PIIS0003999315003950.pdf - Archives of Physical Medicine...

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INTRODUCTION Traumatic Brain Injury Rehabilitation Comparative Effectiveness Research: Introduction to the Traumatic Brain Injury e Practice Based Evidence Archives Supplement Susan D. Horn, PhD, a John D. Corrigan, PhD, b Marcel P. Dijkers, PhD c From the a Institute for Clinical Outcomes Research, International Severity Information Systems, Salt Lake City, UT; b Department of Physical Medicine and Rehabilitation, Ohio State University, Columbus, OH; and c Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY. Current affiliation for Horn, Department of Population Health Sciences, University of Utah School of Medicine, Salt Lake City, UT. Abstract This supplement of the Archives of Physical Medicine and Rehabilitation is devoted to the Traumatic Brain Injury e Practice Based Evidence study, the first practice-based evidence study, to our knowledge, of traumatic brain injury rehabilitation. The purpose of this preface is to place this study in the broader context of comparative effectiveness research and introduce the articles in the supplement. Archives of Physical Medicine and Rehabilitation 2015;96(8 Suppl 3):S173-7 ª 2015 by the American Congress of Rehabilitation Medicine This supplement of the Archives of Physical Medicine and Reha- bilitation offers an initial set of results and analyses of the TBI- PBE study, funded by the National Institutes of Health, National Institute on Disability and Rehabilitation Research, and Ontario Neurotrauma Foundation. It is the first practice-based evidence study, to our knowledge, of traumatic brain injury (TBI) rehabili- tation. Practicing therapists provided detailed documentation of therapy sessions, and this information was combined with medical record abstracted data, downloaded medication data, surveys of patients’ postdischarge outcomes, and clinician profiles of their training and experience in rehabilitation, in general, and with TBI specifically. The purpose of this preface is to place this study in the broader context of comparative effectiveness research (CER) and introduce the articles in the supplement, which offer conclusions based on what we believe is the richest dataset on TBI rehabili- tation ever assembled. The Problem The Centers for Disease Control and Prevention (CDC) estimated that in 2010 approximately 2.5 million people in the United States sustained a TBI. 1 Of these, 2.2 million had emergency department visits, 280,000 were hospitalized and survived, and 52,000 died. 1,2 The Brain Injury Association of America and researchers at the CDC estimated that 3.1 to 5.3 million people in the United States live with long-term disability arising from physical, emotional, or cognitive consequences of TBI. 3-5 Although the personal and fa- milial consequences of TBI are devastating, so are the financial implications. In 2010, the CDC estimated that the annual cost to society of TBI for direct medical care, rehabilitation, and indirect costs (eg, lost productivity) totaled > $76.5 billion, with 90% of these costs attributed to severe injury.

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