{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:47:03Z","timestamp":1792100823995,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2021,9,7]],"date-time":"2021-09-07T00:00:00Z","timestamp":1630972800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2021,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>The objective was to determine the accuracy of a new, rapid blood test combining measurements of both glial fibrillary acidic protein (GFAP) and ubiquitin carboxyl\u2010terminal hydrolase L1 (UCH\u2010L1) for predicting acute traumatic intracranial injury (TII) on head CT scan after mild traumatic brain injury (mTBI).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Analysis of banked venous plasma samples from subjects completing the Prospective Clinical Evaluation of Biomarkers of Traumatic Brain Injury (ALERT\u2010TBI) trial, enrolled 2012\u20132014 at 22 investigational sites in the United States and Europe. All subjects were \u226518\u00a0years old, presented to an emergency department (ED) with a nonpenetrating head injury and Glasgow Coma Scale score (GCS) 9\u201315 (mild to moderate TBI), underwent head CT scanning as part of their clinical care, and had blood sampling within 12\u00a0h of injury. Plasma concentrations of GFAP and UCH\u2010L1 were measured using i\u2010STAT Alinity and TBI plasma cartridge and compared to acute TII on head CT scan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 2011 subjects enrolled in ALERT\u2010TBI, 1918 had valid CT scans and plasma specimens for testing and 1901 (99.1%) had GCS 13\u201315 (mTBI), for which the rapid test was intended. Among these subjects, the rapid test had a sensitivity of 0.958 (95% confidence interval [CI]\u00a0=\u00a00.906 to 0.982), specificity of 0.404 (95% CI\u00a0=\u00a00.382 to 0.427), negative predictive value of 0.993 (95% CI\u00a0=\u00a00.985 to 0.997), and positive predictive value of 0.098 (95% CI\u00a0=\u00a00.082 to 0.116) for acute TII.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>A rapid i\u2010STAT\u2013based test had high sensitivity for prediction of acute TII, comparable to lab\u2010based platforms. The speed, portability, and high accuracy of this test may facilitate clinical adoption of brain biomarker testing as an aid to head CT decision making in EDs.<\/jats:p><\/jats:sec>","DOI":"10.1111\/acem.14366","type":"journal-article","created":{"date-parts":[[2021,8,6]],"date-time":"2021-08-06T18:21:48Z","timestamp":1628274108000},"page":"1308-1317","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":103,"title":["Accuracy of a rapid glial fibrillary acidic protein\/ubiquitin carboxyl\u2010terminal hydrolase L1 test for the prediction of intracranial injuries on head computed tomography after mild traumatic brain injury"],"prefix":"10.1111","volume":"28","author":[{"given":"Jeffrey J.","family":"Bazarian","sequence":"first","affiliation":[{"name":"Departments of Emergency Medicine and Neurology University of Rochester Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0358-2811","authenticated-orcid":false,"given":"Robert D.","family":"Welch","sequence":"additional","affiliation":[{"name":"Department of Emergency Wayne State University School of Medicine Detroit Michigan USA"},{"name":"Biostatistics and Epidemiology Research Design Core Wayne State University Detroit Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Krista","family":"Caudle","sequence":"additional","affiliation":[{"name":"Warfighter Brain Health Project Management Office US Army Medical Materiel Development Activity, US Army Medical Research and Development Command Fort Detrick Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig A.","family":"Jeffrey","sequence":"additional","affiliation":[{"name":"Abbott Point of Care Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James Y.","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Radiology San Diego Veterans Administration Medical Center La Jolla California USA"},{"name":"Department of Radiology UC San Diego Health System La Jolla California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raj","family":"Chandran","sequence":"additional","affiliation":[{"name":"Abbott Diagnostics Abbott Park Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tamara","family":"McCaw","sequence":"additional","affiliation":[{"name":"Abbott Point of Care Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saul A.","family":"Datwyler","sequence":"additional","affiliation":[{"name":"Abbott Diagnostics Abbott Park Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Zhang","sequence":"additional","affiliation":[{"name":"Abbott Point of Care Ottawa Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"McQuiston","sequence":"additional","affiliation":[{"name":"Abbott Diagnostics Abbott Park Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,9,7]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2008.08.021"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2015.16316"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1553-7250(12)38064-1"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra072149"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.13061"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2008.01.002"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.091974"},{"key":"e_1_2_9_9_1","unstructured":"New evidence of head CT scan overuse in the ED.Advisory Board.2015. 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