Mild Injury Outcomes Study (MIOS)

Principal Investigator(s) Yeates, Keith

Mild Injury Outcomes Study (MIOS)

A critical decision confronting health care providers is how to predict in the acute setting which children will suffer persistent postconcussive symptoms (PCS) and functional impairments after mild traumatic brain injury (TBI). Various methods are recommended for the diagnostic evaluation of children with mild TBI, but no previous study has systematically compared the prognostic significance of these methods. The overall goal of MIOS is to examine the utility of diagnostic methods commonly used in clinical settings in the prediction of persistent PCS and functional impairments. Participants include 8- to 15-year-old children with mild TBI (n = 200) or mild orthopedic injuries (n = 100), recruited in the Emergency Departments (ED) at two large children’s hospitals. Acute signs and symptoms of concussion, as well as mental status and balance, are assessed using standardized methods at the time of recruitment. All children complete computerized neuropsychological testing and magnetic resonance imaging (MRI) within 7 days of injury. PCS are assessed remotely on a weekly basis using electronic devices during the first 6 months post injury. Functional impairments are assessed in person acutely and 3 and 6 months post injury. The proposed research is innovative because no previous study has compared the predictive utility of these commonly-used methods for assessing pediatric mild TBI. The specific aims are (1) to examine the prediction of PCS and functional impairments following mild TBI and (2) to determine the incremental predictive utility of each of four assessment methods. A comprehensive study of these diagnostic methods and their incremental utility in predicting outcomes will have a major impact on clinical practice, particularly in acute care settings, by helping improve prognostic determinations, develop decision tools, and focus treatment efforts.


National Institutes of Health (NIH)


  • Ann Bacevice
  • Barbara Bangert
  • Erin Bigler
  • Daniel Cohen
  • Naomi Hunsaker
  • Leslie Mihalov
  • H. Gerry Taylor
  • Nicholas Zumberge

Participating Centers

  • The Research Institute at Nationwide Children’s Hospital (Columbus, OH)
  • Case Western Reserve University/Rainbow Babies and Children’s Hospital (Cleveland, OH)
  • Brigham Young University, Provo, UT