{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T15:36:37Z","timestamp":1791387397602,"version":"4.3.3"},"reference-count":148,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,8,9]],"date-time":"2025-08-09T00:00:00Z","timestamp":1754697600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000245","name":"Michael Smith Health Research BC","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,4]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This review examines the principles, applications and methodological foundations of normative modelling, emphasizing its potential to assist in mitigating longstanding challenges in traumatic brain injury (TBI) research and management. TBI remains a major global health concern, with an incidence exceeding 50\u201360 million cases worldwide. Progress in research and clinical practice has been hindered by the complex and heterogeneous nature of TBI, arising from diverse aetiologies, injury mechanisms and pathophysiological processes that lead to variable clinical presentations.<\/jats:p>\n                  <jats:p>A significant obstacle, particularly present within neuroimaging, is the continued reliance on classification scales and analytical models that do not account for nuanced differences among patients. For example, the Glasgow Coma Scale and many prevalent models categorize injury severity levels by assuming homogeneity within groups, which inevitably results in heterogeneity and obscures individual variability. Similarly, traditional case-control research designs separate injury and control groups to conduct group difference testing, diluting valuable individual data by focusing on mean comparisons.<\/jats:p>\n                  <jats:p>We advocate for a paradigm shift towards normative modelling\u2014a flexible framework that assesses individual differences by comparing patients to a reference cohort. This approach moves beyond traditional methods that emphasize group differences, addressing the limitations of conventional classification by avoiding the aggregation of TBI patients into heterogeneous categories based on simplistic measures. By capturing the full spectrum of variability, normative modelling has the potential to improve patient selection in clinical trials and foster more personalized treatment strategies. Adopting this innovative approach aims to enhance outcomes for TBI patients by emphasizing individual variability rather than relying on broad group classifications. Normative modelling promises to transform the translation of TBI research into clinical practice, ultimately driving progress towards more effective, tailored interventions.<\/jats:p>","DOI":"10.1093\/brain\/awaf296","type":"journal-article","created":{"date-parts":[[2025,8,8]],"date-time":"2025-08-08T12:08:52Z","timestamp":1754654932000},"page":"3817-3832","source":"Crossref","is-referenced-by-count":7,"title":["The normative modelling framework for traumatic brain injury"],"prefix":"10.1093","volume":"148","author":[{"given":"Jake E","family":"Mitchell","sequence":"first","affiliation":[{"name":"Department of Neuroscience, School of Translational Medicine , Monash University, 99 Commercial Road, Melbourne, VIC, 3004 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart J","family":"McDonald","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, School of Translational Medicine , Monash University, 99 Commercial Road, Melbourne, VIC, 3004 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David J","family":"Sharp","sequence":"additional","affiliation":[{"name":"UK Dementia Research Institute Centre for Care Research & Technology Centre , Imperial College London, London W12 0BZ ,","place":["UK"]},{"name":"Department of Brain Sciences, Imperial College London , London W12 0BZ ,","place":["UK"]},{"name":"Centre for Injury Studies, Imperial College London , London W12 0BZ ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gavin","family":"Gan","sequence":"additional","affiliation":[{"name":"Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Faculty of Medicine, Nursing, and Health Sciences, Monash University , Clayton, VIC 3800 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennie L","family":"Ponsford","sequence":"additional","affiliation":[{"name":"Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Faculty of Medicine, Nursing, and Health Sciences, Monash University , Clayton, VIC 3800 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andre","family":"Marquand","sequence":"additional","affiliation":[{"name":"Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University , Nijmegen ,","place":["the Netherlands"]},{"name":"Department of Cognitive Neuroscience, Radboud University Medical Centre , Nijmegen ,","place":["the Netherlands"]},{"name":"Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, King's College London , London ,","place":["UK"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Wellington","sequence":"additional","affiliation":[{"name":"Djavad Mowafaghian Centre for Brain Health, University of British Columbia , Vancouver, BC V6T 1Z3 ,","place":["Canada"]},{"name":"Department of Pathology and Laboratory Medicine, University of British Columbia , Vancouver, BC V6T 1Z3 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Law","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, School of Translational Medicine , Monash University, 99 Commercial Road, Melbourne, VIC, 3004 ,","place":["Australia"]},{"name":"Department of Radiology, Alfred Health , 99 Commercial Road, Melbourne, VIC, 3004 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2525-8775","authenticated-orcid":false,"given":"Sandy R","family":"Shultz","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, School of Translational Medicine , Monash University, 99 Commercial Road, Melbourne, VIC, 3004 ,","place":["Australia"]},{"name":"Centre for Trauma & Mental Health, Vancouver Island University , Nanaimo, BC V9R 5S5 ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7810-1480","authenticated-orcid":false,"given":"Gershon","family":"Spitz","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, School of Translational Medicine , Monash University, 99 Commercial Road, Melbourne, VIC, 3004 ,","place":["Australia"]},{"name":"Monash-Epworth Rehabilitation Research Centre, School of Psychological Sciences, Faculty of Medicine, Nursing, and Health Sciences, Monash University , Clayton, VIC 3800 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,8,9]]},"reference":[{"key":"2025110518424280400_awaf296-B1","doi-asserted-by":"crossref","first-page":"e075049","DOI":"10.1136\/bmjopen-2023-075049","article-title":"Global, regional and national burden of traumatic brain injury and spinal cord injury, 1990\u20132019: A 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