{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T08:01:09Z","timestamp":1773302469640,"version":"3.50.1"},"reference-count":44,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,3,21]],"date-time":"2016-03-21T00:00:00Z","timestamp":1458518400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"NIH-NIBIB","award":["5U54EB007954"],"award-info":[{"award-number":["5U54EB007954"]}]},{"name":"NIH\/NCRR","award":["8UL1-TR000077"],"award-info":[{"award-number":["8UL1-TR000077"]}]},{"name":"University of Cincinnati Neuroscience Institute (UCNI) Pilot Research Program"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2016,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Postconcussion symptoms (<jats:styled-content style=\"fixed-case\">PCS<\/jats:styled-content>) are a common complication of mild traumatic brain injury (<jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content>). Currently, there is no validated clinically available method to reliably predict at the time of injury who will subsequently develop <jats:styled-content style=\"fixed-case\">PCS<\/jats:styled-content>. The purpose of this study was to determine if <jats:styled-content style=\"fixed-case\">PCS<\/jats:styled-content> following mild <jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content> can be predicted during the initial presentation to an emergency department (<jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content>) using a novel robotic\u2010assisted assessment of neurologic function.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>All patients presenting to an urban <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> with a chief complaint of head injury within the preceding 24 hours were screened for inclusion from March 2013 to April 2014. The enrollment criteria were as follows: 1) age of 18 years or greater, 2) ability and willingness to provide written informed consent, 3) blunt head trauma and clinical diagnosis of isolated mild <jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content> by the treating physician, and 4) blood alcohol level of &lt;100 mg\/dL. Eligible mild <jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content> patients were enrolled and their neuromotor function was assessed in the <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> using a battery of five tests that cover a range of proprioceptive, visuomotor, visuospatial, and executive function performance metrics. At 3 weeks postinjury, participants were contacted via telephone to complete the Rivermead Post\u2010Concussion Symptoms Questionnaire to assess the presence of significant <jats:styled-content style=\"fixed-case\">PCS<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 66 mild <jats:styled-content style=\"fixed-case\">TBI<\/jats:styled-content> patients were enrolled in the study with 42 of them completing both the <jats:styled-content style=\"fixed-case\">ED<\/jats:styled-content> assessment and the follow\u2010up; 40 patients were included in the analyses. The area under the receiver operating characteristic curve (<jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content>) for the entire test battery was 0.72 (95% confidence interval [<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>] = 0.54 to 0.90). The <jats:styled-content style=\"fixed-case\">AUC<\/jats:styled-content> for tests that primarily measure visuomotor and proprioceptive performance were 0.80 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> = 0.65 to 0.95) and 0.71 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> = 0.53 to 0.89), respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The robotic\u2010assisted test battery has the ability to discriminate between subjects who developed <jats:styled-content style=\"fixed-case\">PCS<\/jats:styled-content> and those who did not. Additionally, poor visuomotor and proprioceptive performance were most strongly associated with subsequent <jats:styled-content style=\"fixed-case\">PCS<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.12906","type":"journal-article","created":{"date-parts":[[2016,1,25]],"date-time":"2016-01-25T11:31:11Z","timestamp":1453721471000},"page":"382-392","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["A Novel Tool for Evaluation of Mild Traumatic Brain Injury Patients in the Emergency Department: Does Robotic Assessment of Neuromotor Performance Following Injury Predict the Presence of Postconcussion Symptoms at Follow\u2010up?"],"prefix":"10.1111","volume":"23","author":[{"given":"Vignesh","family":"Subbian","sequence":"first","affiliation":[{"name":"Department of Electrical Engineering and Computing Systems University of Cincinnati Cincinnati OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jonathan J.","family":"Ratcliff","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Cincinnati Cincinnati OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Joseph J.","family":"Korfhagen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Cincinnati Cincinnati OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kimberly W.","family":"Hart","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Cincinnati Cincinnati OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason M.","family":"Meunier","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Cincinnati Cincinnati OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George J.","family":"Shaw","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Cincinnati Cincinnati OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher J.","family":"Lindsell","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Cincinnati Cincinnati OH"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"suffix":"Jr","given":"Fred R.","family":"Beyette","sequence":"additional","affiliation":[{"name":"Department of Electrical Engineering