The APAC Cohort analysis is a study of whether lesion progression and clinical outcome are different in patients on antiplatelet agents and anticoagulants (the APAC cohort) when compared to patients not on these agents. 

• The main analysis of the impact on clinical outcome is being driven by Harvey Levin and Claudia Robertson in TRACK-TBI and Marc Maegele in CENTER-TBI, with Hester Lingsma and Nancy Temkin providing methodological input. There have also been useful online discussions between Nancy Temkin and Ewout Steyerberg about analysis strategies, and Lindsay Wilson (from CENTER-TBI) will be liaising with outcome leads in TRACK –TBI to discuss harmonisation of outcome data.  This last issue will also inform the broader issue of cross calibrating/harmonising outcome assessments between the two studies.
• The imaging study is being driven from Work Package 8 of CENTER-TBI (Cambridge), with Pratik Mukherjee facilitating a subsequent analysis in TRACK-TBI.  The CENTER-TBI imaging cohorts have been identified and propensity matching for control populations is now complete.

Data Access Quality & Curation for Observational Research Designs (DAQCORD) is developing a practical self-assessment and reporting method for clinical research studies. The goal is to capture key information about data acquisition, quality control measures, and curation in a tool that is linked to the dataset so that potential research collaborators can determine if the data meets their needs and expectations. This effort originated in the Data Analytics and Management working group of the International Traumatic Brain Injury Research (InTBIR) initiative, however the DAQCORD reporting system is expected to be relevant to many brain diseases and disorders.

Traumatic brain injury (TBI) is a leading cause of mortality, and the leading cause of neurodisability, globally. Less than 50% of the substantial inter-individual variability in outcome in TBI is explained by classical covariates. We know that genetic variation modulates TBI outcome, but past studies have been small with limited gene targets. The Genetic Associations in Neurotrauma (GAIN) Consortium will draw on large studies funded as part of the International Traumatic Brain Injury Research (InTBIR) initiative, supplemented with cohorts from past high-quality studies, to generate a well-characterized sample of patients with blood banked for genetic analysis. Our initial sample consists of over 7000 patients from the CENTER-TBI and TRACK-TBI studies, supplemented by historical datasets and past trials, but the potential exists to expand this to over 10,000 patients.  We will use this substantial resource to conduct the first ever genome-wide association study (GWAS) in TBI, aiming to identify biological mechanisms that modulate response and recovery from injury.  GAIN will also draw on the expertise of genetics consortia in other diseases, to integrate rigorous phenotype harmonization with state-of-the-art genotyping and analysis. Our outputs could transform our understanding of TBI biology, and provide future research dividends. Discovering these variants could characterise novel disease mechanisms, improve prognostic precision, identify new therapeutic targets, and allow patient stratification for precision medicine approaches. GAIN will also remain open to new partners, and foster the collection of DNA as part of any planned or future high quality observational trial or interventional study, since an expanding collection of DNA samples and well characterised phenotype could bear substantial scientific and clinical dividends.