Longitudinal pain intensity and interference symptomatology in mild traumatic brain injury: a TRACK-TBI study
Bibliographic record
Abstract
ABSTRACT: An estimated 50% to 75% of patients with mild traumatic brain injury (mTBI) report chronic pain. Symptomatology evolution, subtypes, and risk factors remain poorly understood. We evaluated patient-reported pain intensity and interference with daily function in a longitudinal U.S. mTBI cohort. The Transforming Research and Clinical Knowledge in Traumatic Brain Injury Study prospectively enrolled patients with TBI across 18 trauma centers who received head computed tomography (CT) within 24 hours post-injury. Subjects aged ≥17 years with arrival Glasgow Coma Scale = 13 to 15, Marshall CT Score = 1 to 2, and PROMIS-Pain Intensity and Interference assessments at 2 weeks, 3 months, 6 months, and 12 months post-injury were included. Subjects with cranial surgery, major extracranial injury, or pre-injury musculoskeletal pain were excluded. Healthy controls (HCs) completed assessments at all timepoints. Pain assessment T-scores were compared using mixed-effect linear regressions. Adjusted mean differences (aMDs; [95% confidence intervals]) were reported. In 906 subjects (mTBI = 710, HC = 196), mean age was 39.6 ± 16.7-years, 64% were male, and 75% were White/Caucasian. In subjects with mTBI, 35% were CT positive, ≥80% reported pain intensity or interference symptoms at 2 weeks post-injury, and <20% received TBI care postdischarge. Compared with HCs, CT-negative subjects had statistically elevated pain intensity (aMD; 2 weeks: +12.8 [10.9-14.6], 3 months: +4.6 [2.7-6.6], 6 months: +3.4 [1.4-5.4], 12 months: +2.7 [0.7-4.7]) and interference (aMD; 2 weeks: +12.3 [10.7-13.9], 3 months: +4.6 [3.0-6.2], 6 months: +3.1 [1.4-4.8], 12 months: +2.1 [0.4-3.8]). Similarly vs HCs, CT-positive subjects had statistically elevated pain intensity (aMD; 2 weeks: +12.5 [10.4-14.6], 3 months: +3.8 [1.7-5.9], 6 months: +2.8 [0.6-5.0], 12 months: +2.4 [0.2-4.6]) and interference (aMD; 2 weeks: +11.7 [9.9-13.5], 3 months: +4.0, [2.2-5.8], 6 months: +2.9 [1.1-4.7], and 12 months: +2.2 [0.3-4.0]). Pain intensity and daily interference symptoms remained longitudinally elevated in patients with mTBI. The majority did not receive follow-up care for TBI, underscoring opportunities for preventative and therapeutic interventions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".