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Deployment of a Novel National Institute of Neurological Disorders and Stroke Clinical, Biomarker, Imaging, and Modifiers (CBI-M) Classification Framework for Emergency Department Patients With Glasgow Coma Scale 15 Traumatic Brain Injury (PIONEER-Prognosis)

8. oktober 2026 opdateret af: Frederick Korley, MD, PhD, University of Michigan

Deployment of a Novel NINDS Clinical, Biomarker, Imaging, and Modifiers (CBI-M) Classification Framework for ED Patients With GCS 15 TBI (PIONEER-Prognosis)

This study is being done to learn how information from blood tests, medical records, and wearable devices that track sleep, activity, and heart rate can help predict how people recover after a concussion. The goal is to improve how doctors monitor recovery and give patients better information about what to expect after a head injury.

Studieoversigt

Status

Ikke rekrutterer endnu

Betingelser

Detaljeret beskrivelse

The PIONEER-Prognosis Study is a prospective, multicenter, observational cohort study of adults aged 18 to 65 years who present to the emergency department (ED) within 24 hours of a mild traumatic brain injury (TBI) and have a Glasgow Coma Scale (GCS) score of 15, meaning they are fully alert. Although these injuries are classified as mild, up to half of such patients report persistent symptoms such as headaches, cognitive difficulties, and mood disturbances a year after injury, and clinicians currently lack a reliable way to predict, at the time of the ED visit, which patients will recover fully and which will not.

This study will apply a new classification framework proposed by the National Institute of Neurological Disorders and Stroke (NINDS), called Clinical, Biomarker, Imaging, and Modifiers (CBI-M). This framework combines clinical findings; blood tests for two brain injury proteins, glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1); results of any head computed tomography (CT) scan performed as part of routine care; and psychosocial and environmental factors. The study will evaluate how well this framework predicts recovery.

A total of 500 participants will be enrolled from five EDs in Michigan, Oregon, and California that already use GFAP and UCH-L1 blood tests in clinical care. Participants will provide a blood sample and clinical information during their ED visit, wear a WHOOP wearable device continuously for 90 days to record heart rate, heart rate variability, sleep, and physical activity, complete a brief daily symptom survey through the device application, and complete additional symptom and sleep questionnaires by email or phone at 1 week, 1 month, and 2 months.

Trained interviewers from a central outcomes team will contact participants by telephone at 14 and 90 days to assess functional recovery using the Glasgow Outcome Scale-Extended (GOS-E), along with symptoms, cognition, life satisfaction, post-traumatic stress symptoms, and resilience.

The primary outcome is complete functional recovery, defined as a GOS-E score of 8 at 90 days. The study does not assign any treatment; participants receive standard ED care. Findings are intended to improve prognostic accuracy, patient counseling, and follow-up care for the largest subgroup of patients with TBI. The prediction models developed will be made available as a free web-based tool. The study is funded by the U.S. Department of Defense and is expected to take approximately 4 years to complete, with each participant followed for 3 months.

Undersøgelsestype

Observationel

Tilmelding (Anslået)

500

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

    • California
      • Torrance, California, Forenede Stater, 90509
        • Harbor-UCLA Medical Center
        • Kontakt:
        • Ledende efterforsker:
          • Kabir Yadav, MD, MS, MSHS,
    • Michigan
      • Ann Arbor, Michigan, Forenede Stater, 48109
        • University of Michigan
        • Kontakt:
        • Ledende efterforsker:
          • Frederick Korley, MD, PhD
      • Clinton Township, Michigan, Forenede Stater, 48038
        • Henry Ford Macomb
        • Ledende efterforsker:
          • Joseph Miller, MD, MS
        • Kontakt:
      • Detroit, Michigan, Forenede Stater, 48202 ·
        • Henry Ford Hospital
        • Ledende efterforsker:
          • Joseph Miller, MD, MS
        • Kontakt:
    • Oregon
      • Portland, Oregon, Forenede Stater, 97239-3098
        • Oregon Health & Science University
        • Kontakt:
        • Ledende efterforsker:
          • Bori Kea, MD, MCR

