{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T17:57:45Z","timestamp":1778263065122,"version":"3.51.4"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Mindsource Brain Injury Network of the Colorado Department of Human Services"},{"name":"Eunice Kennedy Shriver National Institute for Child Health and Human Development","award":["R03 HD094912"],"award-info":[{"award-number":["R03 HD094912"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Clinicians currently make decisions about placing an intracranial pressure (ICP) monitor in children with traumatic brain injury (TBI) without the benefit of an accurate clinical decision support tool. The goal of this study was to develop and validate a model that predicts placement of an ICP monitor and updates as new information becomes available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods<\/jats:title>\n                    <jats:p>A prospective observational cohort study was conducted from September 2014 to January 2024. The setting included one US hospital designated as an American College of Surgeons Level 1 Pediatric Trauma Center. Participants were 389 children with acute TBI admitted to the ICU who had at least one Glasgow Coma Scale (GCS) score \u2264 8 or intubation with at least one GCS-Motor \u2264 5. We excluded children who received ICP monitors prior to arrival, those with GCS\u2009=\u20093 and bilateral fixed, dilated pupils, and those with a do not resuscitate order.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of the 389 participants, 138 received ICP monitoring. Several machine learning models, including a recurrent neural network (RNN), were developed and validated using 4 combinations of input data. The best performing model, an RNN, achieved an F1 of 0.71 within 720 minutes of hospital arrival. The cumulative F1 of the RNN from minute 0 to 720 was 0.61. The best performing non-neural network model, standard logistic regression, achieved an F1 of 0.36 within 720 minutes of hospital arrival.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These findings will contribute to design and implementation of a multidisciplinary clinical decision support tool for ICP monitor placement in children with TBI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jamia\/ocaf120","type":"journal-article","created":{"date-parts":[[2025,7,14]],"date-time":"2025-07-14T14:03:09Z","timestamp":1752501789000},"page":"182-192","source":"Crossref","is-referenced-by-count":3,"title":["Predicting intracranial pressure monitor placement in children with traumatic brain injury: a prospective cohort study to develop a clinical decision support tool"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2436-1367","authenticated-orcid":false,"given":"Seth","family":"Russell","sequence":"first","affiliation":[{"name":"Department of Biomedical Informatics, University of Colorado School of Medicine , Aurora, CO 80045,","place":["United States"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6391-0795","authenticated-orcid":false,"given":"Peter E","family":"DeWitt","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, University of Colorado School of Medicine , Aurora, CO 80045,","place":["United States"]}]},{"given":"Laura","family":"Helmkamp","sequence":"additional","affiliation":[{"name":"Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine , Aurora, CO 80045,","place":["United States"]}]},{"given":"Kathryn","family":"Colborn","sequence":"additional","affiliation":[{"name":"Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine , Aurora, CO 80045,","place":["United States"]},{"name":"Department of Biostatistics and Informatics, Colorado School of Public Health , Aurora, CO 80045,","place":["United States"]}]},{"given":"Charlotte","family":"Gray","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Colorado Research Institute , Aurora, CO 80045,","place":["United States"]}]},{"given":"Margaret","family":"Rebull","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, University of Colorado School of Medicine , Aurora, CO 80045,","place":["United States"]}]},{"given":"Yamila L","family":"Sierra","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Colorado School of Medicine , Aurora, CO 80045,","place":["United States"]}]},{"given":"Rachel","family":"Greer","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Colorado Research Institute , Aurora, CO 80045,","place":["United States"]}]},{"given":"Lexi","family":"Petruccelli","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Colorado Research Institute , Aurora, CO 80045,","place":["United States"]}]},{"given":"Sara","family":"Shankman","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Colorado Research Institute , Aurora, CO 80045,","place":["United States"]},{"name":"Section of Critical Care Medicine, Department of Pediatrics, University of Colorado School of Medicine , Aurora, CO 80045,","place":["United States"]}]},{"given":"Todd C","family":"Hankinson","sequence":"additional","affiliation":[{"name":"Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine , Aurora, CO 80045,","place":["United States"]},{"name":"Pediatric Neurosurgery, University of Colorado School of Medicine , Aurora, CO 80045,","place":["United States"]}]},{"given":"Fuyong","family":"Xing","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Informatics, Colorado School of Public Health , Aurora, CO 80045,","place":["United States"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5369-526X","authenticated-orcid":false,"given":"David J","family":"Albers","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, University of Colorado School of Medicine , Aurora, CO 80045,","place":["United States"]}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1483-4236","authenticated-orcid":false,"given":"Tellen D","family":"Bennett","sequence":"additional","affiliation":[{"name":"Department of Biomedical Informatics, University of Colorado School of Medicine , Aurora, CO 80045,","place":["United States"]},{"name":"Adult and Child Center for Health Outcomes Research and Delivery Science (ACCORDS), University of Colorado School of Medicine , Aurora, CO 80045,","place":["United 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