The Spaulding-Harvard Traumatic Brain Injury (SH-TBI) continuum of care has proposed an ambitious work plan that directly addresses NIDRR’s 2012-2017 TBI Model Systems Competitive Priorities and Long Range Plan initiatives. Our extensive resources will enable us to make a significant contribution to the TBIMS national database and conduct innovative neuroimaging research that will favorably impact persons with severe TBI, their families and rehabilitation providers. Our infrastructure includes the top-ranked university in the world (Harvard University), two U.S. News and World Report top-10 acute care hospitals (Massachusetts General Hospital (MGH): #1 and Brigham and Women’s Hospital (BWH): #9) and the 5th ranked rehabilitation hospital in the nation (Spaulding Rehabilitation Hospital). Our comprehensive and fully-integrated brain injury rehabilitation program encompasses an extensive network of healthcare facilities that provide state-of-the-art care from emergency services in the field to downstream community reintegration and vocational rehabilitation services. The SH-TBI research team is led by Dr. Joseph T. Giacino and supported by a highly accomplished contingent of TBI investigators that includes Drs. Ross Zafonte, Therese O’Neil- Pirozzi and Mel Glenn, all of whom have at least 10 years of TBIMS experience. Our management structure emphasizes full inclusion of diverse stakeholders and underrepresented groups (who provided input into our work plan), cross-communication and transparent operational mechanisms to promote optimal performance. Our evaluation plan couples robust internal auditing procedures with mandatory TBIMS data monitoring procedures to ensure the security, integrity and validity of our research activities. The overarching goal of our proposal is to conduct innovative research that informs evidence-based multi-disciplinary rehabilitation care to enhance the lives of people with TBI. To accomplish this objective, we will:
1. Contribute to the TBIMS national database and monitor long-term functional outcomes. As the largest provider of brain injury rehabilitation services in New England, we anticipate easily exceeding NIDRR’s benchmark of 35 subjects enrolled per year. Based on our high regional volume and the results of our prospective recruitment tracking study, we have set a system goal of at least 50 subjects per year and pledge to continue our 15-year history of conducting long-term follow-up. Consumers provided direct input into our plan of research.
2. Conduct site-specific research using novel neuroimaging technologies to reduce diagnostic error and facilitate restoration of communication in persons with post-traumatic disorders of consciousness (DOC). We expect our assessment approach to reduce the unacceptably high rate of diagnostic error in this population (currently estimated at 40%), and to provide an alternative means of communication for those unable to speak or move. Dr. Giacino is a recognized expert in DOC and has established a strong collaboration with neuroimaging scientists from world-class laboratories at BWH. Our team will develop advanced neuroimaging strategies to improve detection of consciousness and provide a means of communication for those with severe speech and motor impairments.
3. Contribute to improved long term TBI outcomes by participating in at least one collaborative research project. The key members of our research team have a long history of collaboration within NIDRR and its federal partners. Our center is fiscally and operationally equipped to lead and participate in a broad spectrum of TBI research involving multiple sites.
4. Collaborate with the TBIMS Knowledge Translation Center (MSKTC) to disseminate our research findings. We have engaged the MGH Academy, a top KT thought leader, to collaborate closely with the MSKTC in our dissemination efforts to ensure meaningful delivery of information to our target audiences.