberto), Andelic, N. (Nada), Andrea, N. (Nanni), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Ardon, H. (Hilko), Audibert, G. (Gérard), Auslands, K. (Kaspars), Azouvi, P. (Philippe), Baciu, C. (Camelia), Bacon, A. (Andrew), Badenes, R. (Rafael), Baglin, T. (Trevor), Bartels, R. (Ronald), Barzó, P. (Pál), Bauerfeind, U. (Ursula), Beer, R. (Ronny), Belda, F.J. (Francisco Javier), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Bellier, R. (Rémy), Benali, H. (Habib), Benard, T. (Thierry), Berardino, M. (Maurizio), Beretta, L. (Luigi), Beynon, C. (Christopher), Bilotta, F. (Federico), Binder, H. (Harald), Biqiri, E. (Erta), Blaabjerg, M. (Morten), Borgen, L.S. (Lund Stine), Bouzat, P. (Pierre), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brehar, F. (Felix), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Bučková, V. (Veronika), Calappi, E. (Emiliana), Cameron, P. (Peter), Carbayo, L.G. (Lozano Guillermo), Carise, E. (Elsa), Carpenter, C., Castaño-León, A.M. (Ana M.), Causin, F. (Francesco), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Damas, F. (François), Damas, P. (Pierre), Dawes, H. (Helen), De Keyser, V. (Véronique), Della Corte, F. (Francesco), Depreitere, B. (Bart), Ding, S. (Shenghao), Dippel, D.W.J. (Diederik), Dizdarevic, K. (Kemal), Dulière, G.-L. (Guy-Loup), Dzeko, A. (Adelaida), Eapen, G. (George), Engemann, H. (Heiko), Ercole, A. (Ari), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (V.), Feng, J. (Junfeng), Foks, K. (Kelly), Fossi, F. (Francesca), Francony, G. (Gilles), Frantzén, J. (Janek), Freo, U. (Ulderico), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gao, G. (Guoyi), Geleijns, K. (Karin), Ghuysen, A. (Alexandre), Giraud, B. (Benoit), Glocker, B. (Ben), Gomez, P.A. (Pedro A.), Grossi, F. (Francesca), Gruen, R.L. (Russell), Gupta, D. (Deepak), Haagsma, J.A. (Juanita), Hadzic, E. (Ermin), Haitsma, I. (Iain), Hartings, J.A. (Jed), Helbok, R. (Raimund), Helseth, E. (Eirik), Hertle, D. (Daniel), Hill, S. (Sean), Hoedemaekers, A. (Astrid), Hoefer, S. (Stefan), Hutchinson, P.J. (Peter J.), Håberg, A.K. (Asta Kristine), Jacobs, B.C. (Bart), Janciak, I. (Ivan), Janssens, K. (Koen), Jiang, J.-Y. (Ji-Yao), Jones, K. (Kelly), Kalala, J.-P. (Jean-Pierre), Kamnitsas, K. (Konstantinos), Karan, M. (Mladen), Karau, J. (Jana), Katila, A. (Ari), Kaukonen, M. (Maija), Keeling, D. (David), Kerforne, T. (Thomas), Ketharanathan, N. (Naomi), Kettunen, J. (Johannes), Kivisaari, R. (Riku), Kolias, A.G. (Angelos G.), Kolumbán, B. (Bálint), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kalovits, F. (Ferenc), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lauritzen, M. (Martin), Lecky, F.E. (Fiona), Ledig, C. (Christian), Lefering, R., Legrand, V. (Valerie), Lei, J. (Jin), Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H.F. (Hester), Loeckx, D. (Dirk), Lozano, A. (Angels), Luddington, R. (Roger), Luijten-Arts, C. (Chantal), MacDonald, S. (Stephen), MacFayden, C. (Charles), Maegele, M. (Marc), Majdan, M. (Marek), Major, S. (Sebastian), Manara, A. (Alex), Manhes, P. (Pauline), Manley, G. (Geoffrey), Martin, D. (Didier), Martino, C. (Costanza), Maruenda, A. (Armando), Maréchal, H. (Hugues), Mastelova, D. (Dagmara), Mattern, J. (Julia), McMahon, C. (Catherine), Melegh, B. (Béla), Menovsky, T. (Tomas), Morganti-Kossmann, C. (Cristina), Mulazzi, D. (Davide), Mutschler, M. (Manuel), Mühlan, H. (Holger), Negru, A. (Ancuta), Nelson, D. (David), Neugebauer, E. (Eddy), Newcombe, V.F. (Virginia F.), Noirhomme, Q. (Quentin), Nyirádi, J. (József), Oddo, M. (Mauro), Oldenbeuving, A. (Annemarie), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Patruno, A. (Adriana), Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Pichon, N. (Nicolas), Piilgaard, H. (Henning), Piippo, A. (Anna), Pili, F.S. (Floury Sébastien), Pirinen, M. (Matti), Ples, H. (Horia), Pomposo, I. (Inigo), Psota, M. (Marek), Pullens, P. (Pim), Puybasset, L. (Louis), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Rehorčíková, V. (Veronika), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Ripatti, S. (Samuli), Rocka, S. (Saulius), Rodier, N. (Nicolas), Roe, C. (Cecilie), Roise, O. (Olav), Roks, G. (Gerwin), Romegoux, P. (Pauline), Rosand, J. (Jonathan), Rosenfeld, J. (Jeffrey), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rostalski, T. (Tim), Rueckert, D.L. (Danie L.), Ruiz De Arcaute, F. (Felix), Rusnák, M. (Martin), Sacchi, M. (Marco), Sahakian, B. (Barbara), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sala, F. (Francesca), Sanchez-Pena, P. (Paola), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Santos, E. (Edgar), Sasse, N. (Nadine), Sasu, L. (Luminita), Savo, D. (Davide), Schipper, I.B. (Inger), Schlößer, B. (Barbara), Schmidt, S. (Silke), Schneider, A. (Annette), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Schöll, M. (Michael), Sir, O. (Özcan), Skandsen, T. (Toril), Smakman, L. (Lidwien), Smeets, D. (Dirk), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E.L. (Emmanue L.), Stanworth, S. (Simon), Stegemann, K. (Katrin), Steinbüchel, N. (Nicole), Stevens, R. (Robert), Stewart, W. (William), Stocchetti, N. (Nino), Sundström, N. (Nina), Synnot, A. (Anneliese), Szabó, J. (József), Söderberg, J. (Jeannette), Taccone, F.S. (Fabio), Tamás, V. (Viktória), Tanskanen, P. (Päivi), Tascu, A. (Alexandru), Taylor, M.S. (Mark Steven), Te Ao, B. (Braden), Tenovuo, O. (Olli), Teodorani, G. (Guido), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Tolias, C.M. (Christos M.), Tshibanda, J.-F.L. (Jean-Flory Luaba), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Valeinis, E. (Egils), Hecke, W. (Wim) van, Van Praag, D. (Dominique), Van Roost, D. (Dirk), Van Vlierberghe, E. (Eline), Vande Vyvere, T. (Thijs), Vanhaudenhuyse, A. (Audrey), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Vizzino, G. (Giacinta), Vleggeert-Lankamp, C.L.A.M. (Carmen), Volovici, V. (Victor), Vulekovic, P. (Peter), Vámos, Z. (Zoltán), Wade, D. (Derick), Wang, K.K.W. (Kevin K.W.), Wang, L. (Lei), Wildschut, E. (Eno), Williams, G. (Guy), Willumsen, L. (Lisette), Wilson, A. (Adam), Wilson, L. (Lindsay), Winkler, M.K.L. (Maren K. L.), Ylén, P. (Peter), Younsi, A. (Alexander), Zaaroor, M. (Menashe), Zhang, Z. (Zhiqun), Zheng, Z. (Zelong), Zumbo, F. (Fabrizio), De Lange, S. (Stefanie), De Ruiter, G.C.W. (Godard C.W.), Den Boogert, H. (Hugo), Van Dijck, J. (Jeroen), Essen, T.A. (T.) van, van Heugten, C.M. (Caroline M.), Jagt, M. (Mathieu) van der, Naalt, J. (Joukje) van der, Cnossen, M.C. (Maryse), Polinder, S. (Suzanne), Lingsma, H.F. (Hester F.), Maas, A.I.R. (Andrew), Menon, D.K. (David ), Steyerberg, E.W. (Ewout), Adams, H. (Hadie), Alessandro, M. (Masala), Allanson, J.E. (Judith), Amrein, K. (Krisztina), Andaluz, N. (Norberto), Andelic, N. (Nada), Andrea, N. (Nanni), Andreassen, L. (Lasse), Anke, A. (Audny), Antoni, A. (Anna), Ardon, H. (Hilko), Audibert, G. (Gérard), Auslands, K. (Kaspars), Azouvi, P. (Philippe), Baciu, C. (Camelia), Bacon, A. (Andrew), Badenes, R. (Rafael), Baglin, T. (Trevor), Bartels, R. (Ronald), Barzó, P. (Pál), Bauerfeind, U. (Ursula), Beer, R. (Ronny), Belda, F.J. (Francisco Javier), Bellander, B.