The DOI matches its Crossref record; 14 of the 15 references it cites were found in a registry or an index; 1 of the 12 sources its claims cite were checked for support.
Health and Economic Burden of Traumatic Brain Injury: Missouri, 2001–2005
Open accessAbstract
Objective.: We examined the financial and social costs resulting from traumatic brain injury (TBI) in Missouri. Methods.: We computed mortality rates from death certificates, the direct cost of TBI from hospital and emergency department (ED) visit charges, the social cost in terms of years of potential life lost (YPLL) using an abridged Missouri life table, and the indirect financial cost in terms of lost productivity due to premature death for all TBI and four major causes of TBI in Missouri. Results.: During 2001–2005, a mean of 1,358 lives were lost due to TBI in Missouri. Four major causes—unintentional falls, motor vehicle traffic crashes, motorcycle crashes, and firearms—accounted for 88% of all TBI deaths. We estimated the annual direct medical cost of TBI at $95 million, or about $1.67 million per 100,000 Missourians. This cost increased by about 60% between 2001 and 2005. The four major causes of TBI accounted for 68% of all direct medical costs of TBI. We estimated the cost per hospitalization and ED visit at $6,948 and the indirect social cost at 48,501 YPLL. During this period, the mean age of TBI fatality was 44 years. We determined the lost productivity due to TBI mortality—$1.1 billion, or about $18.8 million per 100,000 Missourians—to be three times as high for males as for females. Conclusions.: The types of costs covered in this study underestimated the total cost of TBI in Missouri, as we did not include outpatient care, rehabilitation, and drug costs. Nevertheless, we found the health and economic burden from medical care and mortality related to TBI to be substantial in Missouri.
Overview
AI snapshot
Written from the paper’s full text.
TL;DR
This study estimated the health and economic burden of traumatic brain injury (TBI) in Missouri from 2001–2005, finding substantial mortality, direct medical costs, years of potential life lost, and productivity losses. The authors conclude that TBI imposes a heavy social and economic burden and that many related losses are preventable.
Key findings
- During 2001–2005, TBI caused a mean of 1,358 deaths annually in Missouri, with a death rate of 23.8 per 100,000; rates were almost three times as high in males (35.3) as in females (12.8). Four major causes accounted for 88% of TBI deaths in the abstract and 89% in the Results: motor vehicle traffic crashes (39%), firearms (32%), unintentional falls (15%), and motorcycle crashes (3%).
- Annual direct medical cost was estimated at nearly $95 million, or $1.67 million per 100,000 Missourians; this increased 59.4%, from $69.8 million in 2001 to $111.3 million in 2005. There were 20,688 inpatient hospitalizations (annual mean 4,138, or 70.8 per 100,000) and 47,428 ED visits (annual mean 9,486) related to TBI.
- Estimated annual YPLL due to TBI mortality was 48,501, with a mean loss of 36 YPLL per TBI-related death; males accounted for 73% (35,238) and females 27% (13,263). The mean age of TBI fatality was 44 years, varying from 36 years for motor vehicle traffic crashes to 66 years for unintentional falls.
- Total productivity loss due to TBI-related deaths was almost $1.1 billion annually, or $18.8 million per 100,000 residents ($188 per person), with a rate three times higher for males ($31.7 million) than females ($6.5 million). Motor vehicle crash-related productivity loss was highest at $513 million, followed by firearms ($383 million), unintentional falls ($38 million), and motorcycle crashes ($37 million).
Methods
- The study used a macro, aggregate approach to assess TBI burden in Missouri for 2001–2005, focusing on four major causes: motor vehicle traffic crashes, firearms, unintentional falls, and motorcycle crashes.
- Data sources included the Missouri Patient Abstract System for TBI-related hospitalization and ED visit charges, and Missouri death certificates/records for mortality; TBI was defined using ICD-9-CM codes for hospital/ED data and ICD-10 codes for deaths.
- Direct costs were estimated from hospital and ED charges using a Missouri cost-to-charge ratio of 0.442 and adjusted for inflation with the Consumer Price Index for Medical Care for All Urban Consumers, Midwest region, using 2001 as the base year. YPLL was computed using the 2003 abridged Missouri life table, and productivity losses used national present discounted value of future earnings estimates for 2000 with a 3% discount rate.
