Site-specific and module studies

Mayo Clinic's Traumatic Brain Injury Model System (TBIMS) is conducting research to determine the incidence of traumatic brain injuries (TBIs) among tribal communities in the upper Great Lakes region, understand lived experiences and support needs, and reduce TBI-related health differences within Native American communities.

SITE-SPECIFIC STUDIES

Ways of Knowing: Listening to Great Lakes Tribal Communities To Characterize Traumatic Brain Injury Incidence, Impact and Health Inequities

Tribal communities in the upper Great Lakes region are at high risk of TBIs, and injury estimates are low due to racial misclassification. Investigators at Mayo Clinic are collaborating with the Indian Health Service and state trauma programs in Minnesota and Wisconsin to determine the incidence of TBIs among tribal communities from 2012 to 2022.

The study is to be done by secure, de-identified linking of the state trauma registry and the Indian Health Service tribal registry datasets using specialized software to minimize racial misclassification. The anticipated outcome is a more accurate understanding of the characteristics of TBIs in tribal communities.

A second goal of the study is to better understand the lived experiences, and medical, cultural and social support needs, following TBIs among American Indians and Alaska Natives through Gathering of Native American-type listening sessions. Participants will include:

• Tribal members with TBIs who live in urban and rural settings, as well as their families and care partners and their tribes.
• Tribal, state and healthcare policymakers.
• Tribal healthcare professionals.

Anticipated outcomes are identifying what is important about TBIs in tribal communities and establishing a foundation of trust, respect and knowledge on which to build sustainable research relationships. A long-range goal is working in partnership to identify community priorities and potential public health intervention targets to reduce disease burden related to TBIs.

Recruitment

Mayo Clinic will sponsor several 1.5-day listening events during the study period. Specific locations will be determined by consensus so that rural and urban tribal communities are equally represented.

Study investigators will partner with two respected, trusted and highly skilled facilitators who have been implementing listening sessions in tribal communities for a long time. Up to 30 participants per listening session will be invited from 11 tribal programs and one urban health program in Minnesota.

Recruiting for these in-person listening sessions is underway. Learn how you can take part.

MODULE STUDIES

The TBIMS has a unique and long-standing infrastructure for conducting research. To take advantage of this, and to continue to learn about recovery and rehabilitation after TBIs, centers often work together to carry out additional research.

Below are collaborative studies that are underway.

Predicting Outcome After Moderate-Severe TBI Using a CT Head Deep Learning Model

Mayo Clinic is leading a collaborative study during the TBIMS 2022-2027 funding cycle. CT of the head is used to evaluate acute TBIs. CT results have been found to correlate only with acute outcomes. This includes the need for brain surgery or death, rather than helping to determine long-term prognosis. The latter information is important to patients and families and for planning for care beyond hospitalization.

Deep learning, a form of artificial intelligence, can encode imaging features not visible to the naked eye. This study involves partnering with Mayo Clinic's Digital Innovation Lab and other TBIMS centers to unite clinical information from a projected 8,000 to 10,000 patients with moderate to severe TBIs with their digital CT data. The goal is to inform a deep learning model of anatomical injury severity.

Mayo Clinic is participating in two additional module studies with other TBIMS centers during the 2022-2027 funding cycle:

• State Programs and Outcomes From TBI
• Associations of Early Life Adversity and Neighborhood Environment With TBI Outcomes in the TBIMS National Database

OTHER STUDIES

Comparing Treatment Approaches to Promote Inpatient Rehabilitation Effectiveness for Traumatic Brain Injury (CARE4TBI)

The Comparing Treatment Approaches to Promote Inpatient Rehabilitation Effectiveness for Traumatic Brain Injury (CARE4TBI) study involves 15 TBIMS centers across the U.S. Investigators at Ohio State University and New York University are leading the study. Dmitry Esterov, D.O., M.S., is the site investigator at Mayo Clinic.

The CARE4TBI study will enroll about 1,600 inpatients with moderate to severe TBIs. The study seeks to determine which rehabilitation strategies optimize outcomes over the first year following injury.

ENRICH Brain Health Study — Long-Term Trajectories of Cognition and Psychological Health in Civilians and Veterans With Traumatic Brain Injury

The Leveraging Nationwide Research Infrastructure to Enrich Brain Health after TBI study, also known as the ENRICH Brain Health Study, consists of five projects funded by the U.S. Department of Defense. Nineteen TBIMS centers are participating in ENRICH Project 2, which leverages rich data resources from civilians and Veterans Affairs polytrauma rehabilitation centers and the related TBIMS National Database.

Novel analyses of existing data will characterize transitions across clinical states of function, cognition and mood in the first five years after a TBI. Also, new data will be collected to understand risk and resilience factors associated with two areas of highest concern for people living with TBIs: cognition and suicide risk.