-M. (Bo-Michael), Belli, A. (Antonio), Bellier, R. (Rémy), Benali, H. (Habib), Benard, T. (Thierry), Berardino, M. (Maurizio), Beretta, L. (Luigi), Beynon, C. (Christopher), Bilotta, F. (Federico), Binder, H. (Harald), Biqiri, E. (Erta), Blaabjerg, M. (Morten), Borgen, L.S. (Lund Stine), Bouzat, P. (Pierre), Bragge, P. (Peter), Brazinova, A. (Alexandra), Brehar, F. (Felix), Brorsson, C. (Camilla), Buki, A. (Andras), Bullinger, M. (Monika), Bučková, V. (Veronika), Calappi, E. (Emiliana), Cameron, P. (Peter), Carbayo, L.G. (Lozano Guillermo), Carise, E. (Elsa), Carpenter, C., Castaño-León, A.M. (Ana M.), Causin, F. (Francesco), Chevallard, G. (Giorgio), Chieregato, A. (Arturo), Citerio, G. (Giuseppe), Coburn, M. (Mark), Coles, J.P. (Jonathan P.), Cooper, J.D. (Jamie D.), Correia, M. (Marta), Covic, A. (Amra), Curry, N. (Nicola), Czeiter, E. (Endre), Czosnyka, M. (Marek), Dahyot-Fizelier, C. (Claire), Damas, F. (François), Damas, P. (Pierre), Dawes, H. (Helen), De Keyser, V. (Véronique), Della Corte, F. (Francesco), Depreitere, B. (Bart), Ding, S. (Shenghao), Dippel, D.W.J. (Diederik), Dizdarevic, K. (Kemal), Dulière, G.-L. (Guy-Loup), Dzeko, A. (Adelaida), Eapen, G. (George), Engemann, H. (Heiko), Ercole, A. (Ari), Esser, P. (Patrick), Ezer, E. (Erzsébet), Fabricius, M. (Martin), Feigin, V.L. (V.), Feng, J. (Junfeng), Foks, K. (Kelly), Fossi, F. (Francesca), Francony, G. (Gilles), Frantzén, J. (Janek), Freo, U. (Ulderico), Frisvold, S.K. (Shirin Kordasti), Furmanov, A. (Alex), Gagliardo, P. (Pablo), Galanaud, D. (Damien), Gao, G. (Guoyi), Geleijns, K. (Karin), Ghuysen, A. (Alexandre), Giraud, B. (Benoit), Glocker, B. (Ben), Gomez, P.A. (Pedro A.), Grossi, F. (Francesca), Gruen, R.L. (Russell), Gupta, D. (Deepak), Haagsma, J.A. (Juanita), Hadzic, E. (Ermin), Haitsma, I. (Iain), Hartings, J.A. (Jed), Helbok, R. (Raimund), Helseth, E. (Eirik), Hertle, D. (Daniel), Hill, S. (Sean), Hoedemaekers, A. (Astrid), Hoefer, S. (Stefan), Hutchinson, P.J. (Peter J.), Håberg, A.K. (Asta Kristine), Jacobs, B.C. (Bart), Janciak, I. (Ivan), Janssens, K. (Koen), Jiang, J.-Y. (Ji-Yao), Jones, K. (Kelly), Kalala, J.-P. (Jean-Pierre), Kamnitsas, K. (Konstantinos), Karan, M. (Mladen), Karau, J. (Jana), Katila, A. (Ari), Kaukonen, M. (Maija), Keeling, D. (David), Kerforne, T. (Thomas), Ketharanathan, N. (Naomi), Kettunen, J. (Johannes), Kivisaari, R. (Riku), Kolias, A.G. (Angelos G.), Kolumbán, B. (Bálint), Kompanje, E.J.O. (Erwin), Kondziella, D. (Daniel), Koskinen, L.-O. (Lars-Owe), Kovács, N. (Noémi), Kalovits, F. (Ferenc), Lagares, A. (Alfonso), Lanyon, L. (Linda), Laureys, S. (Steven), Lauritzen, M. (Martin), Lecky, F.E. (Fiona), Ledig, C. (Christian), Lefering, R., Legrand, V. (Valerie), Lei, J. (Jin), Levi, L. (Leon), Lightfoot, R. (Roger), Lingsma, H.F. (Hester), Loeckx, D. (Dirk), Lozano, A. (Angels), Luddington, R. (Roger), Luijten-Arts, C. (Chantal), MacDonald, S. (Stephen), MacFayden, C. (Charles), Maegele, M. (Marc), Majdan, M. (Marek), Major, S. (Sebastian), Manara, A. (Alex), Manhes, P. (Pauline), Manley, G. (Geoffrey), Martin, D. (Didier), Martino, C. (Costanza), Maruenda, A. (Armando), Maréchal, H. (Hugues), Mastelova, D. (Dagmara), Mattern, J. (Julia), McMahon, C. (Catherine), Melegh, B. (Béla), Menovsky, T. (Tomas), Morganti-Kossmann, C. (Cristina), Mulazzi, D. (Davide), Mutschler, M. (Manuel), Mühlan, H. (Holger), Negru, A. (Ancuta), Nelson, D. (David), Neugebauer, E. (Eddy), Newcombe, V.F. (Virginia F.), Noirhomme, Q. (Quentin), Nyirádi, J. (József), Oddo, M. (Mauro), Oldenbeuving, A. (Annemarie), Oresic, M. (Matej), Ortolano, F. (Fabrizio), Palotie, A. (Aarno), Parizel, P.M., Patruno, A. (Adriana), Payen, J.-F. (Jean-François), Perera, N. (Natascha), Perlbarg, V. (Vincent), Persona, P. (Paolo), Peul, W.C. (Wilco), Pichon, N. (Nicolas), Piilgaard, H. (Henning), Piippo, A. (Anna), Pili, F.S. (Floury Sébastien), Pirinen, M. (Matti), Ples, H. (Horia), Pomposo, I. (Inigo), Psota, M. (Marek), Pullens, P. (Pim), Puybasset, L. (Louis), Ragauskas, A. (Arminas), Raj, R. (Rahul), Rambadagalla, M. (Malinka), Rehorčíková, V. (Veronika), Rhodes, J.K.J. (Jonathan K.J.), Richardson, S. (Sylvia), Ripatti, S. (Samuli), Rocka, S. (Saulius), Rodier, N. (Nicolas), Roe, C. (Cecilie), Roise, O. (Olav), Roks, G. (Gerwin), Romegoux, P. (Pauline), Rosand, J. (Jonathan), Rosenfeld, J. (Jeffrey), Rosenlund, C. (Christina), Rosenthal, G. (Guy), Rossaint, R. (Rolf), Rossi, S. (Sandra), Rostalski, T. (Tim), Rueckert, D.L. (Danie L.), Ruiz De Arcaute, F. (Felix), Rusnák, M. (Martin), Sacchi, M. (Marco), Sahakian, B. (Barbara), Sahuquillo, J. (Juan), Sakowitz, O. (Oliver), Sala, F. (Francesca), Sanchez-Pena, P. (Paola), Sanchez-Porras, R. (Renan), Sandor, J. (Janos), Santos, E. (Edgar), Sasse, N. (Nadine), Sasu, L. (Luminita), Savo, D. (Davide), Schipper, I.B. (Inger), Schlößer, B. (Barbara), Schmidt, S. (Silke), Schneider, A. (Annette), Schoechl, H. (Herbert), Schoonman, G.G. (Guus), Schou, R. (Rico), Schwendenwein, E. (Elisabeth), Schöll, M. (Michael), Sir, O. (Özcan), Skandsen, T. (Toril), Smakman, L. (Lidwien), Smeets, D. (Dirk), Smielewski, P. (Peter), Sorinola, A. (Abayomi), Stamatakis, E.L. (Emmanue L.), Stanworth, S. (Simon), Stegemann, K. (Katrin), Steinbüchel, N. (Nicole), Stevens, R. (Robert), Stewart, W. (William), Stocchetti, N. (Nino), Sundström, N. (Nina), Synnot, A. (Anneliese), Szabó, J. (József), Söderberg, J. (Jeannette), Taccone, F.S. (Fabio), Tamás, V. (Viktória), Tanskanen, P. (Päivi), Tascu, A. (Alexandru), Taylor, M.S. (Mark Steven), Te Ao, B. (Braden), Tenovuo, O. (Olli), Teodorani, G. (Guido), Theadom, A. (Alice), Thomas, M. (Matt), Tibboel, D. (Dick), Tolias, C.M. (Christos M.), Tshibanda, J.-F.L. (Jean-Flory Luaba), Tudora, C.M. (Cristina Maria), Vajkoczy, P. (Peter), Valeinis, E. (Egils), Hecke, W. (Wim) van, Van Praag, D. (Dominique), Van Roost, D. (Dirk), Van Vlierberghe, E. (Eline), Vande Vyvere, T. (Thijs), Vanhaudenhuyse, A. (Audrey), Vargiolu, A. (Alessia), Vega, E. (Emmanuel), Verheyden, J. (Jan), Vespa, P.M. (Paul M.), Vik, A. (Anne), Vilcinis, R. (Rimantas), Vizzino, G. (Giacinta), Vleggeert-Lankamp, C.L.A.M. (Carmen), Volovici, V. (Victor), Vulekovic, P. (Peter), Vámos, Z. (Zoltán), Wade, D. (Derick), Wang, K.K.W. (Kevin K.W.), Wang, L. (Lei), Wildschut, E. (Eno), Williams, G. (Guy), Willumsen, L. (Lisette), Wilson, A. (Adam), Wilson, L. (Lindsay), Winkler, M.K.L. (Maren K. L.), Ylén, P. (Peter), Younsi, A. (Alexander), Zaaroor, M. (Menashe), Zhang, Z. (Zhiqun), Zheng, Z. (Zelong), Zumbo, F. (Fabrizio), De Lange, S. (Stefanie), De Ruiter, G.C.W. (Godard C.W.), Den Boogert, H. (Hugo), Van Dijck, J. (Jeroen), Essen, T.A. (T.) van, van Heugten, C.M. (Caroline M.), Jagt, M. (Mathieu) van der, and Naalt, J. (Joukje) van der

