Hostname: page-component-78c5997874-8bhkd Total loading time: 0 Render date: 2024-11-15T20:18:57.275Z Has data issue: false hasContentIssue false
  • English
  • Français

Head Injury: Variability of Course and Presence of Confounding Factors

Published online by Cambridge University Press:  10 March 2009

Howard H. Kaufman ,
Jean-Pierre Bretaudierre ,
Brian J. Rowlands ,
Debra K. Stein ,
David P. Bernstein ,
Karen A. Wagner  and
Philip L. Gildenberg
Howard H. Kaufman
Affiliation:
West Virginia University Medical School
Jean-Pierre Bretaudierre
Affiliation:
Queens University, Belfast
Brian J. Rowlands
Affiliation:
Queens University, Belfast
Debra K. Stein
Affiliation:
The Institute for Rehabilitation and Research, Houston
David P. Bernstein
Affiliation:
The Institute for Rehabilitation and Research, Houston
Karen A. Wagner
Affiliation:
The Institute for Rehabilitation and Research, Houston
Philip L. Gildenberg
Affiliation:
University of Texas Medical School, Houston
Get access Rights & Permissions [Opens in a new window]

Extract

Review of a large data base on 76 patients who had suffered head injuries and whose metabolic changes were being studied demonstrated the variability of their neurological courses and the importance of considering confounding factors in the analysis of such a group. It was apparent that many such patients continue to change neurologically and functionally for long periods of time, and that their ultimate outcome cannot be determined for at least 1 year. The study demonstrates the inherent complexity of a group of patients with head injuries and the need to use sophisticated statistical tools and a computer to demonstrate whether apparent trends are statistically valid in light of confounding factors and variabilities. Failure to take this complexity into account seems to be a major factor in many of the ongoing controversies in research on head injuries. A possible solution to the problem of potential biases introduced by lost patients would be to develop a method to use government records to obtain current addresses for patients involved in federally funded research.

Type
General Essays
Information
International Journal of Technology Assessment in Health Care , Volume 5 , Issue 4 , October 1989 , pp. 631 - 638
Copyright
Copyright © Cambridge University Press 1989

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES

Bailar, J. C. IIILouis, T. A., Lavori, P. W. & Polansky, M.Statistics in practice: A classification for biomedical research reports. New England Journal of Medicine, 1984, 311, 1482–87.Google Scholar
Jennett, B. & Teasdale, G.Management of head injuries. Philadelphia, PA: Davies, 1981.Google Scholar
Karnofsky, D. A., Burchenal, J. H., Armistead, G. C. Jr et al. , Triethylene melamine in the treatment of neoplastic disease. Archives of Internal Medicine, 1951, 87, 477–516.Google ScholarPubMed
Kaufman, H. H., Bretaudiere, J.-P., Rowlands, B. J. et al. General metabolism in head injury. Neurosurgery, 1987, 20, 254–65.CrossRefGoogle ScholarPubMed
Lavori, P. W., Louis, T. A., BailarJ. C., III J. C., III & Polansky, M.Designs for experiments– Parallel comparisons of treatment. New England Journal of Medicine, 1983, 309, 1291–98.CrossRefGoogle ScholarPubMed
Levin, H. S., Benton, A. L. & Grossman, R. G.Neurobehavioral consequences of closed head injury. New York: Oxford University Press. 1982.Google Scholar
Manship, L., McMillin, R. D. & Brown, J. J.The influence of sepsis and multisystem and organ failure on mortality in the surgical intensive care unit. American Surgeon, 1984, 50, 94–101.Google ScholarPubMed
Mosteller, F., Gilbert, J. & McPeek, B.Reporting standards and research strategies of controlled trials. Controlled Clinical Trials, 1980, 1, 37–58.CrossRefGoogle Scholar
Oddy, M. Head injury and social adjustment. In Brooks, N. (ed.), Closed head injury: Psychological, social, and family consequences. New York: Oxford University Press, 1984, 108–22.Google Scholar
Rimel, R. W., Giordani, B., Barth, J. T. & Jane, J. A.Moderate head injury: Completing the clinical spectrum of brain trauma. Neurosurgery, 1982, 11, 344–51.CrossRefGoogle ScholarPubMed
Teasdale, G. & Jennett, B.Assessment of coma and impaired consciousness. Lancet, 1974, ii, 81–84.CrossRefGoogle Scholar