FERNE Clinical Update
MILD TBI BIOMARKERS: CONCLUSIONS AND CLINICAL RECOMMENDATIONS
The Clinical Imperative and Core Concepts - CLINICAL IMPERATIVE
The primary goal of incorporating blood biomarkers (Glial Fibrillary Acidic Protein [GFAP] and Ubiquitin C-Terminal Hydrolase L1 [UCH-L1]) is to safely reduce unnecessary head Computed Tomography (CT) scans and associated radiation exposure in the majority of adult mild TBI (mTBI) patients, who rarely have intracranial lesions (CT-positive prevalence typically 5%–12%). FDA-cleared GFAP/UCH-L1 blood tests provide an objective, high-sensitivity adjunct to clinical decision rules to optimize triage and expedite care.
Representative Case
A 35-year-old male presents to the ED 6 hours after a fall from a skateboard, striking his head. He had a momentary loss of consciousness (LOC) at the scene, headache, and one episode of vomiting en route. His GCS is 15, and his neurological exam is non-focal. Based on clinical decision rules (e.g., Canadian CT Head Rule), imaging may be indicated due to LOC and vomiting. Given his low-risk clinical profile and short duration of symptoms, a GFAP/UCH-L1 biomarker test is drawn. If the test is negative, can we safely defer the CT scan, reduce his radiation exposure, and discharge him sooner? The answer, based on FDA-cleared technology and clinical trial data, is yes, for carefully selected patients.
Presentation and Handouts
- FERNE 2025 EIM Brain Biomarkers in mTBI Sloan ver 112625 Final
- FERNE 2025 Clinical Update ED Mild TBI Patients Lab Testing Conclusions and Recommendations Sloan 112625 Final
- FERNE 2025 Clinical Update ED Mild TBI Patients Lab Testing Sloan 112625 Final
- FERNE 2025 Lab Testing Mild TBI Patients Policy Brief Sloan 102625 Final
- FERNE 2025 Medical Information Document Mild TBI EIM Presentation Dec 2025 Sloan 112625 Final
- FERNE 2025 Lab Testing Mild TBI Conc Rec Changes 2025 Puravet SR and 2018 Bazarian ALERT TBI Data Sloan 120125 Final