Abstract

Introduction: The strength of evidence underpinning care and treatment recommendations in traumatic brain injury (TBI) is low. Comparative effectiveness research (CER) has been proposed as a framework to provide evidence for optimal care for TBI patients. The first step in CER is to map the existing variation. The aim of current study is to quantify variation in general structural and process characteristics among centers participating in the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Methods: We designed a set of 11 provider profiling questionnaires with 321 questions about various aspects of TBI care, chosen based on literature and expert opinion. After pilot testing, questionnaires were disseminated to 71 centers from 20 countries participating in the CENTER-TBI study. Reliability of questionnaires was estimated by calculating a concordance rate among 5% duplicate questions. Results: All 71 centers completed the questionnaires. Median concordance rate among duplicate questions was 0.85. The majority of centers were academic hospitals (n = 65, 92%), designated as a level I trauma center (n = 48, 68%) and situated in an urban location (n = 70, 99%). The availability of facilities for neuro-trauma care varied across centers; e.g. 40 (57%) had a dedicated neuro-intensive care unit (ICU), 36 (51%) had an in-hospital rehabilitation unit and the organization of the ICU was closed in 64% (n = 45) of the centers. In addition, we found wide variation in processes of care, such as the ICU admission policy and intracranial pressure monitoring policy among centers. Conclusion: Even among high-volume, specialized neurotrauma centers there is substantial variation in structures and processes of TBI care. This variation provides an opportunity to study effectiveness of specific aspects of TBI care and to identify best practices with CER approaches.

Published
2016
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5. Variation in monitoring and treatment policies for intracranial hypertension in traumatic brain injury

