August 29, 2012

Jeanette Grider

Communication Sciences, Disorders Receives $1.5 Million Federal Grant

Research to focus on technology to assist veterans with traumatic brain injury.

The Department of Communication Sciences and Disorders at Saint Louis University has received a $1.5 million two-year grant from the Department of Defense to help develop a computer software system to document and track the functional health problems of veterans who sustained traumatic brain injuries (TBI) during Operation Enduring Freedom (Afghanistan) and Operation Iraqi Freedom. Of all persons injured during these wars, 20 percent have died while 80 percent have been left with some level of permanent impairment or disability.

Travis Threats, Ph.D.

Travis Threats, Ph.D., Professor and Chair of the department will serve as Co-Principal Investigator for the study. Serving as consultants on this grant are SLU faculty Yolanda Evans of the Department of Communication Sciences and Disorders, Rosemary Norris of the Department of Physical Therapy and Athletic Training, and Julie Henderson Kalb of the Department of Occupational Science and Occupational Therapy. A graduate student from the Department of Communication Sciences and Disorders also will be part of the research team.

The grant, done in collaboration with Principal Investigator Allen Tien, M.D., President and Director of Applied Research for Medical Decision Logic, Inc. will use the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) to develop the software system. Along with Tien's medical research software company, faculty from Johns Hopkins Division of Health Sciences Informatics also will be involved in this project.

Threats, who has worked with the World Health Organization's ICF program, said there has been a growing interest in the use of the ICF to track and improve functional health outcomes of the U.S. population by federal agencies, including the Center for Medicare and Medicaid and Social Security Disability. However, there has not been funding to develop the software to harness the use of this robust and complex classification system. The Department of Defense has undertaken the task of providing such funding.

The software program would be used by the Department of Defense to track disabilities in life functions which can lead to poor adjustment for these deserving veterans and achieving life goals such as being employed. The results of this project will be shared with Medicare and Social Security Disability to help them deal with the increasing demands for providing the best services for those with long-term chronic disabling conditions.

Study Background
Since 2000 there have been over 220,000 diagnosed cases of traumatic brain injury (TBI) among U.S. armed forces. This number represents a significant medical and moral imperative to provide these service men and women with the best possible rehabilitation and support services to lead their most active and high quality lives achievable. This is challenging because of the effects of TBI on neurological and psychological functioning.

For this purpose, a core resource is the World Health Organization's International Classification of Functioning, Disability and Health (ICF). The ICF was developed to provide a shared conceptual framework and usable coding system to represent functional health issues such as the ability to walk, talk, dress oneself, hold a job and enjoy being with family and friends. However, enabling use of the ICF to satisfy individual clinical care and population management needs across multiple health care settings (e.g. acute care and outpatient services) requires significantly expanded capabilities of health sciences informatics-based web tools.

To this end, Medical Decision Logic, Inc. will work with Dr. Threats and his SLU team to use its Health Sciences Process Framework (HSPF), a web technology and product platform, to support the development of intelligent interactive software systems to improve the functional health and contribute to successful rehabilitation outcomes of U.S. armed forces personnel with TBI.

About Travis Threats
A Full Professor and Chair of the Department of Communication Sciences and Disorders at Saint Louis University, Dr. Threats teaches courses concerning communication and cognitive disorders caused by acquired neurological diseases such as stroke, head trauma and dementia. His primary scholarly work has been with the World Health Organization (WHO) on the International Classification of Functioning, Disability and Health (ICF) and the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY). He has widely published and presented internationally on the ICF as well as evidence-based practice and rehabilitation health care ethics. He was the primary consultant for the development of the communication and swallowing sections of the ICF. He has been the representative liaison for his professional organization, the American Speech-Language-Hearing Association (ASHA), to the World Health Organization since 1999. He is the Senior Consultant for the WHO and the American Psychological Association for the development of the Procedural Manual and Guide for the Standardized Application of the ICF: A Manual for Health Professions, which is to be the guideline for the clinical use of ICF. He is the 2012 recipient of the Certificate for Recognition for Outstanding Contribution in International Achievement from ASHA and is only the second person ever given this award.

Threats will be responsible for the overall coordination of the clinical aspects of this project which would include 1) ICF training of consultants and clinicians participating in the study, 2) deciding the overall approach for selecting and translating specific assessments tools into ICF codes, 3) providing input into the development of the software, 4) assisting with focus groups of stakeholders concerning usability of the software , 5) identification of ICF code/assessment incongruities, 6) ongoing resource concerning the ICF for clinicians throughout the length of the study, and 7) assisting with preparation of the report of findings.

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