Overview

The Southeastern Michigan Traumatic Brain Injury System (SEMTBIS) is a program of research that studies a variety of topics related to traumatic brain injury (TBI). The SEMTBIS studies TBI treatment, recovery, and health outcomes. Day to day research activities are conducted at the Rehabilitation Institute of Michigan (RIM), but the project has strong ties with Wayne State University and the larger hospital network of the Detroit Medical Center.

At the SEMTBIS we are involved in local projects here at Wayne State University's School of Medicine as well as collaborative research efforts conducted across the country. Additionally, the SEMTBIS continues to participate in longitudinal data collection that is submitted four times per year to the TBI Model System National Database. The SEMTBIS is proud to share that we have been collecting data for this project for over 35 years. Our research findings are shared with persons with TBI, families, caregivers, and health care professionals locally, nationally, and internationally.

Local and Collaborative Research Projects

Predictors of financial capacity and risk of exploitation after TBI

The primary objective of this study will be to examine psychological and cognitive characteristics associated with financial capacity and exploitative risk for adults with TBI. Secondary objectives are to assess characteristics including depression and sociodemographics known to be associated with elevated risk. The study will be inviting care partners to answer questions in regard to the decision-making and general attitude about finances. SEMTBIS participants and their care partners are known to have similar socioeconomic and experiential challenges. This site-specific study will focus on financial vulnerability to abuse and exploitation of these underserved individuals known to have limited resources. This community based study will enroll individuals meeting inclusion criteria including at least 12 months post-injury, minimum of 18 years old, English speaking, and ability to consent and complete questionnaires. Consistent with prior research, care partners will be identified by our TBIMS participants as someone who knows them well and is actively involved in our research registry. We expect to enroll 150 dyads of family members and participants with TBI.

Financial Vulnerability in Persons with TBI

The objectives of this study are to examine factors that may affect financial vulnerability in persons who have sustained complicated mild to severe TBI. Financial vulnerability includes instability and quality of life, capacity to withstand financial shocks, and risk of exploitation. The central hypothesis is that economic, cognitive, mood, health, and environmental/social factors will predict financial vulnerability beyond what is accounted for by demographic and injury characteristics. Additionally, we expect that care-partner’s (e.g. a friend or family member who is actively involved with their life) ratings of their loved one’s financial decision making will provide unique value in predicting financial vulnerability of the person with TBI. The second main objective is to accomplish a detailed psychometric evaluation of tools used to assess financial vulnerability in other populations. This endeavor will both inform their use in clinical and research settings, and also enrich our theoretical understanding of financial vulnerability in TBI. Perhaps most important, this collaborative module would serve as the first large-scale, national estimate of the prevalence of problems in financial capacity and exploitation among adults with moderate to severe.

Understanding the Social Determinants of Healthcare Access After TBI

Recently studies have shown how the availability of state programs and services are associated with outcomes from TBI. This study will extend those investigations to develop a reliable method to elicit participant use of state programs and services. Accounting for other sources of social support, the study will also examine the relationship between use of state programs and services on outcomes following moderate/severe traumatic brain injury. First, an interview instrument will be developed and tested for reliability and predictive validity. Then, 200 TBI Model Systems participants at 2-30 years post-injury will complete follow-up interviews at participating centers. From this data we will develop a method for identifying the use of state programs and services and provide an initial test of their effect on outcomes.

Care4TBI

CARE4TBI project is a pragmatic, stakeholder-driven observational study which aims to: 1) standardize electronic medical record (EMR) documentation of rehabilitation therapy to allow extraction for research and operations, 2) compare the effectiveness of well-defined rehabilitation approaches to improve community participation and functional independence of patients with TBI, and 3) identify patient, provider, setting and post-discharge factors that modify the effect of therapy on key outcomes.

BeHealthy: Chronic Disease Management for TBI

This project will produce new knowledge and information to address current evidence gaps in the management of brain injury as a chronic health condition and, in so doing, will help optimize health, function, and community integration after traumatic brain injury (TBI). The primary output of this project will be a chronic disease management (CDM) model for people with TBI, their caregivers, and health care providers. The project will develop this model from a foundational evidence base and refine it using feasibility testing. The project will also generate information and propose policy that will allow implementation. Long-term outcomes of this work will be decreased mortality and improved health, function, and quality of life for people with TBI through (1) prevention and/or reduction in the rates of new onset co-morbid disease and disability after TBI, (2) extended rehabilitation services that better integrate with community-based supports, and (3) creation of evidence-based recommendations for healthy longevity.