Flora M Hammond1,2, Sheryl Katta-Charles3,4, Mary Beth Russell5,6, Ross D Zafonte7,8,9,10, Jan Claassen11,12, Amy K Wagner13, Louis Puybasset14,15, Satoshi Egawa16, Steven Laureys17,18, Michael Diringer19, Robert D Stevens20. 1. Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, 4141 Shore Drive, Indianapolis, IN, 46254, USA. Flora.hammond@rhin.com. 2. Rehabilitation Hospital of Indiana, Indianapolis, IN, USA. Flora.hammond@rhin.com. 3. Department of Physical Medicine and Rehabilitation, Indiana University School of Medicine, 4141 Shore Drive, Indianapolis, IN, 46254, USA. 4. Rehabilitation Hospital of Indiana, Indianapolis, IN, USA. 5. Department of Physical Medicine and Rehabilitation, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA. 6. TIRR Memorial Hermann, Houston, TX, USA. 7. Department of Physical Medicine and Rehabilitation, Harvard Medical School, Harvard University, 300 First Avenue, Boston, MA, 02129, USA. 8. Spaulding Rehabilitation Hospital, Boston, MA, USA. 9. Massachusetts General Hospital, Boston, MA, USA. 10. Brigham and Women's Hospital, Boston, MA, USA. 11. Department of Neurology, NewYork-Presbyterian Hospital, New York City, NY, USA. 12. Columbia University, New York City, NY, USA. 13. Department of Physical Medicine and Rehabilitation and Neuroscience, Clinical and Translational Science Institute, Safar Center for Resuscitation Research, and Center for Neuroscience, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. 14. Department of Anesthesiology and Intensive Care, Sorbonne University, Paris, France. 15. Groupe Hospitalier Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France. 16. Neurointensive Care Unit, Department of Neurosurgery, and Stroke and Epilepsy Center, TMG Asaka Medical Center, Saitama, Japan. 17. Coma Science Group, University Hospital of Liege, Liege, Belgium. 18. International Consciousness Science Institute, Hangzhou Normal University, Hangzhou, China. 19. Departments of Neurology, Neurosurgery, and Anesthesiology, Washington University School of Medicine, St Louis, MO, USA. 20. Division of Neuroscience Critical Care, Departments of Anesthesiology and Critical Care Medicine and Neurology and Neurosurgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Abstract
BACKGROUND: The current state of the science regarding the care and prognosis of patients with disorders of consciousness is limited. Scientific advances are needed to improve the accuracy, relevance, and approach to prognostication, thereby providing the foundation to develop meaningful and effective interventions. METHODS: To address this need, an interdisciplinary expert panel was created as part of the Coma Science Working Group of the Neurocritical Care Society Curing Coma Campaign. RESULTS: The panel performed a gap analysis which identified seven research needs for prognostic modeling and trajectory analysis ("recovery science") in patients with disorders of consciousness: (1) to define the variables that predict outcomes; (2) to define meaningful intermediate outcomes at specific time points for different endotypes; (3) to describe recovery trajectories in the absence of limitations to care; (4) to harness big data and develop analytic methods to prognosticate more accurately; (5) to identify key elements and processes for communicating prognostic uncertainty over time; (6) to identify health care delivery models that facilitate recovery and recovery science; and (7) to advocate for changes in the health care delivery system needed to advance recovery science and implement already-known best practices. CONCLUSION: This report summarizes the current research available to inform the proposed research needs, articulates key elements within each area, and discusses the goals and advances in recovery science and care anticipated by successfully addressing these needs.
BACKGROUND: The current state of the science regarding the care and prognosis of patients with disorders of consciousness is limited. Scientific advances are needed to improve the accuracy, relevance, and approach to prognostication, thereby providing the foundation to develop meaningful and effective interventions. METHODS: To address this need, an interdisciplinary expert panel was created as part of the Coma Science Working Group of the Neurocritical Care Society Curing Coma Campaign. RESULTS: The panel performed a gap analysis which identified seven research needs for prognostic modeling and trajectory analysis ("recovery science") in patients with disorders of consciousness: (1) to define the variables that predict outcomes; (2) to define meaningful intermediate outcomes at specific time points for different endotypes; (3) to describe recovery trajectories in the absence of limitations to care; (4) to harness big data and develop analytic methods to prognosticate more accurately; (5) to identify key elements and processes for communicating prognostic uncertainty over time; (6) to identify health care delivery models that facilitate recovery and recovery science; and (7) to advocate for changes in the health care delivery system needed to advance recovery science and implement already-known best practices. CONCLUSION: This report summarizes the current research available to inform the proposed research needs, articulates key elements within each area, and discusses the goals and advances in recovery science and care anticipated by successfully addressing these needs.
