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Bagg MK, Hicks AJ, Hellewell SC, Ponsford JL, Lannin NA, O'Brien TJ, Cameron PA, Cooper DJ, Rushworth N, Gabbe BJ, Fitzgerald M. The Australian Traumatic Brain Injury Initiative: Statement of Working Principles and Rapid Review of Methods to Define Data Dictionaries for Neurological Conditions. Neurotrauma Rep 2024; 5:424-447. [PMID: 38660461 PMCID: PMC11040195 DOI: 10.1089/neur.2023.0116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2024] Open
Abstract
The Australian Traumatic Brain Injury Initiative (AUS-TBI) aims to develop a health informatics approach to collect data predictive of outcomes for persons with moderate-severe TBI across Australia. Central to this approach is a data dictionary; however, no systematic reviews of methods to define and develop data dictionaries exist to-date. This rapid systematic review aimed to identify and characterize methods for designing data dictionaries to collect outcomes or variables in persons with neurological conditions. Database searches were conducted from inception through October 2021. Records were screened in two stages against set criteria to identify methods to define data dictionaries for neurological conditions (International Classification of Diseases, 11th Revision: 08, 22, and 23). Standardized data were extracted. Processes were checked at each stage by independent review of a random 25% of records. Consensus was reached through discussion where necessary. Thirty-nine initiatives were identified across 29 neurological conditions. No single established or recommended method for defining a data dictionary was identified. Nine initiatives conducted systematic reviews to collate information before implementing a consensus process. Thirty-seven initiatives consulted with end-users. Methods of consultation were "roundtable" discussion (n = 30); with facilitation (n = 16); that was iterative (n = 27); and frequently conducted in-person (n = 27). Researcher stakeholders were involved in all initiatives and clinicians in 25. Importantly, only six initiatives involved persons with lived experience of TBI and four involved carers. Methods for defining data dictionaries were variable and reporting is sparse. Our findings are instructive for AUS-TBI and can be used to further development of methods for defining data dictionaries.
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Affiliation(s)
- Matthew K. Bagg
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Health Sciences, University of Notre Dame Australia, Fremantle, Western Australia, Australia
| | - Amelia J. Hicks
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Victoria, Australia
| | - Sarah C. Hellewell
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Jennie L. Ponsford
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash-Epworth Rehabilitation Research Centre, Epworth Healthcare, Melbourne, Victoria, Australia
| | - Natasha A. Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Alfred Health, Melbourne, Victoria, Australia
| | - Terence J. O'Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Peter A. Cameron
- National Trauma Research Institute, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Emergency and Trauma Centre, The Alfred Hospital, Melbourne, Victoria, Australia
| | - D. Jamie Cooper
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Department of Intensive Care and Hyperbaric Medicine, The Alfred Hospital, Melbourne, Victoria, Australia
| | - Nick Rushworth
- Brain Injury Australia, Sydney, New South Wales, Australia
| | - Belinda J. Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Health Data Research UK, Swansea University Medical School, Swansea University, Singleton Park, United Kingdom
| | - Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Bentley, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
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Hossain S, Moeller H, Sharpe P, Campbell M, Kimlin R, Porykali B, Shannon B, Gray J, Afzali H, Harrison JE, Ivers RQ, Ryder C. Characterising the Aboriginal and Torres Strait Islander patient journey after a serious road traffic injury and barriers to access to compensation: a protocol. Inj Prev 2024; 30:75-80. [PMID: 37923356 DOI: 10.1136/ip-2023-044997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 10/08/2023] [Indexed: 11/07/2023]
Abstract
INTRODUCTION Road safety has been a long-enduring policy concern in Australia, with significant financial burden of road trauma and evident socioeconomic disparities. Transport injuries disproportionately impact individuals in remote areas, those in lower socioeconomic situations, and Aboriginal and Torres Strait Islander populations. There is a lack of insight into transport injuries in Aboriginal and Torres Strait Islander communities, absence of Indigenous perspective in published research and limited utilisation of linked data assets to address the inequity. Aim 1 is to determine the breadth, cost and causal factors of serious injury from road traffic crashes in South Australia (SA) and New South Wales (NSW) with a focus on injury prevention. Aim 2 is to identify enablers and barriers to compensation schemes for Aboriginal and Torres Strait Islander patients in SA and NSW. METHODS AND ANALYSIS This study will be guided by an Aboriginal and Torres Strait Islander Governance Group, applying Knowledge Interface Methodology and Indigenous research principles to ensure Indigenous Data Sovereignty and incorporation of informed perspectives. A mixed-method approach will be undertaken to explore study aims including using big data assets and mapping patient journey. CONCLUSION The results of this study will provide valuable insights for the development of focused injury prevention strategies and policies tailored to Aboriginal and Torres Strait Islander communities. By addressing the specific needs and challenges faced by these communities, the study aims to enhance road safety outcomes and promote equitable access to healthcare and compensation for affected individuals and their families.
