Développement d'un système d'aide à la décision clinique pour optimiser la prise en charge des enfants après traumatisme crânio-cérébral sévère


Guillaume Emeriaud

Centre hospitalier universitaire Sainte-Justine


Domaine : santé de la mère, des enfants et des adolescents

Programme consortium pour le développement de la recherche en traumatologie - volet 2

Concours 2014-2015



Ministère de la Santé et des Services sociaux
Société de l'assurance automobile du Québec
Réseau privincial de recherche en adaptation-réadaptation
Association québécoise d'établissements de santé et de services sociaux
Associtation des établissements de réadaptation en déficience physique du Québec

Traumatic brain injury is a leading cause of death or disability in children. To limit these complications, optimize stabilization of general status and maintenance of brain function is of paramount importance in the acute phase. Several monitoring devices are used to assess brain function, but they are complex to interpret, and erroneous decisions can occur due to inappropriate interpretation. Moreover, management guidelines are inconsistently followed, leading to decreased chances of recovery. Computerized protocols may help the clinicians to accurately assess the patient brain status, to react faster, and to follow recommendations 24h/24. The objective of this project is to develop a computerized clinical decision support system (CDSS) which will continuously extract the data from monitoring devices, make a synthesis to generate a diagnosis, and produce treatment suggestions. In case of an emergency, alerts will also be generated.

The first step of the project (related to the present grant) will consist in creating the CDSS, and will test it using simulated data created by modeling, and with data from a clinical database.

In a second step, utilizing the preliminary data, we will apply for a larger grant to further develop the system. The CDSS will be finalized to allow its clinical use. The clinical decision rules implemented in the system will be extended based on a consensus obtained after international consultation. A clinical study will then be conducted to evaluate the CDSS's performance and treatment suggestions. In the long term, we will conduct larger studies to assess the CDSS's impact on patient care and outcome.

We expect that this innovative CDSS will improve the management of children with severe traumatic brain injury. This should lead to decreased disabilities and related consequences for the child, family, and health care system.