The replication crisis poses important challenges to modern science. Central to this challenge is re-establishing ground truths, or the most fundamental theories that serve as the bedrock to a scientific community. However, the goal to identify hypotheses with the greatest support is nontrivial given the current unprecedented rate of scientific publishing. In this era of high-volume science, the goal of this study is to sample from one research community within clinical neuroscience (traumatic brain injury; TBI) and track major trends that have shaped this literature over the past 50 years. To do so, we first conduct decade-wise (1980-2019) network analysis to examine the scientific communities that shape this literature. To establish the robustness of our network findings, we utilized searches from separate search engines (Web of Science; Semantic Scholar). As a second goal, we sought to determine the most highly cited hypotheses influencing the literature in each decade. In a third goal, we then searched for any papers referring to “replication” or efforts to reproduce findings within our >50,000 paper dataset. From this search, 550 papers were analyzed to determine the frequency and nature of formal replication studies over time. Finally, to maximize transparency, we provide a detailed procedure for the creation and analysis of our dataset, including a discussion of each of our major decision points, to facilitate similar efforts in other areas of neuroscience. We found that the unparalleled rate of scientific publishing within the TBI literature combined with the scarcity of clear hypotheses in individual publications are a challenge to both evaluating accepted findings and determining future directions. Additionally, while the conversation about reproducibility has increased over the past decade, the rate of published replication studies continues to be a negligible proportion of the research. Meta-science and computational methods offer the critical opportunity to assess the state of the science and illuminate pathways forward, but ultimately there is structural change needed in the TBI literature and perhapsothers.

Established literature demonstrates that homeless individuals experience both greater disease burden and greater risk for experiencing traumatic brain injury (TBI) than the general population. Similarly, shared risk factors for both homelessness and/or TBI may exacerbate the risk for repetitive neurotrauma within homeless populations. We leveraged a state-wide trauma registry, the Pennsylvania Trauma Outcome Study (PTOS) to examine pre-existing health conditions (PECs), hospital course, and injury mechanisms for 609 patients discharged to homeless (58% TBI, 42% orthopedic injury (OI)) in comparison to 609 randomly sampled adult patients discharged to home. Aligning with previous research, homelessness affects a greater proportion of non-White patients, and homeless patients present for care with increased frequencies of psychiatric and substance use PECs, and alcohol-positive TBI. Furthermore, the risk for assault impacts a larger proportion of homeless patients, and critically, the window for overnight assault risk resulting in TBI is extended for these patients compared to patients discharged to home. Given the shifting conceptualization of TBI as a chronic condition, identifying homeless patients on admission to trauma centers, rather than retrospectively at discharge can enhance understanding of the challenges facing the homeless as they age with both a complex injury history (specifically TBI) and multimorbidity.