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Affiliation(s)
- Sadia Hossain
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- Translational Health Research Institute, Western Sydney University, Campbelltown, New South Wales, Australia
| | - Holger Moeller
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
- The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Patrick Sharpe
- Far West Community Partnerships, Far West Region, South Australia, Australia
| | - Marnie Campbell
- Women's and Children's Health Network, North Adelaide, South Australia, Australia
| | - Rebecca Kimlin
- Barossa Hills Fleurieu Local Health Network, Mount Barker, South Australia, Australia
| | - Bobby Porykali
- The George Institute for Global Health, Newtown, New South Wales, Australia
| | - Brett Shannon
- School of Public Health, University of Illinois Chicago, Chicago, Illinois, USA
| | - Jodi Gray
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Hossein Afzali
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - James E Harrison
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Rebecca Q Ivers
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Courtney Ryder
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
- School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
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O'Reilly GM, Curtis K, Mitra B, Kim Y, Afroz A, Hunter K, Ryder C, Hendrie DV, Rushworth N, Tee J, D'Angelo S, Solly E, Bhattacharya O, Fitzgerald MC. Hospitalisations and in-hospital deaths following moderate to severe traumatic brain injury in Australia, 2015-20: a registry data analysis for the Australian Traumatic Brain Injury National Data (ATBIND) project. Med J Aust 2023; 219:316-324. [PMID: 37524539 DOI: 10.5694/mja2.52055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/26/2023] [Accepted: 06/29/2023] [Indexed: 08/02/2023]
Abstract
OBJECTIVE To describe the frequency of hospitalisation and in-hospital death following moderate to severe traumatic brain injury (TBI) in Australia, both overall and by patient demographic characteristics and the nature and severity of the injury. DESIGN, SETTING Cross-sectional study; analysis of Australia New Zealand Trauma Registry data. PARTICIPANTS People with moderate to severe TBI (Abbreviated Injury Score [head] greater than 2) who were admitted to or died in one of the twenty-three major Australian trauma services that contributed data to the ATR throughout the study period, 1 July 2015 - 30 June 2020. MAJOR OUTCOME MEASURES Primary outcome: number of hospitalisations with moderate to severe TBI; secondary outcome: number of deaths in hospital following moderate to severe TBI. RESULTS During 2015-20, 16 350 people were hospitalised with moderate to severe TBI (mean, 3270 per year), of whom 2437 died in hospital (14.9%; mean, 487 per year). The mean age at admission was 50.5 years (standard deviation [SD], 26.1 years), and 11 644 patients were male (71.2%); the mean age of people who died in hospital was 60.4 years (SD, 25.2 years), and 1686 deaths were of male patients (69.2%). The overall number of hospitalisations did not change during 2015-20 (per year: incidence rate ratio [IRR], 1.00; 95% confidence interval [CI], 0.99-1.02) and death (IRR, 1.00; 95% CI, 0.97-1.03). CONCLUSION Injury prevention and trauma care interventions for people with moderate to severe TBI in Australia reduced neither the incidence of the condition nor the associated in-hospital mortality during 2015-20. More effective care strategies are required to reduce the burden of TBI, particularly among younger men.