Author

Cnossen, Maryse C., Huijben, Jilske A., van der Jagt, Mathieu, Volovici, Victor, van Essen, Thomas, Polinder, Suzanne, Nelson, David, Ercole, Ari, Stocchetti, Nino, Citerio, Giuseppe, Peul, Wilco C., Maas, Andrew I. R., Menon, David, Steyerberg, Ewout W., Lingsma, Hester F., Adams, Hadie, Alessandro, Masala, Allanson, Judith, Amrein, Krisztina, Andaluz, Norberto, Andelic, Nada, Andrea, Nanni, Andreassen, Lasse, Anke, Audny, Antoni, Anna, Ardon, Hilko, Audibert, Gérard, Auslands, Kaspars, Azouvi, Philippe, Baciu, Camelia, Bacon, Andrew, Badenes, Rafael, Baglin, Trevor, Bartels, Ronald, Barzó, Pál, Bauerfeind, Ursula, Beer, Ronny, Belda, Francisco Javier, Bellander, Bo-Michael, Belli, Antonio, Bellier, Rémy, Benali, Habib, Benard, Thierry, Berardino, Maurizio, Beretta, Luigi, Beynon, Christopher, Bilotta, Federico, Binder, Harald, Biqiri, Erta, Blaabjerg, Morten, Lund, Stine Borgen, Bouzat, Pierre, Bragge, Peter, Brazinova, Alexandra, Brehar, Felix, Brorsson, Camilla, Buki, Andras, Bullinger, Monika, Bucková, Veronika, Calappi, Emiliana, Cameron, Peter, Carbayo, Lozano Guillermo, Carise, Elsa, Carpenter, Keri, Castaño-León, Ana M., Causin, Francesco, Chevallard, Giorgio, Chieregato, Arturo, Cooper, M., Coburn, Mark, Coles, Jonathan, Cooper, Jamie D., Correia, Marta, Covic, Amra, Curry, Nicola, Czeiter, Endre, Czosnyka, Marek, Dahyot-Fizelier, Claire, Damas, François, Damas, Pierre, Dawes, Helen, De Keyser, Véronique, Corte, Francesco Della, Depreitere, Bart, Ding, Shenghao, Dippel, Diederik, Dizdarevic, Kemal, Dulière, Guy-Loup, Dzeko, Adelaida, Eapen, George, Engemann, Heiko, Esser, Patrick, Ezer, Erzsébet, Fabricius, Martin, Feigin, Valery L., Feng, Junfeng, Foks, Kelly, Fossi, Francesca, Francony, Gilles, Frantzén, Janek, Freo, Ulderico, Frisvold, Shirin, Furmanov, Alex, Gagliardo, Pablo, Galanaud, Damien, Gao, Guoyi, Geleijns, Karin, Ghuysen, Alexandre, Giraud, Benoit, Glocker, Ben, Gomez, Pedro A., Grossi, Francesca, Gruen, Russell L., Gupta, Deepak, Haagsma, Juanita A., Hadzic, Ermin, Haitsma, Iain, Hartings, Jed A., Helbok, Raimund, Helseth, Eirik, Hertle, Daniel, Hill, Sean, Hoedemaekers, Astrid, Hoefer, Stefan, Hutchinson, Peter J., Håberg, Kristine Asta, Jacobs, Bram, Janciak, Ivan, Janssens, Koen, Jiang, Ji-Yao, Jones, Kelly, Kalala, Jean-Pierre, Kamnitsas, Konstantinos, Karan, Mladen, Karau, Jana, Katila, Ari, Kaukonen, Maija, Keeling, David, Kerforne, Thomas, Ketharanathan, Naomi, Kettunen, Johannes, Kivisaari, Riku, Kolias, Angelos G., Kolumbán, Bálint, Kompanje, Erwin, Kondziella, Daniel, Koskinen, Lars-Owe, Kovács, Noémi, Kálovits, Ferenc, Lagares, Alfonso, Lanyon, Linda, Laureys, Steven, Lauritzen, Martin, Lecky, Fiona, Ledig, Christian, Lefering, Rolf, Legrand, Valerie, Lei, Jin, Levi, Leon, Lightfoot, Roger, Loeckx, Dirk, Lozano, Angels, Luddington, Roger, Luijten-Arts, Chantal, Macdonald, Stephen, Macfayden, Charles, Maegele, Marc, Majdan, Marek, Major, Sebastian, Manara, Alex, Manhes, Pauline, Manley, Geoffrey, Martin, Didier, Martino, Costanza, Maruenda, Armando, Maréchal, Hugues, Mastelova, Dagmara, Mattern, Julia, Mcmahon, Catherine, Melegh, Béla, Menovsky, Tomas, Morganti-Kossmann, Cristina, Mulazzi, Davide, Mutschler, Manuel, Mühlan, Holger, Negru, Ancuta, Neugebauer, Eddy, Newcombe, Virginia, Noirhomme, Quentin, Nyirádi, József, Oddo, Mauro, Oldenbeuving, Annemarie, Oresic, Matej, Ortolano, Fabrizio, Palotie, Aarno, Parizel, Paul M., Patruno, Adriana, Payen, Jean-François, Perera, Natascha, Perlbarg, Vincent, Persona, Paolo, Pichon, Nicolas, Piilgaard, Henning, Piippo, Anna, Floury, Sébastien Pili, Pirinen, Matti, Ples, Horia, Pomposo, Inigo, Psota, Marek, Pullens, Pim, Puybasset, Louis, Ragauskas, Arminas, Raj, Rahul, Rambadagalla, Malinka, Rehorcíková, Veronika, Rhodes, Jonathan, Richardson, Sylvia, Ripatti, Samuli, Rocka, Saulius, Rodier, Nicolas, Roe, Cecilie, Roise, Olav, Roks, Gerwin, Romegoux, Pauline, Rosand, Jonathan, Rosenfeld, Jeffrey, Rosenlund, Christina, Rosenthal, Guy, Rossaint, Rolf, Rossi, Sandra, Rostalski, Tim, Rueckert, Daniel, de Ruiz, Arcaute Felix, Rusnák, Martin, Sacchi, Marco, Sahakian, Barbara, Sahuquillo, Juan, Sakowitz, Oliver, Sala, Francesca, Sanchez-Pena, Paola, Sanchez-Porras, Renan, Sandor, Janos, Santos, Edgar, Sasse, Nadine, Sasu, Luminita, Savo, Davide, Schipper, Inger, Schlößer, Barbara, Schmidt, Silke, Schneider, Annette, Schoechl, Herbert, Schoonman, Guus, Rico, Frederik Schou, Schwendenwein, Elisabeth, Schöll, Michael, Sir, Özcan, Skandsen, Toril, Smakman, Lidwien, Smeets, Dirk, Smielewski, Peter, Sorinola, Abayomi, Stamatakis, Emmanuel, Stanworth, Simon, Stegemann, Katrin, Steinbüchel, Nicole, Stevens, Robert, Stewart, William, Sundström, Nina, Synnot, Anneliese, Szabó, József, Söderberg, Jeannette, Taccone, Fabio Silvio, Tamás, Viktória, Tanskanen, Päivi, Tascu, Alexandru, Taylor, Mark Steven, Ao Braden, Te, Tenovuo, Olli, Teodorani, Guido, Theadom, Alice, Thomas, Matt, Tibboel, Dick, Tolias, Christos, Tshibanda, Jean-Flory Luaba, Tudora, Cristina Maria, Vajkoczy, Peter, Valeinis, Egils, Hecke, Wim Van, Praag, Dominique Van, Dirk, Van Roost, Vlierberghe, Eline Van, Vyvere, Thijs vande, Vanhaudenhuyse, Audrey, Vargiolu, Alessia, Vega, Emmanuel, Verheyden, Jan, Vespa, Paul M., Vik, Anne, Vilcinis, Rimantas, Vizzino, Giacinta, Vleggeert-Lankamp, Carmen, Vulekovic, Peter, Vámos, Zoltán, Wade, Derick, Wang, Kevin K. W., Wang, Lei, Wildschut, Eno, Williams, Guy, Willumsen, Lisette, Wilson, Adam, Wilson, Lindsay, Winkler, Maren K. L., Ylén, Peter, Younsi, Alexander, Zaaroor, Menashe, Zhang, Zhiqun, Zheng, Zelong, Zumbo, Fabrizio, de Lange, Stefanie, de Ruiter, Godard C. W., den Boogert, Hugo, van Dijck, Jeroen, van Heugten, Caroline, van der Naalt, Joukje, Cnossen, Maryse