Publications and Reports

Giving Trauma The Lancet

Monash University researchers help give Traumatic Brain Injury The Lancet treatment

BehaviourWorks Australia Associate Professor Peter Bragge is one of four Monash University researchers to have contributed to an important Lancet Neurology Commission on the identification, prevention and treatment of an insufficiently recognised global health problem – traumatic brain injury (TBI).

TBI is the leading cause of mortality in young adults and a major cause of death and disability across all ages, with around 50 million people acquiring a TBI each year.

TBI not only places a huge burden on individuals, families and society but is estimated to cost the global economy around $US400 billion a year.

The epidemiology of TBI is also changing, with the number of elderly people acquiring TBI skyrocketing due to an increase in road traffic accidents, falls, sports-related concussions and conflicts/wars.

TBI may also be a risk factor for late neurodegenerative disorders such as dementia and Parkinson’s disease.

About the commission

To ensure that policy-makers, funders, patient representatives, clinicians and researchers are aware of the latest evidence on best-practice clinical care and research, the International Initiative for Traumatic Brain Injury Research (IntBIR) collaborated with the Lancet Neurology on the 30,000-word Commission entitled: ‘Traumatic brain injury – integrated approaches to improving clinical care and research’.

The Commission presents state-of-the-science descriptors of TBI and its severity, as well as methods for epidemiological monitoring. It also argues for a shift from the current paradigm, of a ‘one-size-fits-all’ approach, to more personalised treatments.

It highlights the need for evidence-based treatment guidelines, with A/Prof Bragge providing an overview of developments in knowledge translation (KT) – defined as “the science of developing strategies to integrate evidence-based knowledge into health policy and practice, based upon an understanding of behavioural drivers of practice within specific settings”.

His section demonstrates how KT can be harnessed to address the evidence/policy gap by:

  • defining target behaviours/standards,

  • gaining knowledge of current practice (i.e. the gap between what we know and what is happening in practice),

  • understanding drivers of behaviour, and

  • using information from 1 – 3 to develop a practice change intervention targeting known (rather than assumed) drivers of behaviour.

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The Lancet Neurology Commission was led by Professor Andrew Maas from Belgium’s Antwerp University Hospital and the University of Antwerp and Professor David Menon from the University of Cambridge and Addenbrooke’s Hospital, Cambridge.

The other Monash co-authors were: Anneliese Synnot (Cochrane Australia Research Fellow), Professor Jamie Cooper (Director, Australian and New Zealand Intensive Care Research Centre) and Professor Russell Gruen (Professor of Surgery and Public Health).

The paper can be found here.