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Affiliation(s)
- Gerard M O'Reilly
- Alfred Hospital, Melbourne, VIC
- National Trauma Research Institute, Alfred Hospital, Melbourne, VIC
| | - Kate Curtis
- Sydney Nursing School, University of Sydney, Sydney, NSW
| | | | - Yesul Kim
- National Trauma Research Institute, Alfred Hospital, Melbourne, VIC
- Central Clinical School, Monash University, Melbourne, VIC
| | | | - Kate Hunter
- The George Institute for Global Health, Sydney, NSW
- The University of New South Wales, Sydney, NSW
| | - Courtney Ryder
- College of Medicine and Public Health, Flinders University, Adelaide, SA
| | | | | | - Jin Tee
- National Trauma Research Institute, Alfred Hospital, Melbourne, VIC
| | - Shane D'Angelo
- College of Medicine and Public Health, Flinders University, Adelaide, SA
| | - Emma Solly
- National Trauma Research Institute, Alfred Hospital, Melbourne, VIC
| | | | - Mark C Fitzgerald
- Alfred Hospital, Melbourne, VIC
- National Trauma Research Institute, Alfred Hospital, Melbourne, VIC
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Wahba AJ, Cromwell DA, Hutchinson PJ, Mathew RK, Phillips N. Mortality as an indicator of quality of neurosurgical care in England: a retrospective cohort study. BMJ Open 2022; 12:e067409. [PMID: 36332948 PMCID: PMC9639111 DOI: 10.1136/bmjopen-2022-067409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Postoperative mortality is a widely used quality indicator, but it may be unreliable when procedure numbers and/or mortality rates are low, due to insufficient statistical power. The objective was to investigate the statistical validity of postoperative 30-day mortality as a quality metric for neurosurgical practice across healthcare providers. DESIGN Retrospective cohort study. SETTING Hospital Episode Statistics data from all neurosurgical units in England. PARTICIPANTS Patients who underwent neurosurgical procedures between April 2013 and March 2018. Procedures were grouped using the National Neurosurgical Audit Programme classification. OUTCOMES MEASURED National 30-day postoperative mortality rates were calculated for elective and non-elective neurosurgical procedural groups. The study estimated the proportion of neurosurgeons and NHS trusts in England that performed sufficient procedures in 3-year and 5-year periods to detect unusual performance (defined as double the national rate of mortality). The actual difference in mortality rates that could be reliably detected based on procedure volumes of neurosurgeons and units over a 5-year period was modelled. RESULTS The 30-day mortality rates for all elective and non-elective procedures were 0.4% and 6.1%, respectively. Only one neurosurgeon in England achieved the minimum sample size (n=2402) of elective cases in 5 years needed to detect if their mortality rate was double the national average. All neurosurgical units achieved the minimum sample sizes for both elective (n=2402) and non-elective (n=149) procedures. In several neurosurgical subspecialties, approximately 80% of units (or more) achieved the minimum sample sizes needed to detect if their mortality rate was double the national rate, including elective neuro-oncology (baseline mortality rate=2.3%), non-elective neuro-oncology (rate=5.7%), neurovascular (rate=6.7%) and trauma (rate=11%). CONCLUSION Postoperative mortality lacks statistical power as a measure of individual neurosurgeon performance. Neurosurgical units in England performed sufficient procedure numbers overall and in several subspecialty areas to support the use of mortality as a quality indicator.