C., Huijben, Jilske A., Van der Jagt, Mathieu, Volovici, Victor, Van Essen, Thoma, Polinder, Suzanne, Nelson, David, Ercole, Ari, Stocchetti, Nino, Citerio, Giuseppe, Peul, Wilco C., Maas, Andrew I. R., Menon, David, Steyerberg, Ewout W., Lingsma, Hester F., on behalf of the CENTER-TBI, Investigator, Beretta, Luigi, Cnossen, M, Huijben, J, van der Jagt, M, Volovici, V, van Essen, T, Polinder, S, Nelson, D, Ercole, A, Stocchetti, N, Citerio, G, Peul, W, Maas, A, Menon, D, Steyerberg, E, Lingsma, H, Molecular Neuroscience and Ageing Research (MOLAR), Psychiatrie & Neuropsychologie, RS: MHeNs - R1 - Cognitive Neuropsychiatry and Clinical Neuroscience, Commission of the European Communities, CENTER-TBI Investigators, Medical Informatics, Public and occupational health, Ragauskas, Arminas, Ročka, Saulius, Vilcinis, Rimantas, Public Health, Intensive Care, Neurosurgery, CENTER-TBI investigators, Adams, H., Alessandro, M., Allanson, J., Amrein, K., Andaluz, N., Andelic, N., Andrea, N., Andreassen, L., Anke, A., Antoni, A., Ardon, H., Audibert, G., Auslands, K., Azouvi, P., Baciu, C., Bacon, A., Badenes, R., Baglin, T., Bartels, R., Barzó, P., Bauerfeind, U., Beer, R., Belda, F.J., Bellander, B.M., Belli, A., Bellier, R., Benali, H., Benard, T., Berardino, M., Beretta, L., Beynon, C., Bilotta, F., Binder, H., Biqiri, E., Blaabjerg, M., Borgen, L.S., Bouzat, P., Bragge, P., Brazinova, A., Brehar, F., Brorsson, C., Buki, A., Bullinger, M., Bučková, V., Calappi, E., Cameron, P., Lozano, G.C., Carise, E., Carpenter, K., Castaño-León, A.M., Causin, F., Chevallard, G., Chieregato, A., Citerio, G., Cnossen, M., Coburn, M., Coles, J., Cooper, J.D., Correia, M., Covic, A., Curry, N., Czeiter, E., Czosnyka, M., Dahyot-Fizelier, C., Damas, F., Damas, P., Dawes, H., De Keyser, V., Corte, F.D., Depreitere, B., Ding, S., Dippel, D., Dizdarevic, K., Dulière, G.L., Dzeko, A., Eapen, G., Engemann, H., Ercole, A., Esser, P., Ezer, E., Fabricius, M., Feigin, V.L., Feng, J., Foks, K., Fossi, F., Francony, G., Frantzén, J., Freo, U., Frisvold, S., Furmanov, A., Gagliardo, P., Galanaud, D., Gao, G., Geleijns, K., Ghuysen, A., Giraud, B., Glocker, B., Gomez, P.A., Grossi, F., Gruen, R.L., Gupta, D., Haagsma, J.A., Hadzic, E., Haitsma, I., Hartings, J.A., Helbok, R., Helseth, E., Hertle, D., Hill, S., Hoedemaekers, A., Hoefer, S., Hutchinson, P.J., Håberg, A.K., Jacobs, B., Janciak, I., Janssens, K., Jiang, J.Y., Jones, K., Kalala, J.P., Kamnitsas, K., Karan, M., Karau, J., Katila, A., Kaukonen, M., Keeling, D., Kerforne, T., Ketharanathan, N., Kettunen, J., Kivisaari, R., Kolias, A.G., Kolumbán, B., Kompanje, E., Kondziella, D., Koskinen, L.O., Kovács, N., Kálovits, F., Lagares, A., Lanyon, L., Laureys, S., Lauritzen, M., Lecky, F., Ledig, C., Lefering, R., Legrand, V., Lei, J., Levi, L., Lightfoot, R., Lingsma, H., Loeckx, D., Lozano, A., Luddington, R., Luijten-Arts, C., Andrew, IRM, MacDonald, S., MacFayden, C., Maegele, M., Majdan, M., Major, S., Manara, A., Manhes, P., Manley, G., Martin, D., Martino, C., Maruenda, A., Maréchal, H., Mastelova, D., Mattern, J., McMahon, C., Melegh, B., Menon, D., Menovsky, T., Morganti-Kossmann, C., Mulazzi, D., Mutschler, M., Mühlan, H., Negru, A., Nelson, D., Neugebauer, E., Newcombe, V., Noirhomme, Q., Nyirádi, J., Oddo, M., Oldenbeuving, A., Oresic, M., Ortolano, F., Palotie, A., Parizel, P.M., Patruno, A., Payen, J.F., Perera, N., Perlbarg, V., Persona, P., Peul, W., Pichon, N., Piilgaard, H., Piippo, A., Floury, S.P., Pirinen, M., Ples, H., Polinder, S., Pomposo, I., Psota, M., Pullens, P., Puybasset, L., Ragauskas, A., Raj, R., Rambadagalla, M., Rehorčíková, V., Rhodes, J., Richardson, S., Ripatti, S., Rocka, S., Rodier, N., Roe, C., Roise, O., Roks, G., Romegoux, P., Rosand, J., Rosenfeld, J., Rosenlund, C., Rosenthal, G., Rossaint, R., Rossi, S., Rostalski, T., Rueckert, D., de Arcaute, F.R., Rusnák, M., Sacchi, M., Sahakian, B., Sahuquillo, J., Sakowitz, O., Sala, F., Sanchez-Pena, P., Sanchez-Porras, R., Sandor, J., Santos, E., Sasse, N., Sasu, L., Savo, D., Schipper, I., Schlößer, B., Schmidt, S., Schneider, A., Schoechl, H., Schoonman, G., Schou, R.F., Schwendenwein, E., Schöll, M., Sir, Ö., Skandsen, T., Smakman, L., Smeets, D., Smielewski, P., Sorinola, A., Stamatakis, E., Stanworth, S., Stegemann, K., Steinbüchel, N., Stevens, R., Stewart, W., Steyerberg, E.W., Stocchetti, N., Sundström, N., Synnot, A., Szabó, J., Söderberg, J., Taccone, F.S., Tamás, V., Tanskanen, P., Tascu, A., Taylor, M.S., Te Ao, B., Tenovuo, O., Teodorani, G., Theadom, A., Thomas, M., Tibboel, D., Tolias, C., Tshibanda, J.L., Tudora, C.M., Vajkoczy, P., Valeinis, E., Van Hecke, W., Van Praag, D., Van Roost, D., Van Vlierberghe, E., Vyvere, T.V., Vanhaudenhuyse, A., Vargiolu, A., Vega, E., Verheyden, J., Vespa, P.M., Vik, A., Vilcinis, R., Vizzino, G., Vleggeert-Lankamp, C., Volovici, V., Vulekovic, P., Vámos, Z., Wade, D., Wang, KKW, Wang, L., Wildschut, E., Williams, G., Willumsen, L., Wilson, A., Wilson, L., Winkler, MKL, Ylén, P., Younsi, A., Zaaroor, M., Zhang, Z., Zheng, Z., Zumbo, F., de Lange, S., de Ruiter, GCW, den Boogert, H., van Dijck, J., van Essen, T.A., van Heugten, C., van der Jagt, M., van der Naalt, J., Rocka, Saulius, „Springer' grupė, Apollo - University of Cambridge Repository, Centre of Excellence in Complex Disease Genetics, Department of Mathematics and Statistics, Institute for Molecular Medicine Finland, Biostatistics Helsinki, Aarno Palotie / Principal Investigator, University of Helsinki, Neurokirurgian yksikkö, Clinicum, Samuli Olli Ripatti / Principal Investigator, Complex Disease Genetics, Genomics of Neurological and Neuropsychiatric Disorders, and Statistical and population genetics

