Kevin Henshall

Counties Manukau District Health Board

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Andrew D. MacCormick

University of Auckland

Patria A. Hume

Auckland University of Technology

Katherine Forch

Auckland University of Technology

Doug King

Auckland University of Technology

Kris Fernando

Sri Lanka Institute of Information Technology

Mark Fulcher

Royal Australasian College of Physicians

Alice Theadom

Auckland University of Technology

Natalie Hardaker

Auckland University of Technology

Nusratnaaz Shaikh

Auckland University of Technology

Sam Jewell

Wellington Hospital

Cooperative Institutions

Australia and New Zealand Banking Group

Auckland University of Technology

National University of Singapore

University of Auckland

University of Melbourne

Singapore General Hospital

The Royal Melbourne Hospital

Counties Manukau District Health Board

Duke-NUS Medical School

National Cancer Centre Singapore

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The Brain Injury Screening Tool (BIST): Tool development, factor structure and validity

PLoS ONE (2021)

Alice Theadom Natalie Hardaker Charlotte Bray Richard J. Siegert Kevin Henshall

Currently health care pathways (the combination and order of services that a patient receives to manage their injury) following a mild traumatic brain injury vary considerably. Some clinicians lack confidence in injury recognition, management and knowing when to refer. A clinical expert group developed the Brain Injury Screening Tool (BIST) to provide guidance on health care pathways based on clinical indicators of poor recovery. The tool aims to facilitate access to specialist services (if required) to improve longer term prognosis. The tool was developed using a three-step process including: 1) domain mapping; 2) item development and 3) item testing and review. An online retrospective survey of 114 adults (>16 years) who had experienced a mild brain injury in the past 10 years was used to determine the initial psychometric properties of the 15-item symptom scale of the BIST. Participants were randomised to complete the BIST and one of two existing symptom scales; the Rivermead Post-concussion Symptom Questionnaire (RPQ) or the Sports Concussion Assessment Test (SCAT-5) symptom scale to determine concurrent validity. Participant responses to the BIST symptom scale items were used to determine scale reliability using Cronbach’s alpha. A principal components analysis explored the underlying factor structure. Spearman’s correlation coefficients determined concurrent validity with the RPQ and SCAT-5 symptom scales. The 15 items were found to require a reading age of 6–8 years old using readability statistics. High concurrent validity was shown against the RPQ ( r = 0.91) and SCAT-5 ( r = 0.90). The BIST total symptom scale (α = 0.94) and the three factors identified demonstrated excellent internal consistency: physical/emotional (α = 0.90), cognitive (α = 0.92) and vestibular-ocular (α = 0.80). This study provides evidence to support the utility, internal consistency, factor structure and concurrent validity of the BIST. Further research is warranted to determine the utility of the BIST scoring criteria and responsiveness to change in patients.

Concurrent validity

Acquired brain injury

10.1371/journal.pone.0246512

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Citations (16)

Chicago Journal of Theoretical Computer Science (2010)

Kevin Henshall Peter Schachte Harald Søndergaard Leigh Whiting

This paper is concerned with the problem of Boolean approximation in the following sense: given a Boolean function class and an arbitrary Boolean function, what is the function's best proxy in the class?Specifically, what is its strongest logical consequence (or envelope) in the class of affine Boolean functions.We prove various properties of affine Boolean functions and their representation as ROBDDs.Using these properties, we develop an ROBDD algorithm to find the affine envelope of a Boolean function.

10.4086/cjtcs.2010.011

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The Red Blanket Protocol in a tertiary centre in Aotearoa New Zealand: does this trauma protocol improve time to surgery and clinical outcomes?

ANZ Journal of Surgery (2022)

Fardowsa Mohamed Megan Grinlinton Kevin Henshall Murray P. Cox Andrew D. MacCormick

Patients who are haemodynamically unstable from surgical emergencies require prompt surgical intervention, and delay to surgery may lead to poorer clinical outcomes. The Red Blanket Protocol (RBP) is a communication algorithm intended to facilitate surgery as expediently and safely as possible. By developing a protocol for these channels of communication, RBP may reduce the time to surgical intervention and improve patient outcomes. Our aim was to identify whether patient outcomes, including time to surgery, blood product use and survival were improved by the Red Blanket protocol.Haemodynamically unstable adults in Middlemore Hospital, Aotearoa New Zealand from 1/1/2014 to 31/12/2015 were compared with RBP patients from 1/4/2017 to 1/4/2020. Time from emergency department (ED) to knife-to-skin (KTS) was compared between the groups. The number of blood products used, LOS and 30- and 90-day survival were also compared between the pre-protocol and RBP groups.Thirty-two patients were identified in the pre-protocol group, and 25 in the RBP group. The median time from ED to KTS reduced from 84 to 70.5 min after the implementation of RBP (P = 0.044). The median number of blood products was 21 pre-protocol and 11.5 in the RBP group (P = 0.102). The median LOS was 8 versus 4 days in the RBP group (P = 0.204). 30-day survival rate was comparable in the two groups (65% versus 60% (P 0.71)).RBP was associated with a shorter time to knife-to-skin for haemodynamically unstable patients. There was no significant difference in clinical outcomes between the two groups. Larger studies are required to assess clinical outcomes of the RBP.

