Craniocerebral Injury, Crushing Skull Injury, Head Injuries, Closed, Head Injuries, Multiple, Head Injury, Head Injury Major, Head Injury, Minor, Head Injury, Open, Head Trauma, Head Trauma,Closed, Head Trauma Injury, Head Trauma, Penetrating, Injury, Craniocerebral, Injury, Head, Multiple Head Injury, Trauma, Head
Conditions
Brief summary
The goal of this study is to determine the sensitivity, specificity, and positive and negative predictive values of the portable near-infrared-based device (portable NIR-based device), the InfraScanner 2500™, to detect intracranial hematomas (epidural hematomas (EDH) and/or subdural hematomas (SDH)) in patients hospitalized at Mbarara Regional Referral Hospital (MRRH) or Mayanja Memorial Hospital (MMH) who have sustained or who are suspected to have sustained head trauma.
Detailed description
When applicable (conscious patient and/or family or legally authorized representative is present) the study will be introduced to the patient and relevant parties prior to the research team approaching the patient. While head trauma frequently results in impaired cognition and/or consciousness, and due to the urgency of these circumstances patients are often not accompanied by kin, whenever appropriate, the purpose of the research and the procedure will be explained in detail with all questions answered to the patient's and/or representative's satisfaction. Because patients who sustain head trauma injuries typically remain within the hospital for multiple days for monitoring and care, each participant may undergo multiple Computed Tomography (CT) scans over the course of his or her hospitalization, affording the opportunity of one to numerous measurements from each patient during his or her hospital stay. Upon presentation to the casualty unit at MRRH or MMH and following each CT scan, the study team will approach the patient to scan the patient's cranium with the InfraScanner 2500™. If permission is granted, the study team member sequentially measures the optical absorption for each of the 8 quadrants of the scalp (frontal, temporal, parietal, and occipital bilaterally). The device is engineered such that the light emitter and receiver are spaced 4 cm apart, allowing the light's intensity to be measured between adjacent light guides. This entire procedure, including greeting and scanning the patient should take \<10 minutes. Subsequent CT scan(s) the patient receives determines the number of potential data collections. The patient and/or representative may refuse a scan during any encounter, and as such, the scan will not be done. For each patient scanned with the InfraScanner 2500™ they will be de-identified with a subject number, with age, sex, gender, skin color, hair color, hair thickness, mechanism of injury, Glasgow Coma Scale score, and mean time elapsed between CT scan and near-infrared measurement. These data will be stored in de-identified form on the Research Electronic Data Capture (REDCap) database and/or Microsoft Excel on a secured network drive within the Department of Neurosurgery at Duke. The collection period for each research subject concludes 30-days following his or her initial measurement with the InfraScanner 2500™, patient discharge, or patient death.
Interventions
The Infrascanner is a portable screening device that uses Near-Infrared (NIR) technology to screen patients for intracranial bleeding, identifying those who would most benefit from immediate referral to a CT scan and neurosurgical intervention.
Sponsors
Study design
Eligibility
Inclusion criteria
* Any patient who presents to MRRH or MMH with suspected head trauma, who is able to, or who has a legally authorized representative who is able to consent in English, Swahili, or Luganda will be considered for this study.
Exclusion criteria
* Patients for which wounds to their head are too large to properly use the InfraScanner 2500™ will be excluded from this study. Patients will also be excluded if hair cannot be appropriately parted to allow for the fiberoptic tips of the device to make direct contact with the scalp. Patients for whom it is not possible to obtain an Infrascan within 30 minutes of their CT imaging will also be excluded from the study.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Infrascanner 2500™ Diagnostic Performance | Within 30 minutes following CT scan | Number of participants with detection of intracranial hemorrhage (ICH) by the InfraScanner 2500™ stratified by CT Positive and CT Negative using the CT as the gold standard for ICH presence. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Sensitivity of Intracranial Hemorrhage (ICH) Detection by the Infrascanner 2500™ | Within 30 minutes following CT scan | The accuracy of the Infrascanner 2500™ reported through the sensitivity of intracranial hemorrhage (ICH) detection (as compared to CT findings). Sensitivity measures the ability to identify true positives. |
| Specificity of Intracranial Hemorrhage (ICH) Detection by the Infrascanner 2500™ | Within 30 minutes following CT scan | The accuracy of the Infrascanner 2500™ reported through the specificity of intracranial hemorrhage (ICH) detection (as compared to CT findings). Specificity measures the ability to identify true negatives. |
Countries
Uganda
Contacts
Duke University
Participant flow
Recruitment details
Participants were recruited from a patient population presenting with suspected head trauma at MRRH and MMH, in Mbarara, Uganda. Patients ages 13 and above, able to give consent themselves or have a legally authorized representative (LAR) who could consent in English, Runyankole, or Luganda. Criteria excluded patients for whom could not obtain complete Infrascanner 2500™ measurements within 30 minutes of their CT scan. Recruitment started July 30th, 2024 and ended February 28th, 2025.
Pre-assignment details
186 consented/assessed; 6 excluded pre-assignment due to inability to obtain protocol-required CT or Infrascanner measurement (scalp/hair access or not completed within 30 min of CT), or ineligibility (post-neurosurgery in-hospital TBI, no presenting head trauma). Participants who consented but could not complete required device measurements were considered screen failures and were not assigned/enrolled. Thus 180 were assigned/enrolled.
Baseline characteristics
| Characteristic | — |
|---|---|
| Age, Continuous | 34.2 years STANDARD_DEVIATION 13.83 |
| Sex: Female, Male Female | 14 Participants |
| Sex: Female, Male Male | 166 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | 0 / 180 |
| other Total, other adverse events | 0 / 180 |
| serious Total, serious adverse events | 0 / 180 |