A composite outcome for mild traumatic brain injury in trials of hyperbaric oxygen

创伤性脑损伤 高压氧 析因分析 随机对照试验 医学 临床试验 物理疗法 事后 心理学 内科学 麻醉 精神科
作者
Lindell K. Weaver,Susan Churchill,Steffanie H Wilson,Donald Hebert,Kayla Deru,Anne S. Lindblad
出处
期刊:Undersea & Hyperbaric Medicine [Undersea and Hyperbaric Medical Society (UHMS)]
卷期号:46 (3): 341-352 被引量:7
标识
DOI:10.22462/13.15.2019.11
摘要

Global outcomes can strengthen inferences from clinical trials. We evaluate global outcomes for persistent post-concussive symptoms (PCS) after mild traumatic brain injury (mTBI) in two clinical trials of hyperbaric oxygen (HBO2) in United States service members.During study design, outcomes of symptom, cognitive, and functional impairments planned for a trial of HBO2 for PCS (HOPPS) were weighted and grouped into different domains to formulate the composite outcome total score. The composite outcome was compared between the intervention groups in HOPPS and those in a subsequent HBO2 trial (BIMA) for validation. Additionally, two post hoc global outcome measures were explored, including one composed of components that demonstrated favorable characteristics in both studies and another via components used in another TBI randomized trial (COBRIT).In total, 143 active-duty or veteran military personnel were randomized across the two studies. Composite total scores improved from baseline for HBO2 (mean ± SD -2.9±9.0) and sham (-2.9±6.6) groups in HOPPS but did not differ significantly between groups (p=0.33). In BIMA, 13-week changes from baseline favored the HBO2 group (-3.6±6.4) versus sham (-0.3±5.2; p=0.02). No between-group differences were found when COBRIT composite scoring was applied to BIMA. Overall, HBO2 effects were maximized when the post hoc global measure derived from both studies was applied to the data.Composite total scores in HOPPS and BIMA were consistent with primary study results. The global measures considered may offer utility as endpoints to achieve maximal HBO2 effect in future trials of the mTBI population.clinicaltrials.gov Identifiers NCT01611194 (BIMA) and NCT01306968 (HOPPS).

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