Limitations
- The authors state that ED visit and hospitalization costs were underestimated because TBI incidence was underestimated, as some TBI incidents were not reported.
- The authors state that data on TBI-related disability, lost wages, quality of life, and other costs (e.g., prescriptions, transportation for care, and care wait time) were unavailable in Missouri.
- The text also makes evident that the study excluded outpatient care, rehabilitation, and drug costs; that charges do not represent true economic cost; that case-level rather than visit-level data were unavailable; and that national rather than Missouri-specific estimates were used for productivity losses.
Model-written summary. Check it against the paper before relying on it.
Integrity signals
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Verification
Claims the paper makes
32 Own result · 6 No full text of the sources · 5 Own interpretation · 3 Sources not found · 1 Partly supported · 1 Not checked yet · accuracy not yet measured
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Males between the ages of 20 and 29 and females aged 30–39 had the highest TBI death rates due to motorcycle crashes (Table 2).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
In the paper
“This study found that the indirect costs were higher than the direct costs for TBI-related deaths, which is confirmed in the literature.17”
What the sources say
- Not checked — no full text of the sourcecites [17] Borg J, Holm L, Peloso PM, Cassidy JD, Carroll LJ, Von Holst H, et al. Non-surgical intervention and cost for mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med. 2004;36(43) Suppl:S76–83. doi: 10.1080/16501960410023840. [DOI] [PubMed] [Google Scholar] source
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Even after adjusting for inflation, the cost of TBI ED visits and hospitalizations increased 59.4%, from $69.8 million in 2001 to $111.3 million in 2005.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We estimated a mean loss of 36 YPLL per TBI-related death during 2001–2005.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Also during this period, we estimated the mean age of TBI fatality as 44 years.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We estimated the total productivity loss due to TBI-related deaths at almost $1.1 billion annually in Missouri.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: National estimates of present discounted value of future earnings for 2000 are applicable to Missouri for estimating productivity losses.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We determined the TBI death rate to be 23.8 per 100,000 Missouri population, a rate that was almost three times as high in males (35.3) as in females (12.8).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Missouri has seen a troubling increase of 17% in combined emergency department (ED) visits and hospitalizations related to TBI (from 203.5 per 100,000 in 1998 to 237.8 per 100,000 in 2005) (Figure 1).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“For the period 2001–2005, we determined the estimated annual YPLL due to mortality from TBI as 48,501.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Rests on an assumption: The 2003 abridged life table values are representative of 2001–2005 for computing years of potential life lost.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We determined the TBI death rate to be 23.8 per 100,000 Missouri population, a rate that was almost three times as high in males (35.3) as in females (12.8).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
- Probably not a substantial claim. 10
- It may state two separate claims as one. 21
- The quote only partly states this claim. 1
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“A study in England found the same two causes of TBI: unintentional falls (50%) and road traffic collisions (33%).13”
What the sources say
- Partly supportedcites [13] Christensen MC, Ridley S, Lecky FE, Munro V, Morris S. Outcomes and costs of blunt trauma in England and Whales. Crit Care. 2008;12:R23. doi: 10.1186/cc6797. [DOI] [PMC free article] [PubMed] [Google Scholar] sourceExperimental — accuracy not yet measured
The Results (Patient and injury characteristics) report falls (50%) and road traffic collisions (33%) as the leading causes of injury among all patients in an England-and-Wales blunt-trauma cohort. These percentages are not reported specifically for traumatic brain injury (TBI); Table 2 lists serious head injuries in about 20% of the cohort. (LLM, conf=0.91)
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Partly supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We observed a similar pattern by gender by the four major causes of TBI: the rate of productivity loss due to motor vehicle crashes was $9 million per 100,000 Missouri residents, followed by firearms ($6.7 million); unintentional falls and motorcycle crashes each caused $0.7 million in productivity loss (Table 4).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one. The quote only partly states this claim.
