Biomarkers for Traumatic Brain Injury Proceedings of a Workshop (2023) / Chapter Skim
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5 Looking Ahead
5 Looking Ahead
Pages 47-54
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From page 47... ...
WHERE TBI BIOMARKERS CAN CURRENTLY HAVE IMPACT Leslie Prichep, BrainScope Company, introduced the final discussion session. With many potential directions to pursue and limited resources, she said, identifying areas with the greatest potential for return on investment and added value to patients and families can help chart a course for the future.
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From page 48... ...
Similarly, for the second question, respondents ranked the contri butions that TBI biomarkers could currently play as being greatest for diagnosis/classification, optimizing/targeting treatment, research to fill gaps, and monitoring recovery. The third informal poll question asked about key considerations for integrating biomarkers into clinical workflows.
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From page 49... ...
However, the lessons from incorporating troponin into cardiac care demonstrate the importance of conducting biological variation studies and understanding reference ranges, standardizing assays, and establishing laboratory turnaround time needs and expectations as part of the translation and implementation of biomarkers into practice. There are a lot of opportunities in the biomarker tool kit, another participant commented, and there is a need for different types of tools.
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From page 50... ...
Another participant agreed with the need to study biomarker profiles in the full range of patients who experience TBI, noting that it will be crucial to ensure gender and racial diversity in the ongoing research and care agenda. The continued collection and analysis of biomarker profiles over time and how these profiles inform TBI prognostication over the longer term is an area that needs to be further explored and represents a potential future evolution for the field.
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From page 51... ...
For example, a participant noted that incorporating biomarkers into practice in emergency department settings will require addressing the speed of results and effect on emergency department throughput, cost- effectiveness, and patient acceptance, as well as how results can be incorporated into patient electronic medical records. Widespread implementation of TBI biomarkers in emergency settings also has the potential to greatly increase the number of patients diagnosed with mild TBI who need postacute care, a participant emphasized.
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From page 52... ...
During the course of the workshop, a number of participants emphasized the opportunity for the TBI field to incorporate additional biomarker information in ongoing efforts to develop more precise classification systems for TBI. Considering Future Questions and Directions The workshop highlighted a variety of areas in which further study is needed -- including further research in various patient populations, for different mechanisms and severities of injury, in different clinical settings and contexts of use, and in further biomarker discovery, validation, and multimodal analyses.
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From page 53... ...
During the course of the meeting, a number of participants noted patient populations in which biomarker performance after TBI injury and during recovery needs to be better understood, including geriatric TBI patients, people who have experienced multiple head injuries, and those with coexisting medical conditions, including seizures, epilepsy, or dementia. The ability to account for the potential confounding effect on biomarker results from situations such as preexisting head injury and coexisting medical conditions is important.
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From page 54... ...
Corinne Peek-Asa, University of California, San Diego, closed out the workshop, thanking speakers and participants and noting that the sessions highlighted multiple ways in which biomarkers can play expand ing roles in the assessment, care, and monitoring of traumatic brain injury in preclinical TBI research, and in informing clinical trials for new treat ments and interventions. This is an active area for the TBI field, although a number of challenges will need to be overcome to collectively push the frontiers of the field forward and fully realize the promise of biomarkers in improving care for TBI patients and families.
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