and Computing Systems University of Cincinnati Cincinnati OH"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,3,21]]},"reference":[{"key":"e_1_2_8_2_1","volume-title":"Traumatic Brain Injury in the United States: Emergency Department Visits, Hospitalizations, and Deaths, 2002\u20102006","author":"Coronado VG","year":"2010"},{"key":"e_1_2_8_3_1","volume-title":"Surveillance for Traumatic Brain Injury\u2010related Deaths: United States, 1997\u20102007","author":"Coronado VG","year":"2011"},{"key":"e_1_2_8_4_1","volume-title":"Report to Congress on Mild Traumatic Brain Injury in the United States: Steps to Prevent a Serious Public Health Problem","author":"National Center for Injury Prevention and Control (US)","year":"2003"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1080\/16501960410023877"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/16501960410023732"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1080\/02699050601111419"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2004.019273"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1186\/1748-5908-9-8"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/emermed-2012-201667"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2013.2984"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2014.04.003"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2013.3040"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-1331.2012.03813.x"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2009.1059"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11682-012-9156-5"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1682\/JRRD.2010.04.0057"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/1545968309356091"},{"key":"e_1_2_8_19_1","first-page":"S16","article-title":"The efficiency of clinical study assistants in screening for research subjects is affected by patient volume and research activity","volume":"14","author":"Fermann GJ","year":"2014","journal-title":"Acad Emerg Med"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/1545968309345267"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0140525X07001392"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00221-009-2079-8"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn1427"},{"key":"e_1_2_8_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/0166-2236(92)90344-8"},{"key":"e_1_2_8_25_1","doi-asserted-by":"publisher","DOI":"10.1186\/1743-0003-9-72"},{"key":"e_1_2_8_26_1","doi-asserted-by":"publisher","DOI":"10.1002\/1097-4679(198707)43:4<402::AID-JCLP2270430411>3.0.CO;2-E"},{"key":"e_1_2_8_27_1","doi-asserted-by":"publisher","DOI":"10.2466\/pms.1958.8.3.271"},{"key":"e_1_2_8_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-4679(199808)54:5<585::AID-JCLP4>3.0.CO;2-K"},{"key":"e_1_2_8_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/1743-0003-11-47"},{"key":"e_1_2_8_30_1","volume-title":"The Computational Neurobiology of Reaching and Pointing: A Foundation for Motor Learning","author":"Shadmehr R","year":"2005"},{"key":"e_1_2_8_31_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrn807"},{"key":"e_1_2_8_32_1","doi-asserted-by":"publisher","DOI":"10.1007\/BF00868811"},{"key":"e_1_2_8_33_1","doi-asserted-by":"publisher","DOI":"10.1007\/s004150050254"},{"key":"e_1_2_8_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2013.434"},{"key":"e_1_2_8_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/NPT.0b013e318254bd4f"},{"key":"e_1_2_8_36_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_2_8_37_1","unstructured":"R Core Team.R: A Language and Environment for Statistical Computing.https:\/\/www.r-project.org\/ 2014."},{"key":"e_1_2_8_38_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2105-12-77"},{"key":"e_1_2_8_39_1","unstructured":"HarrellFE DupontC.Hmisc: Harrell miscellaneous. R package version 3.15\u20100 2014."},{"key":"e_1_2_8_40_1","first-page":"1\u20139","article-title":"Integration of new technology for research in the emergency department: feasibility of deploying a robotic assessment tool for mild traumatic brain injury evaluation","volume":"3","author":"Subbian V","year":"2015","journal-title":"J Transl Eng Health Med"},{"key":"e_1_2_8_41_1","first-page":"79","article-title":"Motor control and learning principles for rehabilitation of upper limb movements after brain injury","volume":"9","author":"Winstein C","year":"2003","journal-title":"Handbook Neuropsychol"},{"key":"e_1_2_8_42_1","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/awh066"},{"key":"e_1_2_8_43_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0003-9993(99)90111-9"},{"key":"e_1_2_8_44_1","doi-asserted-by":"publisher","DOI":"10.1080\/09540260310001606692"},{"key":"e_1_2_8_45_1","doi-asserted-by":"publisher","DOI":"10.1080\/026990500120754"}],"container-title":["Academic Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Facem.12906","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/acem.12906","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T03:45:46Z","timestamp":1695699946000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/acem.12906"}},"subtitle":[],"editor":[{"given":"Peter D.","family":"Panagos","sequence":"additional","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2016,3,21]]},"references-count":44,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2016,4]]}},"alternative-id":["10.1111\/acem.12906"],"URL":"https:\/\/doi.org\/10.1111\/acem.12906","archive":["Portico"],"relation":{},"ISSN":["1069-6563","1553-2712"],"issn-type":[{"value":"1069-6563","type":"print"},{"value":"1553-2712","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,3,21]]},"assertion":[{"value":"2015-07-07","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2015-10-25","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2016-03-21","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}