- Rests on an assumption: National estimates of present discounted value of future earnings for 2000 are applicable to Missouri for estimating productivity losses.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of the four major causes of TBI, unintentional falls caused the greatest number of TBI hospitalizations and ED visits, but motor vehicle traffic accidents caused the highest mortality rate.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Of the total, males accounted for about 82% of the productivity loss and females accounted for 18%.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: National estimates of present discounted value of future earnings for 2000 are applicable to Missouri for estimating productivity losses.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During this period, unintentional falls were the most common cause of TBI (37%), followed by motor vehicle traffic crashes (26%), and struck by/against a person or object (21%).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We estimated the rate of productivity loss at $18.8 million per 100,000 Missouri residents ($188 per person), with a three times higher rate for males ($31.7 million) than for females ($6.5 million) (Table 4).”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: National estimates of present discounted value of future earnings for 2000 are applicable to Missouri for estimating productivity losses.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among the four major causes, motor vehicle traffic crashes led to the highest TBI-related death rate (9.2), followed by firearms (7.6), unintentional falls (3.6), and motorcycle crashes (0.6).”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The gender disparity in TBI-related death was highest in motorcycle crashes and lowest in unintentional falls (Table 2).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Motor vehicle crash-related productivity loss was the highest at $513 million, followed by firearms ($383 million), unintentional falls ($38 million), and motorcycle crashes ($37 million).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Rests on an assumption: National estimates of present discounted value of future earnings for 2000 are applicable to Missouri for estimating productivity losses.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Firearms-related TBI deaths were highest for males ≥80 years of age, and for females the highest rate was for those aged 40–49 years.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The four major causes of TBI accounted for 68% of all direct medical costs of TBI: motor vehicle traffic crashes (33%), unintentional falls (30%), motorcycle crashes (3%), and firearms (2%).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During 2001–2005, in terms of the level of severity, moderately serious TBI accounted for 56% of the total injuries, followed by the most serious injuries (40%) and the least serious injuries (3%).”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“We estimated the associated annual direct cost to be nearly $95 million in total, or $1.67 million per 100,000 population.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“TBI from motor vehicle traffic crashes caused the highest YPLL, followed by TBI from firearms, unintentional falls, and motorcycle crashes.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Males between the ages of 20 and 29 years had the highest number of motor vehicle traffic crash-related TBI deaths, and females aged 10–19 years had the highest rates.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Males' YPLL accounted for 73% (35,238), whereas females' YPLL accounted for 27% (13,263) of the total YPLL.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“During 2001–2005, there were 20,688 inpatient hospitalizations (an annual mean of 4,138 hospitalizations, or 70.8 per 100,000) and 47,428 ED visits (an annual mean of 9,486 ED visits) related to TBI in Missouri.”
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
None of the sources cited for this claim have been checked yet.
In the paper
“Like the studies at the national level, our study observed an interesting scenario: though the unintentional falls-related TBI were highest among the youngest and oldest Missourians (those aged 0–5 and those aged ≥80 years), the rate of mortality was highest only for people aged ≥80 years.5,14”
What the sources say
- Not matchedcites [5] Langlois JA, Rutland-Brown W, Thomas KE. Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Atlanta: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control (US); 2004. [Google Scholar]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
- Not checked yetcites [14] Traumatic brain injury—Colorado, Missouri, Oklahoma, and Utah, 1990–1993. MMWR Morb Mortal Wkly Rep. 1997;46(01):8–11. [PubMed] [Google Scholar]
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, this mean age varied by cause of TBI, with people dying at a younger age (age 36) due to motor vehicle traffic crashes and an older age (66 years) due to unintentional falls.”
- Also stated in: § RESULTS · plain
“The mean age at death due to firearms was 43 years; the mean age at death due to motorcycle crashes was 39 years (Table 3).”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Also stated in: § RESULTS · plain
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Those ≥80 years of age had the highest overall TBI mortality, as well as the highest TBI mortality from unintentional falls for both genders.”
plaincorrelational- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: unclear — It is unclear whether the paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
In the paper
“One study concluded that adhering to the BTF treatment protocol could attain a significant reduction in length of hospital stay and charges for TBI.16”
What the sources say
- Not checked — no full text of the sourcecites [16] Fakhry SM, Trask AL, Waller MA, Watts DD. IRTC Neurotrauma Task Force. Management of brain-injured patients by an evidence-based medicine protocol improves outcomes and decreases hospital charges. J Trauma. 2004;56:492–500. doi: 10.1097/01.ta.0000115650.07193.66. [DOI] [PubMed] [Google Scholar] source
hedgeddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“In Missouri, TBI accounted for 2.3% of all injuries annually from 2001 to 2005.1”
What the sources say
- Not matchedcites [1] Missouri Department of Health and Senior Services. Patient Abstract System. Jefferson City (MO): Missouri Department of Health and Senior Services; 1999–2003. [Google Scholar]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
- Not matched
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“To the best of our knowledge, this is the first study to evaluate the health and economic burden of TBI for an entire state.”
