Biomarkers + Guidelines for Traumatic Brain Injury

Not yet recruiting at 5 trial locations
DN
Overseen ByDevon Newman, MS
Age: 18+
Sex: Any
Trial Phase: Academic
Sponsor: University of Michigan
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)

What You Need to Know Before You Apply

What is the purpose of this trial?

This is a pragmatic, open-label, multicenter, stepped-wedge, Type II hybrid effectiveness-implementation study. It is designed to evaluate both the comparative effectiveness and implementation feasibility of a biomarker-plus-clinical guidelines algorithm to reduce low-value brain computed tomography (CT) use in emergency department (ED) patients evaluated for suspected traumatic brain injury (TBI). The biomarkers are Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin Carboxy-terminal Hydrolase L1 (UCH-L1), two brain-injury proteins cleared by the FDA to support brain CT imaging decisions after trauma. All six participating EDs will contribute baseline data for the first 6 months under usual care (clinical guidelines only). Beginning in month 7, two sites will transition to implementing the biomarker-guided algorithm. At month 13, two additional sites will implement the biomarker-guided approach, and the final two sites will transition at month 19. By the end of the 24-month rollout period, all sites will have implemented the biomarker-guided pathway.

Who Is on the Research Team?

FK

Frederick Korley, MD, PhD

Principal Investigator

University of Michigan

Are You a Good Fit for This Trial?

This trial is for people who come to the emergency department with a suspected traumatic brain injury, such as concussion or head injury. There are no detailed inclusion or exclusion criteria listed, so it appears open to most patients being evaluated for these conditions.

Inclusion Criteria

Presentation to the emergency department within 24 hours of injury
I am 18 years old or older.
I came to the emergency room after a traumatic injury or accident.
See 2 more

Exclusion Criteria

Planned computed tomography (CT) imaging of the maxillofacial bones, chest, abdomen, or pelvis during the ED encounter and clinicians do not intend to avoid brain CT imaging even if the biomarker test is negative
Presentation more than 24 hours after injury due to declining diagnostic sensitivity of Glial Fibrillary Acidic Protein (GFAP) and Carboxy-terminal Hydrolase L1 (UCH-L1) beyond this time window
I am currently taking blood thinners or antiplatelet medications.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Baseline Data Collection

All six participating EDs contribute baseline data under usual care (clinical guidelines only)

6 months
Ongoing data collection

Implementation

Transition to implementing the biomarker-guided algorithm at different sites

18 months
Stepped-wedge implementation across sites

Follow-up

Participants are monitored for safety and effectiveness after treatment

4 weeks

What Are the Treatments Tested in This Trial?

Trial Overview

The study compares two ways of deciding if someone needs a brain CT scan after a head injury: using standard clinical guidelines alone versus using both guidelines and special blood tests (biomarkers) that detect signs of brain injury.

How Is the Trial Designed?

2

Treatment groups

Experimental Treatment

Active Control

Group I: Clinical Pathway 1: Guidelines + BiomarkersExperimental Treatment1 Intervention
Group II: Clinical Pathway 2: Clinical Guidelines OnlyActive Control1 Intervention

Find a Clinic Near You

Who Is Running the Clinical Trial?

University of Michigan

Lead Sponsor

Trials
1,891
Recruited
6,458,000+

United States Department of Defense

Collaborator

Trials
940
Recruited
339,000+