Toward More Accurate Prediction of Community Integration Outcomes for Persons with Traumatic Brain Injury

As the winner of the 2014 Leonard Diller Award for excellence in the field of brain injury and neurorehabilitation, Mark Sherer, PhD, ABPP, FACRM, was keynote speaker at the 16th annual conference of the American Psychological Association’s Division of Rehabilitation Psychology, held in February in San Antonio. Dr. Sherer presented early results of a new investigation intended to determine clusters of measures that can be used to predict outcomes after traumatic brain injury (TBI). The project’s ultimate goal is the creation of a website, accessible to rehabilitation professionals, that can be used to guide treatment for persons with TBI.

“Using a study sample of 504 participants, we identified 10 themes or outcomes that we consider important: self-reported cognitive impairment, cognitive processing speed, resilience, physical functioning, memory, physical symptoms, emotional and family support, verbal fluency, economic and personal independence, and post-concussive symptoms and emotional distress,” says Dr. Sherer, senior scientist and director of research at TIRR Memorial Hermann and clinical professor of physical medicine and rehabilitation at Baylor College of Medicine and McGovern Medical School at UTHealth. “The next step will be to use these 10 measures to categorize a large group of people, which will lead to the eventual development of a useful classification scheme with the potential to improve treatment for persons with TBI.

In early May 2014, a national panel of 16 experts gathered at a working conference in Galveston, Texas, to develop treatment recommendations for each classification cluster based on its characteristics. The “State-of-the-Science Conference of Rehabilitation Research and Training Center on Developing Strategies to Foster Community Integration and Participation in Persons with TBI” included specialists in the treatment of TBI who have been involved in the research study and others who are acknowledged experts in the field. “Although the treatment recommendations will be based on expert opinion and not validated by scientific studies, we consider it a good starting point,” Dr. Sherer says. “Our goal is the creation of a website practitioners can use to enter scores for the 10 measures, and receive a report identifying the cluster with which the patient’s characteristics are most closely aligned. We don’t expect patients to be an exact match to the clusters, but the website will provide information and options for treatment for each type of patient.” He expects the site to go live by early 2015.

Supported by the U.S. Department of Education and the National Institute on Disability and Rehabilitation Research, the study includes faculty and researchers at TIRR Memorial Hermann and Baylor College of Medicine, the University of Alabama at Birmingham, the Rehabilitation Institute of Michigan/Wayne State University, University of Arkansas for Medical Sciences and New York University Langone Medical Center.