Subjects
Neurology, Letter, IMPACT, Critical Care and Intensive Care Medicine, Intracranial hypertension, 0302 clinical medicine, Traumatic brain injury, Clinical Protocols, Trauma Centers, Surveys and Questionnaires, Brain Injuries, Traumatic, Medicine and Health Sciences, Longitudinal Studies, Prospective Studies, Prospective cohort study, Comparative effectiveness research, Survey, Comparative, effectiveness research, Intracranial pressure, Response rate (survey), Medicine (all), Head injury, lcsh:Medical emergencies. Critical care. Intensive care. First aid, 11 Medical And Health Sciences, Orvostudományok, 3. Good health, Europe, Neurosurgery, medicine.medical_specialty, Critical Care, Other Research Radboud Institute for Molecular Life Sciences [Radboudumc 0], PRESSURE, Klinikai orvostudományok, Healthcare improvement science Radboud Institute for Health Sciences [Radboudumc 18], 03 medical and health sciences, ICP, ICU, medicine, MANAGEMENT, Humans, Monitoring, Physiologic, business.industry, MORTALITY, Research, 3112 Neurosciences, HEAD-INJURY, 030208 emergency & critical care medicine, lcsh:RC86-88.9, CARE, medicine.disease, Emergency & Critical Care Medicine, nervous system diseases, traumatic brain injury, comparative effectiveness research, survey, Emergency medicine, Physical therapy, Dentistry (all), MODERATE, Human medicine, business, 030217 neurology & neurosurgery, EUROPEAN-BRAIN
Abstract

