Harmonization of social and physical health measures across prospective clinical studies of combat exposed service members and veterans: the total brain diagnostics program - Report - MDSpire

Harmonization of social and physical health measures across prospective clinical studies of combat exposed service members and veterans: the total brain diagnostics program

  • By

  • Shannon M. Nugent

  • Kate Clauss

  • Sara Vlajic

  • Maya E. O’Neil

  • Samuel R. Walton

  • Kelly M. Reavis

  • Christine Clermont

  • Alyssa Currao

  • Cree Foeller

  • Catherine B. Fortier

  • Sreekanth Kamineni

  • Arielle R. Knight

  • Aubrey A. Knoff

  • Landon B. Lempke

  • Helal Mobasher

  • William C. Walker

  • William P. Milberg

  • David X. Cifu

  • July 8, 2026

  • 0 min

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Standardization of Social and Physical Health Metrics in Clinical Research

Background

Traumatic Brain Injury (TBI) is a significant concern for veterans and military service members, leading to various psychosocial and functional challenges. Despite existing studies, there is a lack of comprehensive longitudinal data that combines biological, psychological, and social variables.

Data Highlights

VariableStudyFindings
73LIMBIC and TRACTSVariables harmonized
HigherLIMBICPain intensity and headache disability

Key Findings

  • A total of 73 variables were harmonized across LIMBIC and TRACTS studies.
  • No differences in sex or ethnicity distributions were found between the studies.
  • Pain intensity and headache disability were reported to be higher in the LIMBIC cohort.
  • Principal Component Analysis indicated that the data is suitable for pooled analysis.
  • Direct and indirect harmonization methods were employed for various health metrics.

Clinical Implications

The harmonization of health metrics can facilitate more effective research on TBI outcomes among veterans and service members. This approach may enhance the ability to identify specific clinical phenotypes and improve personalized treatment strategies.

Conclusion

The initial proof-of-concept for harmonizing health metrics demonstrates the feasibility of this approach in TBI research among military populations.

Related Resources & Content

  1. American Journal of Epidemiology, 2023 -- Disparities in Traumatic Brain Injury Outcomes Linked to Structural Inequities in the All of Us Database
  2. Journal of Neuro-Oncology, 2024 -- Connectivity of White Matter and Its Impact on Social Functioning in Pediatric Brain Tumor Survivors
  3. BMC Psychiatry, 2026 -- Measuring neighborhood climate and public stigma among veterans with mental illnesses
  4. VA/DoD Clinical Practice Guideline for the Management and Rehabilitation of Post-Acute Mild Traumatic Brain Injury, 2021
  5. Traumatic Brain Injury Center of Excellence 2025 Annual Report
  6. Investigation of Concurrent Transients in Cerebral Hemodynamics and Autonomic Nervous System Activity Utilizing Time-Lagged Cross-Correlation Matrices: Findings from the CENTER-TBI Study
  7. Traumatic Brain Injury | NINDS CDE
  8. Data Dictionary | FITBIR
  9. VA/DoD Clinical Practice Guideline for the Management and Rehabilitation of Post-Acute Mild Traumatic Brain Injury
  10. 2025 TBICoE Acute Concussion Care Pathway Training
  11. Traumatic Brain Injury Center of Excellence 2025 Annual Report
  12. A National Institute of Neurological Disorders and Stroke (NINDS) Project: Traumatic Brain Injury v3.0 Clinical Common Data Element Recommendations - ScienceDirect
  13. Echoes of the Battlefield: Five-Year Longitudinal Cognitive Trajectories Show Trend of Recovery for Deployment-Related Mild TBI in the LIMBIC-CENC Cohort - ScienceDirect
  14. Plasma Biomarkers, Brain Volume, and Cognitive Performance in Service Members and Veterans With mTBI: A LIMBIC-CENC Study - PMC
  15. Aerobic exercise and brain structure among military service members and Veterans with varying histories of mild traumatic brain injury: A LIMBIC-CENC exploratory investigation | PLOS One
  16. Action Collaborative on Traumatic Brain Injury Care: Adapted Clinical Practice Guideline - PMC

Original Source(s)

Harmonization of social and physical health measures across prospective clinical studies of combat exposed service members and veterans: the total brain diagnostics program

  • by Shannon M. Nugent, Kate Clauss, Sara Vlajic, Maya E. O’Neil, Samuel R. Walton, Kelly M. Reavis, Christine Clermont, Alyssa Currao, Cree Foeller, Catherine B. Fortier, Sreekanth Kamineni, Arielle R. Knight, Aubrey A. Knoff, Landon B. Lempke, Helal Mobasher, William C. Walker, William P. Milberg, David X. Cifu

  • July 8, 2026

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