Decision-making in severe traumatic brain injury: patient outcome, hospital costs, and research practice

Dijck, J.T.J.M. van (2021)

Doctoral Thesis

Even after thousands of years of experience in treating patients with TBI, decisions regarding the optimal treatment strategy remain difficult for both healthcare workers as policy makers. The first part of this thesis investigated the challenges of the treatment decision-making process in patients with (severe) TBI by focussing on three factors considered to be important in this process: patient outcome, in-hospital healthcare consumption, and in-hospital costs. The second part investigated the procedural difficulties in TBI research efficiency by focussing on the process of institutional review board approval and the use of informed consent procedures in patients with TBI with an inability to provide informed consent. Finally, we elaborate on the role of patient outcome and in-hospital costs in the acute treatment decision-making process in patients with severe TBI and make suggestions to optimize future research initiatives.

• Traumatic brain injury
• Treatment
• Decision-making
• Patient outcome
• Healthcare consumption
• Hospital costs
• Informed consent
• Institutional review board

• All authors: Dijck, J.T.J.M. van
• Supervisor: Peul, W.C.
• Co-supervisor: Kompanje, E.J.O.; Polinder, S.
• Committee: Steyerberg, E.W.; Stiggelbout, A.M.; Dupuis, H.M.; Bartels, R.H.M.A.; Vandertop, W.P.
• Qualification: Doctor (dr.)
• Awarding Institution: Faculty of Medicine, Leiden University Medical Center (LUMC), Leiden University
• Date: 2021-09-16
• ISBN (print): 9789463327671
• Sponsorship: The European Union seventh Framework Program (grant 602150) for Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) ; Hersenstichting Nederland (Dutch Brain Foundation) for Neurotraumatology Quality Registry (Net-QuRe)