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 65 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Ikke-sandsynlighedsprøve

Studiebefolkning

Adult patients aged 18 to 65 years at the time of enrollment who present to participating emergency departments (EDs) with suspected traumatic brain injury (TBI) meeting the 2023 American Congress of Rehabilitation Medicine (ACRM) criteria and a Glasgow Coma Scale (GCS) score of 15. Key exclusion criteria include pre-existing neurological disability resulting in a pre-injury Glasgow Outcome Scale-Extended (GOS-E) score <8, high risk of loss to follow-up (e.g., no reliable phone, homelessness, incarceration, or ward of the state), pregnancy, and inability to speak English or Spanish

Beskrivelse

Inclusion Criteria:

  • Diagnosis of mild traumatic brain injury (TBI), as defined by the 2023 American Congress of Rehabilitation Medicine (ACRM) criteria.

  • Enrollment within 24 hours of injury.

  • Glasgow Coma Scale (GCS) score of 15 at emergency department (ED) enrollment.

  • Consent to study procedures, including:

    • Blood collection for biomarker measurement, including glial fibrillary acidic protein (GFAP) and ubiquitin C-terminal hydrolase L1 (UCH-L1).
    • Continuous use of a health-monitoring device for 3 months.
    • Follow-up assessments by telephone at 14 days and 90 days.
    • Completion of a daily symptom inventory via WHOOP/smartphone.

Exclusion Criteria:

  • Pre-existing neurological disability or pre-injury condition that would have resulted in a Glasgow Outcome Scale-Extended (GOS-E) score <8 if assessed before the injury.
  • High risk of loss to follow-up, including patients without a reliable phone, those experiencing homelessness, those who are incarcerated, or those who are wards of the state.
  • Pregnancy at the time of enrollment.
  • Inability to speak English or Spanish, which would prevent completion of the required assessments.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

  • Observationsmodeller: COHORT
  • Tidsperspektiver: PROSPECTIVE

Kohorter og interventioner

Gruppe / kohorte
GCS 15 TBI patients

Patients presenting to a study emergency department with a Glasgow Coma Scale (GCS) score of 15 and traumatic brain injury (TBI).

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Functional recovery
Tidsramme: 3 months

Functional recovery will be assessed using the Glasgow Outcome Scale-Extended (GOS-E). The GOS-E rates patient status on one of eight levels. The minimum score is 1 and the maximum score is 8: 1 = death; 2 = vegetative state; 3 = lower severe disability; 4 = upper severe disability; 5 = lower moderate disability; 6 = upper moderate disability; 7 = lower good recovery; and 8 = upper good recovery.

3 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Daily symptom burden
Tidsramme: Up to 90 days

Daily symptom burden will be measured using five commonly endorsed items-fatigue, headache, poor concentration, frustration, and sleep problems-from the Rivermead Post-Concussion Questionnaire (RPQ), a validated instrument that assesses post-concussive symptom severity. Each symptom is rated from 0 to 4, with 0 indicating that the symptom is not experienced and 4 indicating a severe problem. Scores for the five items are summed to yield a total score ranging from 0 to 20, with higher scores indicating greater daily post-concussive symptom burden.

Up to 90 days
Heart rate variability (HRV)
Tidsramme: Up to 90 days

HRV will be continuously measured using the WHOOP wearable device. HRV will be reported in milliseconds (ms) and reflects variation in the time intervals between successive heartbeats. HRV is a continuous physiological measure with no predefined minimum or maximum value. Higher or lower HRV values are not inherently classified as better or worse outcomes; values will be evaluated as physiological measures in relation to recovery following traumatic brain injury.