Background No definitive evidence exists on how intracranial hypertension should be treated in patients with traumatic brain injury (TBI). It is therefore likely that centers and practitioners individually balance potential benefits and risks of different intracranial pressure (ICP) management strategies, resulting in practice variation. The aim of this study was to examine variation in monitoring and treatment policies for intracranial hypertension in patients with TBI. Methods A 29-item survey on ICP monitoring and treatment was developed on the basis of literature and expert opinion, and it was pilot-tested in 16 centers. The questionnaire was sent to 68 neurotrauma centers participating in the Collaborative European Neurotrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study. Results The survey was completed by 66 centers (97% response rate). Centers were mainly academic hospitals (n = 60, 91%) and designated level I trauma centers (n = 44, 67%). The Brain Trauma Foundation guidelines were used in 49 (74%) centers. Approximately 90% of the participants (n = 58) indicated placing an ICP monitor in patients with severe TBI and computed tomographic abnormalities. There was no consensus on other indications or on peri-insertion precautions. We found wide variation in the use of first- and second-tier treatments for elevated ICP. Approximately half of the centers were classified as using a relatively aggressive approach to ICP monitoring and treatment (n = 32, 48%), whereas the others were considered more conservative (n = 34, 52%). Conclusions Substantial variation was found regarding monitoring and treatment policies in patients with TBI and intracranial hypertension. The results of this survey indicate a lack of consensus between European neurotrauma centers and provide an opportunity and necessity for comparative effectiveness research. Electronic supplementary material The online version of this article (doi:10.1186/s13054-017-1816-9) contains supplementary material, which is available to authorized users.

Published
2017
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6. Neuroinflammation and its relationship to changes in brain volume and white matter lesions in multiple sclerosis.

Author

Datta G, Colasanti A, Rabiner EA, Gunn RN, Malik O, Ciccarelli O, Nicholas R, Van Vlierberghe E, Van Hecke W, Searle G, Santos-Ribeiro A, and Matthews PM

Subjects
Acetamides, Adult, Atrophy, Brain pathology, Carbon Radioisotopes, Female, Humans, Image Processing, Computer-Assisted, Magnetic Resonance Imaging, Male, Microglia, Middle Aged, Organ Size, Positron-Emission Tomography, Pyridines, Receptors, GABA, White Matter pathology, Young Adult, Brain diagnostic imaging, Inflammation diagnostic imaging, Multiple Sclerosis, Chronic Progressive diagnostic imaging, Multiple Sclerosis, Relapsing-Remitting diagnostic imaging, White Matter diagnostic imaging
Abstract

Brain magnetic resonance imaging is an important tool in the diagnosis and monitoring of multiple sclerosis patients. However, magnetic resonance imaging alone provides limited information for predicting an individual patient's disability progression. In part, this is because magnetic resonance imaging lacks sensitivity and specificity for detecting chronic diffuse and multi-focal inflammation mediated by activated microglia/macrophages. The aim of this study was to test for an association between 18 kDa translocator protein brain positron emission tomography signal, which arises largely from microglial activation, and measures of subsequent disease progression in multiple sclerosis patients. Twenty-one patients with multiple sclerosis (seven with secondary progressive disease and 14 with a relapsing remitting disease course) underwent T1- and T2-weighted and magnetization transfer magnetic resonance imaging at baseline and after 1 year. Positron emission tomography scanning with the translocator protein radioligand 11C-PBR28 was performed at baseline. Brain tissue and lesion volumes were segmented from the T1- and T2-weighted magnetic resonance imaging and relative 11C-PBR28 uptake in the normal-appearing white matter was estimated as a distribution volume ratio with respect to a caudate pseudo-reference region. Normal-appearing white matter distribution volume ratio at baseline was correlated with enlarging T2-hyperintense lesion volumes over the subsequent year (ρ = 0.59, P = 0.01). A post hoc analysis showed that this association reflected behaviour in the subgroup of relapsing remitting patients (ρ = 0.74, P = 0.008). By contrast, in the subgroup of secondary progressive patients, microglial activation at baseline was correlated with later progression of brain atrophy (ρ = 0.86, P = 0.04). A regression model including the baseline normal-appearing white matter distribution volume ratio, T2 lesion volume and normal-appearing white matter magnetization transfer ratio for all of the patients combined explained over 90% of the variance in enlarging lesion volume over the subsequent 1 year. Glial activation in white matter assessed by translocator protein PET significantly improves predictions of white matter lesion enlargement in relapsing remitting patients and is associated with greater brain atrophy in secondary progressive disease over a period of short term follow-up., (© The Author (2017). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Published
2017
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7. Reliable measurements of brain atrophy in individual patients with multiple sclerosis.

