New Opportunities in Traumatic Brain Injury Research: Advancing the National Agenda - Executive Summary

INMHA the Canadian Institutes of Health Research (CIHR) entity whose mandate covers the neurosciences, mental health and addiction, in partnership with the Ontario Neurotrauma Foundation (ONF), hosted an invitational workshop on New Opportunities in Traumatic Brain Injury Research: Advancing the National Agenda, in Toronto on April 12 and 13, 2012.

The workshop brought together key stakeholders in the field of traumatic brain injury (TBI) from a variety of public and private sector organizations and institutions throughout Canada and the United States, to address what has become both a national and global crisis. TBI research is universally recognized as an area of urgent and unmet medical need and one in which collaboration is necessary to achieve progress.

Recognizing the opportunity to improve both the health of Canadians and the nation's economic wellbeing through a strategic approach to TBI research, more than 100 scientists, clinicians, administrators, and others with an expertise or interest in the subject attended the event to discuss opportunities, gaps, and ways forward.

The main purpose of the workshop was to introduce new opportunities to forge networks and partnerships in the field of TBI research, both nationally and internationally, and to identify the most promising areas in which Canada could draw upon  its best skills and expertise.

Major topics of discussion included new opportunities to participate in several new research funding opportunities to be launched soon by INMHA and its partners that in turn would be aligned with  a new International Initiative for TBI Research (InTBIR). Consideration was also given to the need to develop a national strategy for TBI research in Canada.

Slated to begin in mid-2013 and open to interested national funding agencies, InTBIR aims to develop effective strategies for pooling clinical data on a large scale that will identify the most effective early interventions to improve outcomes in TBI patients. The European Union will commit approximately  €30 million to this effort over the next seven years, and members of a U.S. consortium will support a $10 million data management infrastructure.

In line with InTBIR's objectives related to best practices in early diagnosis and treatment, this workshop focused on mild TBI (mTBI) and concussion in children and youth—a demographic that suffers an alarmingly high number of incidents, many of which still go unreported. There is also increasing concern about a possible relationship between multiple TBIs and early onset dementia, later substance-use disorders, and mental illness.

Those in attendance benefitted from a series of expert presentations on the current state of brain injury research in Canada, along with discussions concerning unmet needs, and knowledge translation (KT) toward standards of practice. Participants then broke into smaller groups for a series of concurrent brainstorming sessions centred around five themes:

  1. addressing the unique challenges of paediatric TBI,
  2. harnessing new technologies,
  3. implementing best practices in neuro-rehabilitation,
  4. improving the understanding and treatment of TBI comorbidities, and
  5. moving research into practice.

Participants displayed both a high degree of engagement and achieved a high degree of consensus within and among the groups on next steps and needs moving forward, which included the following:

  • Improve/standardize classifications and definitions of TBI to inform procedures for diagnosis and treatment.
  • Define common data elements, standardize data collection , and develop a national data registry.
  • Use the best evidence from research to develop practice guidelines for implementation.
  • Undertake studies/research to address gaps in diagnoses, treatments, and outcomes.
  • Create a research network and networking space to enable the sharing of samples, bio-specimens, results, technologies, human resources, and ideas.
  • Identify new biomarkers and conduct experiments to use them as part of a toolset for assessing early severity, prognosis, and monitoring.
  • Create a visible national platform, communities of practice, and networks founded on the utilization of best technologies for treatment, education, and delivery.
  • Harmonize program outcomes and the evaluation of current service systems across jurisdictions.
  • Harness public awareness of TBI to increase support from decision-makers at all levels.

The input from the workshop will be used by INMHA and its partners to develop new opportunities in support of TBI research in Canada, including a series of programs to be launched in the near future related to best practices in mTBI recognition, diagnosis, and treatment.

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