SAN FRANCISCO (KCBS RADIO) – For the last half century, Traumatic Brain Injury (TBI) cases have been handled by mostly the same method by medical practitioners. Now, a group of researchers at UCSF are working to change that.
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“With a lot of the things that have happened over the last 10 to 20 years, we've had the development of blood-based biomarkers. Several years ago, we were able to get an FDA [U.S. Food and Drug Administration] test cleared to help us to manage patients with traumatic brain injury and rule out the need for a head CT,” UCSF neurosurgeon Geoff Manley explained to KCBS Radio’s Bret Burkhart on the latest “As Prescribed” episode.
Manley is one of the researchers working on creating a new framework to address TBI cases. He said that the new blood biomarker approach helps cut down on unnecessary CTs, tests that can expose patients to radiation. While Manley said CTs are relatively inexpensive and quick, he also said that they are ordered about 10 times more often than they are really needed.
Another aspect of TBI treatment that Manley is seeking to change is the scoring system used to categorize the injuries. Right now, the system addresses levels of consciousness and puts patients into three categories: mild, moderate and severe.
“We know, particularly over the work that's been done in the last 20 years or so, that there's a lot of limitations to this,” he told Burkhart.
Even some mild injuries can have a serious impact on patients’ ability to work and leave them with lifelong issues. On the other hand, some injuries categorized as severe have a “milder” impact.
“And today, when people get this label, oftentimes it reduces the level of care that they get. And there’s a lot of nihilism,” Manley added.
At the same time, Manley noted that TBI is essentially an “invisible injury” since medical providers cannot see through patients’ skulls to see the damage. That’s where the blood biomarker test comes in.
“The blood-based biomarkers have only recently been cleared by the FDA. And so, they’re just starting to make their way into emergency departments around the country,” he said.
Manley said the test is focused on measuring certain proteins in the bloodstream. If they are below a certain level, a CT scan isn’t needed.
“So what we're seeing now is just the beginnings of implementation, but we have plans working with the American College of Surgeons and several other professional societies of developing care pathways that use this framework in order to basically be able to take better care of patients when they seek out medical care for head injuries,” he said.
This new tool can be implemented along with consciousness observations and imaging tests to provide a more varied and robust approach to assessing and treating TBIs. Manley said it can benefit initial care and improve long-term outcomes for the estimated 5 million people each year seeking care for head injuries.
“We feel a lot of pressure to move this forward as quickly as we can because, you know, this is based upon a lot of sound data,” Manley said. “This isn’t just opinion about how we should do it, but this is evidence based. And we know that we need to do a better job to take care of these patients.”
Going forward, researchers are working on using the blood-based biomarker test in other applications.
Listen to this week’s “As Prescribed” to learn more.
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