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Response to performance of the Hull Salford Cambridge Decision Rule: the start of the traumatic brain injury (TBI) assessment and recovery journey
  1. Carl Marincowitz1,
  2. Benjamin Gravesteijn2,
  3. Trevor Sheldon3,
  4. Ewout Steyerberg4,
  5. Fiona Lecky1
  1. 1 School of Health and Related Research (ScHARR), The University of Sheffield, Sheffield, UK
  2. 2 Department of Public Health, Erasmus Medical Center, Rotterdam, The Netherlands
  3. 3 Institute of Population Health Sciences, Queen Mary University of London Barts and The London School of Medicine and Dentistry, London, UK
  4. 4 Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
  1. Correspondence to Dr Carl Marincowitz, School of Health and Related Research (ScHARR), 30 Regent St, The University of Sheffield, Sheffield, S1 4DA, UK; c.marincowitz{at}

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We thank Henshall et al for their interest in our work1 and think that they highlight the important burden of persistent symptoms and disability associated with mild traumatic brain injury (mTBI).2 In the CENTER-TBI core cohort, 30% of patients with TBI managed and discharged from the ED had persistent disability and a Glasgow Outcome Scale score of less than eight months following injury.3 However, initial CT findings in mTBI are not necessarily predictive of longer term disability and functional …

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  • Handling editor Ellen J Weber

  • Contributors The letter was conceived by CM with input from BG, TS, FL and ES. All authors read and approved the final manuscript.

  • Funding FL is supported by the NHS Trusts ’Trauma Audit and Research Network' ( Research Trainees Coordinating Centre (CM is a National Institute for Health Research Clinical Lecturer in Emergency Medicine).

  • Competing interests None declared.

  • Provenance and peer review Commissioned; internally peer reviewed.

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