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Investigating the Variability in Mild Traumatic Brain Injury Definitions: A Prospective Cohort Study

Crowe, Louise M.; Hearps, Stephen; Anderson, Vicki; Borland, Meredith; Phillips, Natalie; Kochar, Amit; Dalton, Sarah; Cheek, John A.; Gilhotra, Yuri; Furyk, Jeremy; Neutze, Jocelyn; Lyttle, Mark; Bressan, Silvia; Donath, Susan; Molesworth, Charlotte; Oakley, Ed; Dalziel, Stuart R.; Babl, Franz E.

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Louise M. Crowe

Stephen Hearps

Vicki Anderson

Meredith Borland

Natalie Phillips

Amit Kochar

Sarah Dalton

John A. Cheek

Yuri Gilhotra

Jeremy Furyk

Jocelyn Neutze

Mark Lyttle

Silvia Bressan

Susan Donath

Charlotte Molesworth

Ed Oakley

Stuart R. Dalziel

Franz E. Babl


© 2018 American Congress of Rehabilitation Medicine Objective: To prospectively compare the proportion of traumatic brain injuries (TBIs) that would be classified as mild by applying different published definitions of mild TBI to a large prospectively collected dataset, and to examine the variability in the proportions included by various definitions. Design: Prospective observational study. Setting: Hospital emergency departments. Participants: Children (N=11,907) aged 3 to 16 years (mean age, 8.2±3.9y). Of the participants, 3868 (32.5%) were girls, and 7374 (61.9%) of the TBIs were the result of a fall. Median Glasgow Coma Scale score was 15. Main Outcome Measures: We applied 17 different definitions of mild TBI, identified through a published systematic review, to children aged 3 to 16 years. Adjustments and clarifications were made to some definitions. The number and percentage identified for each definition is presented. Results: Adjustments had to be made to the 17 definitions to apply to the dataset: none in 7, minor to substantial in 10. The percentage classified as mild TBI across definitions varied from 7.1% (n=841) to 98.7% (n=11,756) and varied by age group. Conclusions: When applying the 17 definitions of mild TBI to a large prospective multicenter dataset of TBI, there was wide variability in the number of cases classified. Clinicians and researchers need to be aware of this variability when examining literature concerning children with mild TBI.


Crowe, L. M., Hearps, S., Anderson, V., Borland, M., Phillips, N., Kochar, A., …Babl, F. E. (2018). Investigating the Variability in Mild Traumatic Brain Injury Definitions: A Prospective Cohort Study. Archives of Physical Medicine and Rehabilitation, 99(7), 1360-1369.

Journal Article Type Article
Acceptance Date Dec 14, 2017
Online Publication Date Feb 4, 2018
Publication Date Jul 1, 2018
Publicly Available Date Feb 4, 2019
Journal Archives of Physical Medicine and Rehabilitation
Print ISSN 0003-9993
Electronic ISSN 1532-821X
Publisher Elsevier
Peer Reviewed Peer Reviewed
Volume 99
Issue 7
Pages 1360-1369
Keywords traumatic brain injury, head injuries, child
Public URL
Publisher URL
Additional Information Additional Information : This is the author's accepted manuscript. The final published version is available here:


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