Pommerich Uwe M, Stubbs Peter W, Nielsen Jørgen Feldbæk
Department of Clinical Medicine, Hammel Neurorehabilitation Centre-University Research Clinic, Aarhus University, Voldbyvej 15, 8450, Hammel, Denmark.
Discipline of Physiotherapy, Graduate School of Health, Faculty of Health, University of Technology Sydney, Sydney, Australia.
Diagn Progn Res. 2025 Jan 7;9(1):1. doi: 10.1186/s41512-024-00183-3.
The initial theme of the PROGRESS framework for prognosis research is termed overall prognosis research. Its aim is to describe the most likely course of health conditions in the context of current care. These average group-level prognoses may be used to inform patients, health policies, trial designs, or further prognosis research. Acquired brain injury, such as stroke, traumatic brain injury or encephalopathy, is a major cause of disability and functional limitations, worldwide. Rehabilitation aims to maximize independent functioning and meaningful participation in society post-injury. While some observational studies can allow for an inference of the overall prognosis of the level of independent functioning, the context for the provision of rehabilitation is rarely described. The aim of this protocol is to provide a detailed account of the clinical context to aid the interpretation of our upcoming overall prognosis study.
The study will occur at a Danish post-acute inpatient rehabilitation facility providing specialised inpatient rehabilitation for individuals with moderate to severe acquired brain injury. Routinely collected electronic health data will be extracted from the healthcare provider's database and deterministically linked on an individual level to construct the study cohort. The study period spans from March 2011 to December 2022. Four outcomes will measure the level of functioning. Rehabilitation needs will also be described. Outcomes and rehabilitation needs will be described for the entire cohort, across rehabilitation complexity levels and stratified for relevant demographic and clinical parameters. Descriptive statistics will be used to estimate average prognoses for the level of functioning at discharge from post-acute rehabilitation. The patterns of missing data will be investigated.
This protocol is intended to provide transparency in our upcoming study based on routinely collected clinical data. It will aid in the interpretation of the overall prognosis estimates within the context of our current clinical practice and the assessment of potential sources of bias independently.
预后研究的PROGRESS框架的初始主题被称为总体预后研究。其目的是描述在当前护理背景下健康状况最可能的发展过程。这些平均的群体水平预后可用于为患者、卫生政策、试验设计或进一步的预后研究提供信息。获得性脑损伤，如中风、创伤性脑损伤或脑病，是全球范围内残疾和功能受限的主要原因。康复旨在使受伤后独立功能和有意义的社会参与最大化。虽然一些观察性研究可以推断独立功能水平的总体预后，但很少描述提供康复的背景情况。本方案的目的是详细描述临床背景，以帮助解释我们即将开展的总体预后研究。
该研究将在丹麦一家急性后期住院康复机构进行，该机构为中重度获得性脑损伤患者提供专门的住院康复服务。将从医疗服务提供者的数据库中提取常规收集的电子健康数据，并在个体层面进行确定性链接，以构建研究队列。研究期从2011年3月至2022年12月。将通过四项指标来衡量功能水平。还将描述康复需求。将针对整个队列、不同康复复杂程度水平以及按相关人口统计学和临床参数分层，描述结果和康复需求。将使用描述性统计来估计急性后期康复出院时功能水平的平均预后。将调查数据缺失模式。
本方案旨在基于常规收集的临床数据，为我们即将开展的研究提供透明度。它将有助于在我们当前临床实践的背景下解释总体预后估计，并独立评估潜在的偏倚来源。