Author

Smeets D, Ribbens A, Sima DM, Cambron M, Horakova D, Jain S, Maertens A, Van Vlierberghe E, Terzopoulos V, Van Binst AM, Vaneckova M, Krasensky J, Uher T, Seidl Z, De Keyser J, Nagels G, De Mey J, Havrdova E, and Van Hecke W

Abstract

Introduction: As neurodegeneration is recognized as a major contributor to disability in multiple sclerosis (MS), brain atrophy quantification could have a high added value in clinical practice to assess treatment efficacy and disease progression, provided that it has a sufficiently low measurement error to draw meaningful conclusions for an individual patient., Method: In this paper, we present an automated longitudinal method based on Jacobian integration for measuring whole-brain and gray matter atrophy based on anatomical magnetic resonance images (MRI), named MS metrix . MS metrix is specifically designed to measure atrophy in patients with MS, by including iterative lesion segmentation and lesion filling based on FLAIR and T1-weighted MRI scans., Results: MS metrix is compared with SIENA with respect to test-retest error and consistency, resulting in an average test-retest error on an MS data set of 0.13% (MS metrix ) and 0.17% (SIENA) and a consistency error of 0.07% (MS metrix ) and 0.05% (SIENA). On a healthy subject data set including physiological variability the test-retest is 0.19% (MS metrix ) and 0.31% (SIENA)., Conclusion: Therefore, we can conclude that MS metrix could be of added value in clinical practice for the follow-up of treatment and disease progression in MS patients.

Published
2016
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8. Quantifying brain volumes for Multiple Sclerosis patients follow-up in clinical practice - comparison of 1.5 and 3 Tesla magnetic resonance imaging.

Author

Lysandropoulos AP, Absil J, Metens T, Mavroudakis N, Guisset F, Van Vlierberghe E, Smeets D, David P, Maertens A, and Van Hecke W

Subjects
Adult, Atrophy diagnostic imaging, Female, Follow-Up Studies, Humans, Image Interpretation, Computer-Assisted, Longitudinal Studies, Male, Middle Aged, Organ Size, Prospective Studies, Software, Young Adult, Brain diagnostic imaging, Magnetic Resonance Imaging instrumentation, Multiple Sclerosis diagnostic imaging
Abstract

Introduction: There is emerging evidence that brain atrophy is a part of the pathophysiology of Multiple Sclerosis (MS) and correlates with several clinical outcomes of the disease, both physical and cognitive. Consequently, brain atrophy is becoming an important parameter in patients' follow-up. Since in clinical practice both 1.5Tesla (T) and 3T magnetic resonance imaging (MRI) systems are used for MS patients follow-up, questions arise regarding compatibility and a possible need for standardization., Methods: Therefore, in this study 18 MS patients were scanned on the same day on a 1.5T and a 3T scanner. For each scanner, a 3D T1 and a 3D FLAIR were acquired. As no atrophy is expected within 1 day, these datasets can be used to evaluate the median percentage error of the brain volume measurement for gray matter (GM) volume and parenchymal volume (PV) between 1.5T and 3T scanners. The results are obtained with MSmetrix, which is developed especially for use in the MS clinical care path, and compared to Siena (FSL), a widely used software for research purposes., Results: The MSmetrix median percentage error of the brain volume measurement between a 1.5T and a 3T scanner is 0.52% for GM and 0.35% for PV. For Siena this error equals 2.99%. When data of the same scanner are compared, the error is in the order of 0.06-0.08% for both MSmetrix and Siena., Conclusions: MSmetrix appears robust on both the 1.5T and 3T systems and the measurement error becomes an order of magnitude higher between scanners with different field strength.

Published
2016
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9. Association of digital vascular function with cardiovascular risk factors: a population study.

Author

Kuznetsova T, Van Vlierberghe E, Knez J, Szczesny G, Thijs L, Jozeau D, Balestra C, D'hooge J, and Staessen JA

Subjects
Adult, Aged, Belgium, Cardiovascular Diseases physiopathology, Cohort Studies, Endothelium, Vascular physiology, Female, Fingers blood supply, Fingers physiology, Heart Rate, Humans, Hypertension physiopathology, Male, Middle Aged, Overweight complications, Overweight physiopathology, Photoplethysmography methods, Pulse, Pulse Wave Analysis, Risk Factors, Sex Factors, Smoking adverse effects, Arteries physiology, Arteries physiopathology, Body Mass Index, Cardiovascular Diseases etiology, Endothelium, Vascular physiopathology, Hyperemia physiopathology, Smoking physiopathology, Vasodilation
Abstract

Objectives: Vasodilation of the peripheral arteries during reactive hyperaemia depends in part on release of nitric oxide from endothelial cells. Previous studies mainly employed a fingertip tonometric device to derive pulse wave amplitude (PWA) and PWA hyperaemic changes. An alternative approach is based on photoplethysmography (PPG). We sought to evaluate the correlates of digital PPG PWA hyperaemic responses as a measure of peripheral vascular function., Design: The Flemish Study on Environment, Genes and Health Outcomes (FLEMENGHO) is a population-based cohort study., Setting: Respondents were examined at one centre in northern Belgium., Participants: For this analysis, our sample consisted of 311 former participants (53.5% women; mean age 52.6 years; 43.1% hypertensive), who were examined from January 2010 until March 2012 (response rate 85.1%)., Primary Outcome Measures: Using a fingertip PPG device, we measured digital PWA at baseline and at 30 s intervals for 4 min during reactive hyperaemia induced by a 5 min forearm cuff occlusion. We performed stepwise regression to identify correlates of the hyperaemic response ratio for each 30 s interval after cuff deflation., Results: The maximal hyperaemic response was detected in the 30-60 s interval. The explained variance for the PPG PWA ratio ranged from 9.7% at 0-30 s interval to 22.5% at 60-90 s time interval. The hyperaemic response at each 30 s interval was significantly higher in women compared with men (p≤0.001). The PPG PWA changes at 0-90 s intervals decreased with current smoking (p≤0.0007) and at 0-240 s intervals decreased with higher body mass index (p≤0.035). These associations with sex, current smoking and body mass index were mutually independent., Conclusions: Our study is the first to implement the new PPG technique to measure digital PWA hyperaemic changes in a general population. Hyperaemic response, as measured by PPG, is inversely associated with traditional cardiovascular risk factors such as male sex, smoking and obesity.

Published
2014
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