Reliability of the NINDS common data elements cranial tomography (CT) rating variables for traumatic brain injury (TBI)

Leah Harburg, Erin McCormack, Kimbra Kenney, Carol Moore, Kelly Yang, Pieter Vos, Bram Jacobs, Christopher J. Madden, Ramon Diaz-Arrastia, Tanya Bogoslovsky

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background: Non-contrast head computer tomography (CT) is widely used to evaluate eligibility of patients after acute traumatic brain injury (TBI) for clinical trials. The NINDS Common Data Elements (CDEs) TBI were developed to standardize collection of CT variables. The objectives of this study were to train research assistants (RAs) to rate CDEs and then to evaluate their performance. The aim was to assess inter-rater reliability (IRR) of CDEs between trained RAs and a neurologist and to evaluate applicability of CDEs in acute and sub-acute TBI to test the feasibility of using CDE CT ratings in future trials and ultimately in clinical practice. The second aim was to confirm that the ratings of CDEs reflect pathophysiological events after TBI. Methods and results: First, a manual was developed for application of the CDEs, which was used to rate brain CTs (n = 100). An excellent agreement was found in combined kappas between RAs on admission and on 24-hour follow-up CTs (Iota = 0.803 and 0.787, respectively). Good IRR (kappa > 0.61) was shown for six CDEs on admissions and for seven CDEs on follow-up CTs. Low IRR (kappa < 0.4) was determined for five CDEs on admission and for four CDEs on follow-up CT. Combined IRR of each assistant with the neurologist were good on admission (Iota = 0.613 and 0.787) and excellent on follow-up CT (Iota = 0.906 and 0.977). Second, Principal Component Analysis (PCA) was applied to cluster the rated CDEs (n = 255) and five major components were found that explain 53% of the variance. Conclusions: CT CDEs are useful in clinical studies of TBI. Trained RAs can reliably collect variables. PCA identifies CDE clusters with clinical and biologic plausibility.

Original languageEnglish (US)
Pages (from-to)1-11
Number of pages11
JournalBrain Injury
DOIs
StateAccepted/In press - Dec 12 2016

Fingerprint

National Institute of Neurological Disorders and Stroke
Tomography
Common Data Elements
Traumatic Brain Injury
Rating
Principal Component Analysis
Research
Brain Injuries
Interrater Reliability
Admission

Keywords

  • common data elements
  • cranial tomography
  • CT scanning
  • head trauma
  • Traumatic brain injury

ASJC Scopus subject areas

  • Developmental and Educational Psychology
  • Arts and Humanities (miscellaneous)
  • Clinical Neurology

Cite this

Harburg, L., McCormack, E., Kenney, K., Moore, C., Yang, K., Vos, P., ... Bogoslovsky, T. (Accepted/In press). Reliability of the NINDS common data elements cranial tomography (CT) rating variables for traumatic brain injury (TBI). Brain Injury, 1-11. https://doi.org/10.1080/02699052.2016.1225989

Reliability of the NINDS common data elements cranial tomography (CT) rating variables for traumatic brain injury (TBI). / Harburg, Leah; McCormack, Erin; Kenney, Kimbra; Moore, Carol; Yang, Kelly; Vos, Pieter; Jacobs, Bram; Madden, Christopher J.; Diaz-Arrastia, Ramon; Bogoslovsky, Tanya.

In: Brain Injury, 12.12.2016, p. 1-11.

