Methodology of AA CRASH: a prospective observational study evaluating the incidence and pathogenesis of adverse post-traumatic sequelae in African-Americans experiencing motor vehicle collision

Abstract

IntroductionA motor vehicle collision (MVC) is one of the most common life-threatening events experienced by individuals living in the USA. While most individuals recover following MVC, a significant proportion of individuals develop adverse post-traumatic sequelae such as post-traumatic stress disorder or persistent musculoskeletal pain. Adverse post-traumatic sequelae are common, morbid and costly public health problems in the USA and other industrialised countries. The pathogenesis of these disorders following MVC remains poorly understood. In the USA, available data suggest that African-Americans experience an increased burden of adverse post-traumatic sequelae after MVC compared to European Americans, but to date no studies examining the pathogenesis of these disorders among African-Americans experiencing MVC have been performed.Methods and analysisThe African-American CRASH (AA CRASH) study is an NIH-funded, multicentre, prospective study that enrols African-Americans (n=900) who present to the emergency department (ED) within 24 hours of MVC. Participants are enrolled at 13 ED sites in the USA. Individuals who are admitted to the hospital or who report a fracture or tissue injury are excluded. Participants complete a detailed ED interview that includes an assessment of crash history, current post-traumatic symptoms and health status prior to the MVC. Blood samples are also collected in the ED using PAXgene DNA and PAXgene RNA tubes. Serial mixed-mode assessments 6 weeks, 6 months and 1 year after MVC include an assessment of adverse sequelae, general health status and health service utilisation. The results from this study will provide insights into the incidence and pathogenesis of persistent pain and other post-traumatic sequelae in African-Americans experiencing MVC.Ethics and disseminationAA CRASH has ethics approval in the USA, and the results will be published in a peer-reviewed journal.

Gender Differences in Pain Experience and Treatment after Motor Vehicle Collisions: A Secondary Analysis of the CRASH Injury Study

“…Details of the original study methods have been previously published. 2, 22, 23 In brief, participants were screened and enrolled by trained research assistants. Screening occurred during day and evening hours based on availability of research assistants and occurred for approximately 12 to 16 hours each day at each site.…”

“…Screening occurred during day and evening hours based on availability of research assistants and occurred for approximately 12 to 16 hours each day at each site. 22, 23 Data were collected by trained research assistants during the ED visit using patient interview; additional data were collected from the medical record following the completion of the ED visit.…”

Nausea in the peri-traumatic period is associated with prospective risk for PTSD symptom development

“…Participants. Participants were enrolled as part of two large, multicenter prospective cohorts of adult patients (one of European-Americans and one of African-Americans) that recruited from eight EDs as previously described [23]. The study was approved by the IRB at each of the study sites, and all participants provided written informed consent.…”

Evaluation of the Association Between Genetic Variants in Circadian Rhythm Genes and Posttraumatic Stress Symptoms Identifies a Potential Functional Allele in the Transcription Factor TEF

“…Baseline characteristics of participants in the discovery and replication cohorts are shown in Table 1 . The motor vehicle collision (MVC) cohort has been described previously ( 49 ). This study exclusively enrolled African American women and men ( n = 930) who reported to the emergency department (ED) within 24 h of an MVC.…”

“…This prospective longitudinal study enrolled African American individuals ≥18 and ≤65 years of age presenting to the ED within 24 h of MVC. The details of this study have been described previously ( 49 ). This study was approved by the institutional review boards at the data-coordinating center (The University of North Carolina at Chapel Hill) and at all participating hospitals.…”