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Affiliation(s)
- Adam J Wahba
- Clinical Effectiveness Unit, Royal College of Surgeons, London, UK
- Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, UK
| | - David A Cromwell
- Clinical Effectiveness Unit, Royal College of Surgeons, London, UK
- Health Services Research & Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Peter J Hutchinson
- Academic Neurosurgery, University of Cambridge, Cambridge, UK
- Clinical Research, Royal College of Surgeons, London, UK
| | - Ryan K Mathew
- Leeds Institute of Medical Research, School of Medicine, University of Leeds, Leeds, UK
- Department of Neurosurgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - Nick Phillips
- Department of Neurosurgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Clinical Lead for Cranial Neurosurgery, Getting It Right First Time (GIRFT), London, UK
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O'Reilly GM, Curtis K, Kim Y, Mitra B, Hunter K, Ryder C, Hendrie DV, Rushworth N, Afroz A, D'Angelo S, Tee J, Fitzgerald MC. The Australian Traumatic Brain Injury National Data (ATBIND) project: a mixed methods study protocol. Med J Aust 2022; 217:361-365. [PMID: 35922394 DOI: 10.5694/mja2.51674] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 06/06/2022] [Accepted: 06/07/2022] [Indexed: 01/07/2023]
Abstract
BACKGROUND Traumatic brain injury (TBI) is the largest contributor to death and disability in people who have experienced physical trauma. There are no national data on outcomes for people with moderate to severe TBI in Australia. OBJECTIVES To determine the incidence and key determinants of outcomes for patients with moderate to severe TBI, both for Australia and for selected population subgroups, including Aboriginal and Torres Strait Islander Australians. METHODS AND ANALYSIS The Australian Traumatic Brain Injury National Data (ATBIND) project will analyse Australia New Zealand Trauma Registry (ATR) data and National Coronial Information Service (NCIS) deaths data. The ATR documents the demographic characteristics, injury event description and severity, processes of care, and outcomes for people with major injury, including TBI, assessed and managed at the 27 major trauma services in Australia. We will include data for people with moderate to severe TBI (Abbreviated Injury Scale [AIS] (head) score higher than 2) who had Injury Severity Scores [ISS] higher than 12 or who died in hospital. People will also be included if they died before reaching a major trauma service and the coronial report details were consistent with moderate to severe TBI. The primary research outcome will be survival to discharge. Secondary outcomes will be hospital discharge destination, hospital length of stay, ventilator-free days, and health service cost. ETHICS APPROVAL The Alfred Ethics Committee approved ATR data extraction (project reference number 670/21). Further ethics approval has been sought from the NCIS and multiple Aboriginal health research ethics committees. The ATBIND project will conform with Indigenous data sovereignty principles. DISSEMINATION OF RESULTS Our findings will be disseminated by project partners with the aim of informing improvements in equitable system-level care for all people in Australia with moderate to severe TBI. STUDY REGISTRATION Not applicable.
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Affiliation(s)
- Gerard M O'Reilly
- National Trauma Research Institute, Alfred Hospital, Melbourne, VIC
- Alfred Health, Melbourne, VIC
- Monash University, Melbourne, VIC
| | - Kate Curtis
- Sydney Nursing School, University of Sydney, Sydney, NSW
- Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, NSW
- Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, NSW
- The George Institute for Global Health, Sydney, NSW
| | - Yesul Kim
- National Trauma Research Institute, Alfred Hospital, Melbourne, VIC
- Central Clinical School, Monash University, Melbourne, VIC
| | - Biswadev Mitra
- National Trauma Research Institute, Alfred Hospital, Melbourne, VIC
- Alfred Health, Melbourne, VIC
- Monash University, Melbourne, VIC
| | - Kate Hunter
- The George Institute for Global Health, Sydney, NSW
| | - Courtney Ryder
- The George Institute for Global Health, Sydney, NSW
- Flinders University, Adelaide, SA
| | | | | | - Afsana Afroz
- National Trauma Research Institute, Alfred Hospital, Melbourne, VIC
| | | | - Jin Tee
- National Trauma Research Institute, Alfred Hospital, Melbourne, VIC
- Alfred Health, Melbourne, VIC
- Central Clinical School, Monash University, Melbourne, VIC
| | - Mark C Fitzgerald
- National Trauma Research Institute, Alfred Hospital, Melbourne, VIC
- Alfred Health, Melbourne, VIC
- Central Clinical School, Monash University, Melbourne, VIC