Research output: Contribution to journalArticle

Harburg, L, McCormack, E, Kenney, K, Moore, C, Yang, K, Vos, P, Jacobs, B, Madden, CJ, Diaz-Arrastia, R & Bogoslovsky, T 2016, 'Reliability of the NINDS common data elements cranial tomography (CT) rating variables for traumatic brain injury (TBI)', Brain Injury, pp. 1-11. https://doi.org/10.1080/02699052.2016.1225989
Harburg, Leah ; McCormack, Erin ; Kenney, Kimbra ; Moore, Carol ; Yang, Kelly ; Vos, Pieter ; Jacobs, Bram ; Madden, Christopher J. ; Diaz-Arrastia, Ramon ; Bogoslovsky, Tanya. / Reliability of the NINDS common data elements cranial tomography (CT) rating variables for traumatic brain injury (TBI). In: Brain Injury. 2016 ; pp. 1-11.
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AU - Harburg, Leah

AU - McCormack, Erin

AU - Kenney, Kimbra

AU - Moore, Carol

AU - Yang, Kelly

AU - Vos, Pieter

AU - Jacobs, Bram

AU - Madden, Christopher J.

AU - Diaz-Arrastia, Ramon

AU - Bogoslovsky, Tanya

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N2 - Background: Non-contrast head computer tomography (CT) is widely used to evaluate eligibility of patients after acute traumatic brain injury (TBI) for clinical trials. The NINDS Common Data Elements (CDEs) TBI were developed to standardize collection of CT variables. The objectives of this study were to train research assistants (RAs) to rate CDEs and then to evaluate their performance. The aim was to assess inter-rater reliability (IRR) of CDEs between trained RAs and a neurologist and to evaluate applicability of CDEs in acute and sub-acute TBI to test the feasibility of using CDE CT ratings in future trials and ultimately in clinical practice. The second aim was to confirm that the ratings of CDEs reflect pathophysiological events after TBI. Methods and results: First, a manual was developed for application of the CDEs, which was used to rate brain CTs (n = 100). An excellent agreement was found in combined kappas between RAs on admission and on 24-hour follow-up CTs (Iota = 0.803 and 0.787, respectively). Good IRR (kappa > 0.61) was shown for six CDEs on admissions and for seven CDEs on follow-up CTs. Low IRR (kappa < 0.4) was determined for five CDEs on admission and for four CDEs on follow-up CT. Combined IRR of each assistant with the neurologist were good on admission (Iota = 0.613 and 0.787) and excellent on follow-up CT (Iota = 0.906 and 0.977). Second, Principal Component Analysis (PCA) was applied to cluster the rated CDEs (n = 255) and five major components were found that explain 53% of the variance. Conclusions: CT CDEs are useful in clinical studies of TBI. Trained RAs can reliably collect variables. PCA identifies CDE clusters with clinical and biologic plausibility.

AB - Background: Non-contrast head computer tomography (CT) is widely used to evaluate eligibility of patients after acute traumatic brain injury (TBI) for clinical trials. The NINDS Common Data Elements (CDEs) TBI were developed to standardize collection of CT variables. The objectives of this study were to train research assistants (RAs) to rate CDEs and then to evaluate their performance. The aim was to assess inter-rater reliability (IRR) of CDEs between trained RAs and a neurologist and to evaluate applicability of CDEs in acute and sub-acute TBI to test the feasibility of using CDE CT ratings in future trials and ultimately in clinical practice. The second aim was to confirm that the ratings of CDEs reflect pathophysiological events after TBI. Methods and results: First, a manual was developed for application of the CDEs, which was used to rate brain CTs (n = 100). An excellent agreement was found in combined kappas between RAs on admission and on 24-hour follow-up CTs (Iota = 0.803 and 0.787, respectively). Good IRR (kappa > 0.61) was shown for six CDEs on admissions and for seven CDEs on follow-up CTs. Low IRR (kappa < 0.4) was determined for five CDEs on admission and for four CDEs on follow-up CT. Combined IRR of each assistant with the neurologist were good on admission (Iota = 0.613 and 0.787) and excellent on follow-up CT (Iota = 0.906 and 0.977). Second, Principal Component Analysis (PCA) was applied to cluster the rated CDEs (n = 255) and five major components were found that explain 53% of the variance. Conclusions: CT CDEs are useful in clinical studies of TBI. Trained RAs can reliably collect variables. PCA identifies CDE clusters with clinical and biologic plausibility.

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