Authors: Risa Nakase-Richardson; John Whyte; Joseph T Giacino; Shital Pavawalla; Scott D Barnett; Stuart A Yablon; Mark Sherer; Kathleen Kalmar; Flora M Hammond; Brian Greenwald; Lawrence J Horn; Ron Seel; Marissa McCarthy; Johanna Tran; William C Walker Journal: J Neurotrauma Date: 2011-08-04 Impact factor: 5.269
Authors: Alexis F Turgeon; François Lauzier; Jean-François Simard; Damon C Scales; Karen E A Burns; Lynne Moore; David A Zygun; Francis Bernard; Maureen O Meade; Tran Cong Dung; Mohana Ratnapalan; Stephanie Todd; John Harlock; Dean A Fergusson Journal: CMAJ Date: 2011-08-29 Impact factor: 8.262
Authors: Alexis F Turgeon; François Lauzier; Karen E A Burns; Maureen O Meade; Damon C Scales; Ryan Zarychanski; Lynne Moore; David A Zygun; Lauralyn A McIntyre; Salmaan Kanji; Paul C Hébert; Valérie Murat; Giuseppe Pagliarello; Dean A Fergusson Journal: Crit Care Med Date: 2013-04 Impact factor: 7.598
Authors: John Whyte; Risa Nakase-Richardson; Flora M Hammond; Shane McNamee; Joseph T Giacino; Kathleen Kalmar; Brian D Greenwald; Stuart A Yablon; Lawrence J Horn Journal: Arch Phys Med Rehabil Date: 2013-05-31 Impact factor: 3.966
Authors: Joseph T Giacino; Douglas I Katz; Nicholas D Schiff; John Whyte; Eric J Ashman; Stephen Ashwal; Richard Barbano; Flora M Hammond; Steven Laureys; Geoffrey S F Ling; Risa Nakase-Richardson; Ronald T Seel; Stuart Yablon; Thomas S D Getchius; Gary S Gronseth; Melissa J Armstrong Journal: Neurology Date: 2018-08-08 Impact factor: 9.910
Authors: Flora M Hammond; Joseph T Giacino; Risa Nakase Richardson; Mark Sherer; Ross D Zafonte; John Whyte; David B Arciniegas; Xinyu Tang Journal: J Neurotrauma Date: 2018-10-19 Impact factor: 5.269
Authors: Robert G Kowalski; Flora M Hammond; Alan H Weintraub; Risa Nakase-Richardson; Ross D Zafonte; John Whyte; Joseph T Giacino Journal: JAMA Neurol Date: 2021-05-01 Impact factor: 18.302
Authors: Ruud van der Veen; Jaap Oosterlaan; Mike Bos; Mara van Dooren; Işıl Düdükçü; Andries van Iperen; Linda Kooiman; Karel Nicolas; Saskia Peerdeman; Marsh Königs Journal: J Med Syst Date: 2022-04-04 Impact factor: 4.920
Authors: Shraddha Mainali; Venkatesh Aiyagari; Sheila Alexander; Yelena Bodien; Varina Boerwinkle; Melanie Boly; Emery Brown; Jeremy Brown; Jan Claassen; Brian L Edlow; Ericka L Fink; Joseph J Fins; Brandon Foreman; Jennifer Frontera; Romergryko G Geocadin; Joseph Giacino; Emily J Gilmore; Olivia Gosseries; Flora Hammond; Raimund Helbok; J Claude Hemphill; Karen Hirsch; Keri Kim; Steven Laureys; Ariane Lewis; Geoffrey Ling; Sarah L Livesay; Victoria McCredie; Molly McNett; David Menon; Erika Molteni; DaiWai Olson; Kristine O'Phelan; Soojin Park; Len Polizzotto; Jose Javier Provencio; Louis Puybasset; Chethan P Venkatasubba Rao; Courtney Robertson; Benjamin Rohaut; Michael Rubin; Tarek Sharshar; Lori Shutter; Gisele Sampaio Silva; Wade Smith; Robert D Stevens; Aurore Thibaut; Paul Vespa; Amy K Wagner; Wendy C Ziai; Elizabeth Zink; Jose I Suarez Journal: Neurocrit Care Date: 2022-05-10 Impact factor: 3.532
Authors: Raimund Helbok; Verena Rass; Ettore Beghi; Yelena G Bodien; Giuseppe Citerio; Joseph T Giacino; Daniel Kondziella; Stephan A Mayer; David Menon; Tarek Sharshar; Robert D Stevens; Hanno Ulmer; Chethan P Venkatasubba Rao; Paul Vespa; Molly McNett; Jennifer Frontera Journal: Neurocrit Care Date: 2022-02-09 Impact factor: 3.532