Aotearoa

10.1111/ans.17878

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Citations (3)

Binary Decision Diagrams for Affine Approximation

arXiv (Cornell University) (2008)

Kevin Henshall Peter Schachte Harald Søndergaard Leigh Whiting

Selman and Kautz's work on ``knowledge compilation'' established how approximation (strengthening and/or weakening) of a propositional knowledge-base can be used to speed up query processing, at the expense of completeness. In this classical approach, querying uses Horn over- and under-approximations of a given knowledge-base, which is represented as a propositional formula in conjunctive normal form (CNF). Along with the class of Horn functions, one could imagine other Boolean function classes that might serve the same purpose, owing to attractive deduction-computational properties similar to those of the Horn functions. Indeed, Zanuttini has suggested that the class of affine Boolean functions could be useful in knowledge compilation and has presented an affine approximation algorithm. Since CNF is awkward for presenting affine functions, Zanuttini considers both a sets-of-models representation and the use of modulo 2 congruence equations. In this paper, we propose an algorithm based on reduced ordered binary decision diagrams (ROBDDs). This leads to a representation which is more compact than the sets of models and, once we have established some useful properties of affine Boolean functions, a more efficient algorithm.

Binary decision diagram

Completeness (order theory)

Conjunctive normal form

Function representation

Representation

Base (topology)

10.48550/arxiv.0804.0066

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Brain Injury Screening Tool (BIST): test–retest reliability in a community adult sample

BMJ Open (2022)

Nusratnaaz Shaikh Yelda Tokhi Natalie Hardaker Kevin Henshall Katherine Forch

To determine the test-retest reliability of the Brain Injury Screening Tool (BIST), which was designed to support the initial assessment of mild traumatic brain injury (mTBI) across a variety of contexts, including primary and secondary care.

Depression

10.1136/bmjopen-2021-057701

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Citations (1)

Brain Injury Screening Tool

PsycTESTS Dataset (2021)

Alice Theadom Natalie Hardaker Charlotte Bray Richard J. Siegert Kevin Henshall

10.1037/t81993-000

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Citations (1)

Issue Information

ANZ Journal of Surgery (2024)

Yun Le Linn Yvette Chong Eng‐King Tan Ye Xin Koh Peng Chung Cheow

10.1111/ans.18530

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Tube thoracostomy for trauma at Counties Manukau District Health Board, Aotearoa New Zealand

ANZ Journal of Surgery (2022)

Jennifer Scott Christin Coomarasamy Kevin Henshall Andrew D. MacCormick

Tube thoracostomy (TT) in trauma is lifesaving. A previous audit at Counties Manukau District Health Board (CMDHB), New Zealand, showed a 22% complication rate for trauma TT. Subsequently CMDHB introduced a procedural guideline to reduce complications. The Health and Disability Commission published a report concerning oversights in TT removal. This led us to evaluate complications, documentation and procedural monitoring to identify ways to improve patient safety.A 30-month retrospective audit of patients presenting to CMDHB, with injuries which may require TT. Those who had a TT in situ, did not require a TT or whose presentation was not secondary to trauma were excluded.One hundred and forty-three TTs were performed in one hundred and fifteen patients. About 87% had injuries secondary to blunt mechanism. Penetrating injuries were more likely to require TT (P = 0.015). Non-accidental injuries were more likely to need TT (P = 0.025). The complication rate was 25.2%. TT prior to imaging had a 31% complication rate (P < 0.03). About 23% had no TT insertion note. 40% had no TT removal note. About 9% TT insertions had no tertiary information to identify the proceduralist and a complication rate of 46%. About 22% of insertions and 4% of removals documented consent. About 2% of insertions documented anticoagulation status. Interventional radiology had the best documentation of data points assessed (P < 0.0001). Post-procedural monitoring recommendations were documented in 1% insertions and 11% removals.The complication rate has not reduced despite introduction of a guideline. Procedural documentation and monitoring were inadequate, potentially impacting patient safety.

Thoracostomy

Guideline

Accidental

Major trauma

10.1111/ans.17996

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Investigating major trauma in Māori youth at Te Whatu Ora Counties Manukau

ANZ Journal of Surgery (2024)

Mira M. Sobhy Maria Brand Kevin Henshall Andrew D. MacCormick

The Ninth Perioperative Mortality Review Committee (POMRC) report found the likelihood of death was over three times higher in Māori youth compared to non-Māori (age: 15-18 years) in the 30-days following major trauma. The aim of our study is to investigate variations in care provided to Māori youth presenting to Te Whatu Ora Counties Manukau (TWO-CM) with major trauma, to inform policies and improve care.

10.1111/ans.18948

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Citations (1)

In reply: Carl Marincowitzet al, Performance of the Hull Salford Cambridge Decision Rule: the start of the traumatic brain injury (TBI) assessment and recovery journey

Emergency Medicine Journal (2022)

Kevin Henshall

10.1136/emermed-2022-212449

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Citations (1)