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BMJ Open. 2017 Jul 13;7(7):e017012. doi: 10.1136/bmjopen-2017-017012.

Advancing Concussion Assessment in Pediatrics (A-CAP): a prospective, concurrent cohort, longitudinal study of mild traumatic brain injury in children: protocol study.

Author information

1
Department of Psychology, University of Calgary, Calgary, Alberta, Canada.
2
Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
3
Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
4
Department of Psychology, Universite de Montreal and Ste Justine Hospital, Montreal, Québec, Canada.
5
Department of Pediatrics, University of Alberta and Stollery Children's Hospital, Edmonton, Alberta, Canada.
6
Department of Pediatrics, University of British Columbia and BC Children's Hospital, Vancouver, British Columbia, Canada.
7
Department of Pediatrics and Emergency Medicine, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, Ontario, Canada.
8
Department of Pediatrics, Universite de Montreal and Ste Justine Hospital, Montreal, Québec, Canada.
9
Department of Radiology, University of Calgary, Calgary, Alberta, Canada.
10
Department of Radiology, University of Ottawa and Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
11
Department of Biomedical Engineering, University of Alberta, Edmonton, Alberta, Canada.
12
Department of Radiology, Radiooncology and Nuclear Medicine, Université de Montréal and Ste Justine Hospital, Montreal, Québec, Canada.
13
Department of Medical Genetics, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada.
14
Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
15
Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
16
Department of Pediatrics, University of Calgary and Alberta Children's Hospital, Calgary, Alberta, Canada.
17
Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
18
Research Innovation and Analytics, Alberta Health Services, Calgary, Alberta, Canada.

Abstract

INTRODUCTION:

Paediatric mild traumatic brain injury (mTBI) is a public health burden. Clinicians urgently need evidence-based guidance to manage mTBI, but gold standards for diagnosing and predicting the outcomes of mTBI are lacking. The objective of the Advancing Concussion Assessment in Pediatrics (A-CAP) study is to assess a broad pool of neurobiological and psychosocial markers to examine associations with postinjury outcomes in a large sample of children with either mTBI or orthopaedic injury (OI), with the goal of improving the diagnosis and prognostication of outcomes of paediatric mTBI.

METHODS AND ANALYSIS:

A-CAP is a prospective, longitudinal cohort study of children aged 8.00-16.99 years with either mTBI or OI, recruited during acute emergency department (ED) visits at five sites from the Pediatric Emergency Research Canada network. Injury information is collected in the ED; follow-up assessments at 10 days and 3 and 6 months postinjury measure a variety of neurobiological and psychosocial markers, covariates/confounders and outcomes. Weekly postconcussive symptom ratings are obtained electronically. Recruitment began in September 2016 and will occur for approximately 24 months. Analyses will test the major hypotheses that neurobiological and psychosocial markers can: (1) differentiate mTBI from OI and (2) predict outcomes of mTBI. Models initially will focus within domains (eg, genes, imaging biomarkers, psychosocial markers), followed by multivariable modelling across domains. The planned sample size (700 mTBI, 300 OI) provides adequate statistical power and allows for internal cross-validation of some analyses.

ETHICS AND DISSEMINATION:

The ethics boards at all participating institutions have approved the study and all participants and their parents will provide informed consent or assent. Dissemination will follow an integrated knowledge translation plan, with study findings presented at scientific conferences and in multiple manuscripts in peer-reviewed journals.

KEYWORDS:

neurological injury; paediatric neurology; paediatrics

PMID:
28710227
PMCID:
PMC5724225
DOI:
10.1136/bmjopen-2017-017012
[Indexed for MEDLINE]
Free PMC Article

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