Up to 90 days
Resting heart rate (rHR)
Tidsramme: Up to 90 days

Physiological outcomes will be continuously measured via the WHOOP wearable device. WHOOP is a wearable health and fitness tracker that continuously monitors key physiological metrics

Up to 90 days
Sleep patterns - Sleep duration
Tidsramme: Up to 90 days

Sleep duration will be continuously measured using the WHOOP wearable device. WHOOP is a wearable health and fitness tracker that continuously monitors key physiological metrics.

Up to 90 days
Sleep patterns - Sleep efficiency
Tidsramme: Up to 90 days

Sleep efficiency will be continuously measured using the WHOOP wearable device. WHOOP is a wearable health and fitness tracker that continuously monitors key physiological metrics.

Up to 90 days
Sleep patterns - Sleep latency
Tidsramme: Up to 90 days

Sleep latency will be continuously measured using the WHOOP wearable device. WHOOP is a wearable health and fitness tracker that continuously monitors key physiological metrics.

Up to 90 days
Sleep patterns - Total amount of sleep
Tidsramme: Up to 90 days

Total amount of sleep will be continuously measured using the WHOOP wearable device. WHOOP is a wearable health and fitness tracker that continuously monitors key physiological metrics.

Up to 90 days
Sleep patterns - percentage of restorative sleep
Tidsramme: Up to 90 days

Percentage of restorative sleep will be continuously measured using the WHOOP wearable device. WHOOP is a wearable health and fitness tracker that continuously monitors key physiological metrics.

Up to 90 days
Strain
Tidsramme: Up to 90 days

Strain will be continuously measured using the WHOOP wearable device. WHOOP is a wearable health and fitness tracker that continuously monitors key physiological metrics.

Up to 90 days
Body temperature
Tidsramme: Up to 90 days

Body temperature will be continuously measured using the WHOOP wearable device. WHOOP is a wearable health and fitness tracker that continuously monitors key physiological metrics. ClinicalTrials.gov PRS_ Protoco…

Up to 90 days
Oxygen saturation
Tidsramme: Up to 90 days

Oxygen saturation will be continuously measured using the WHOOP wearable device. WHOOP is a wearable health and fitness tracker that continuously monitors key physiological metrics.

Up to 90 days
Rivermead Post-Concussion Questionnaire score
Tidsramme: Up to 2 months

Post-concussive symptoms will be assessed using the Rivermead Post-Concussion Questionnaire (RPQ). The RPQ assesses 16 common post-concussive symptoms, with each symptom rated from 0 to 4, where 0 indicates that the symptom is not experienced, 1 indicates no more of a problem than before the injury, and 2-4 indicate mild, moderate, or severe problems, respectively. For standard scoring, responses of 1 are scored as 0, resulting in a total score ranging from 0 to 64. Higher scores indicate greater post-concussive symptom burden and therefore a worse outcome.

Up to 2 months

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Sponsor

Samarbejdspartnere

Efterforskere

  • Ledende efterforsker: Frederick Korley, MD, PhD, University of Michigan

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Anslået)

1. oktober 2026

Primær færdiggørelse (Anslået)

31. december 2028

Studieafslutning (Anslået)

30. august 2029

Datoer for studieregistrering

Først indsendt

29. september 2026

Først indsendt, der opfyldte QC-kriterier

29. september 2026

Først opslået (Faktiske)

5. oktober 2026

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

13. oktober 2026

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

8. oktober 2026

Sidst verificeret

1. oktober 2026

Mere information

Begreber relateret til denne undersøgelse

Andre undersøgelses-id-numre

  • HUM00284360
  • HT942524TBIPHRPFPA (Andet bevillings-/finansieringsnummer: Department of Defense- Defense Health Program)

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

JA

IPD-planbeskrivelse

De-identified individual participant data collected during this study may be retained for future secondary analyses and will be shared in accordance with applicable U.S. Department of Defense (DoD) data-sharing policies and requirements.

IPD-delingstidsramme

Data will be made available in accordance with applicable DoD policies and requirements.

IPD-delingsadgangskriterier

Access to study data will be provided in accordance with applicable DoD policies and requirements, including any required data use agreements or other applicable protections.

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