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Fitzgerald M, Ponsford J, Lannin NA, O'Brien TJ, Cameron P, Cooper DJ, Rushworth N, Gabbe B. AUS-TBI: The Australian Health Informatics Approach to Predict Outcomes and Monitor Intervention Efficacy after Moderate-to-Severe Traumatic Brain Injury. Neurotrauma Rep 2022; 3:217-223. [PMID: 35919508 PMCID: PMC9279124 DOI: 10.1089/neur.2022.0002] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Predicting and optimizing outcomes after traumatic brain injury (TBI) remains a major challenge because of the breadth of injury characteristics and complexity of brain responses. AUS-TBI is a new Australian Government–funded initiative that aims to improve personalized care and treatment for children and adults who have sustained a TBI. The AUS-TBI team aims to address a number of key knowledge gaps, by designing an approach to bring together data describing psychosocial modulators, social determinants, clinical parameters, imaging data, biomarker profiles, and rehabilitation outcomes in order to assess the influence that they have on long-term outcome. Data management systems will be designed to track a broad range of suitable potential indicators and outcomes, which will be organized to facilitate secure data collection, linkage, storage, curation, management, and analysis. It is believed that these objectives are achievable because of our consortium of highly committed national and international leaders, expert committees, and partner organizations in TBI and health informatics. It is anticipated that the resulting large-scale data resource will facilitate personalization, prediction, and improvement of outcomes post-TBI.
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Affiliation(s)
- Melinda Fitzgerald
- Curtin Health Innovation Research Institute, Curtin University, Nedlands, Western Australia, Australia
- Perron Institute for Neurological and Translational Science, Nedlands, Western Australia, Australia
| | - Jennie Ponsford
- School of Psychological Sciences, Monash University, Melbourne, Victoria, Australia
- Monash Epworth Rehabilitation Research Centre–Epworth Healthcare, Richmond, Victoria, Australia
| | - Natasha A. Lannin
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Terence J. O'Brien
- Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Peter Cameron
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - D. James Cooper
- Australian and New Zealand Intensive Care Research Centre Recovery Program (ANZIC-RC), Monash University, Melbourne, Victoria, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Nick Rushworth
- Brain Injury Australia, Sydney, New South Wales, Australia
| | - Belinda Gabbe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Ryder C, Wilson R, D'Angelo S, O'Reilly GM, Mitra B, Hunter K, Kim Y, Rushworth N, Tee J, Hendrie D, Fitzgerald MC, Curtis K. Indigenous Data Sovereignty and Governance: The Australian Traumatic Brain Injury National Data Project. Nat Med 2022; 28:888-889. [PMID: 35440783 DOI: 10.1038/s41591-022-01774-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Courtney Ryder
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia. .,The George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia.
| | - Roland Wilson
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Shane D'Angelo
- College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia
| | - Gerard M O'Reilly
- National Trauma Research Institute, Alfred Health, Melbourne, Victoria, Australia.,Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Biswadev Mitra
- National Trauma Research Institute, Alfred Health, Melbourne, Victoria, Australia.,Emergency and Trauma Centre, Alfred Health, Melbourne, Victoria, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Kate Hunter
- The George Institute for Global Health, The University of New South Wales, Sydney, New South Wales, Australia
| | - Yen Kim
- National Trauma Research Institute, Alfred Health, Melbourne, Victoria, Australia.,Department of Surgery, Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Nick Rushworth
- Brain Injury Australia, Putney, New South Wales, Australia
| | - Jin Tee
- National Trauma Research Institute, Alfred Health, Melbourne, Victoria, Australia.,Neurosurgery, Alfred Health, Melbourne, Victoria, Australia
| | - Delia Hendrie
- School of Population Health, Curtin University, Perth, Western Australia, Australia
| | - Mark C Fitzgerald
- National Trauma Research Institute, Alfred Health, Melbourne, Victoria, Australia.,Trauma Service, Alfred Health, Melbourne, Victoria, Australia
| | - Kate Curtis
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.,Illawarra Health and Medical Research Institute, University of Wollongong, Wollongong, New South Wales, Australia.,Emergency Department, Wollongong Hospital, Illawarra Shoalhaven Local Health District, Wollongong, New South Wales, Australia
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