John Kramer and Catherine Jutzeler, ICORD, University of British Columbia, Vancouver, Canada

Neuro-surveillance in order to enhance spontaneous neurological recovery

Funded in: 2021, 2022, 2023

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Problem: Lack of prospective understanding for recovery
Target: Developing Neuro-Surveillance (Neuro-Surv)
Goal: Monitor neurological recovery in real-time in clinical practice

The overarching goal of the research project is to implement a system to monitor neurological recovery in clinical practice in real-time. Using Neuro-Surv, clinicians will be alerted to patients that are under- or overperforming in order – a necessary step towards prospectively understanding barriers and facilitators of recovery. To support the implementation of Neuro-Surv, the scientists will use data from the European Multi-center study about Spinal Cord Injury (EMSCI). This observational study has been ongoing in Europe for 20 uninterrupted years, during which various neurological and functional outcome measures have been collected on more than 5.000 patients during their transition from acute to chronic injury.

A limitation of the EMSCI thus far is its static nature, as data is only used retrospectively, when extracted for research purposes. Neuro-Surv will see the shift of EMSCI from a static research tool to a dynamic, educational and clinical instrument. Neuro-Surv utilizes data from the EMSCI database to provide precision estimates of neurological recovery based on demographic (e.g. age and sex) and acute injury characteristics (e.g. severity and level). After further developing Neuro-Surv (i.e. increasing speed and usability), version 2.0 will be integrated into the EMSCI centers as a real-time visualization and education tool. This will be done within the framework of weekly grand rounds at two participating EMSCI centers in Germany (i.e. Murnau and Heidelberg).

After implementing Neuro-Surv into their clinical practice, care providers (e.g. physicians, nurses, PTs and OTs) will be queried about their experience and provide feedback for improvements.

The primary scientific aim will address the reliability of neurological recovery at three-months post injury. A future direction is to tailor Neuro-Surv to also support patient education and involvement in research.