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: fails — The paper may give no reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
In the paper
“Another study estimated the same top two causes of TBI nationally: falls (41%) and motor vehicle traffic crashes (39%).12”
What the sources say
- Not checked — no full text of the sourcecites [12] McGarry LJ, Thompson D, Millham FH, Cowell L, Snyder PJ, Lenderking WR, et al. Outcomes and costs of acute treatment of traumatic brain injury. J Trauma. 2002;53:1152–9. doi: 10.1097/00005373-200212000-00020. [DOI] [PubMed] [Google Scholar] source
hedged- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“However, the losses related to TBI (e.g., in terms of deaths, as well as adverse health, social, and financial costs) are easily preventable.”
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence.
- Rests on an assumption: Unintentional falls are easily preventable types of injuries.
In the paper
“The adoption of Brain Trauma Foundation (BTF) guidelines for treating severe TBI has been shown to result in substantial savings in costs and lives.15”
What the sources say
- Not checked — no full text of the sourcecites [15] Faul M, Wald MM, Rutland-Brown W, Sullivent EE, Sattin RW. Using a cost-benefit analysis to estimate outcomes of a clinical treatment guideline: testing the Brain Trauma Foundation guidelines for the treatment of severe traumatic brain injury. J Trauma. 2007;63:1271–8. doi: 10.1097/TA.0b013e3181493080. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Prevention measures such as safety belt and helmet use, and drinking and driving laws, have proved to be effective strategies in reducing injury severity and fatalities, and they can be implemented at a very low cost.18”
What the sources say
- Not matchedcites [18] Homan SG, Kabeer NH, Kayani NA, Feyerharm RW, Zhu BP. The public health burden of traumatic brain injuries in Missouri. Jefferson City (MO): Missouri Department of Health and Senior Services, Division of Community and Public Health; 2006. Also available from: URL: http://www.dhss.mo.gov/HIA-Council/TBI-BurdenReport.pdf [cited 2009 Mar 5] [Google Scholar]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
boosteddirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: passes — The paper’s conclusions depend on it.
- Based: passes — The paper gives a reason why it holds.
It may state two separate claims as one.
- Not matched
In the paper
“In addition, states' surveillance systems can play an important role in identifying causes and risk factors for developing interventions.19”
What the sources say
- Not checked — no full text of the sourcecites [19] Thurman DJ, Alverson C, Dunn KA, Guerrero J, Sniezek JE. Traumatic brain injury in the United States: a public health perspective. J Head Trauma Rehabil. 1999;14:602–15. doi: 10.1097/00001199-199912000-00009. [DOI] [PubMed] [Google Scholar] source
plainconditional- Asserted: passes — The authors put it forward as true.
- Checkable: fails — It may be too vague to check against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
In the paper
“Nationally, the top three causes of TBI followed suit: falls (28%), motor vehicle traffic crashes (20%), and struck by/against a person or object (19%).5”
What the sources say
- Not matchedcites [5] Langlois JA, Rutland-Brown W, Thomas KE. Traumatic brain injury in the United States: emergency department visits, hospitalizations, and deaths. Atlanta: Centers for Disease Control and Prevention, National Center for Injury Prevention and Control (US); 2004. [Google Scholar]
Couldn’t be matched to a paper in Crossref, so it can’t be checked.
plain- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Not matched
In the paper
“According to this study, compliance with the TBI protocol saved $4.7 million in hospital charges during the period of six years.”
What the sources say
- Not checked — no full text of the sourcecites [16] Fakhry SM, Trask AL, Waller MA, Watts DD. IRTC Neurotrauma Task Force. Management of brain-injured patients by an evidence-based medicine protocol improves outcomes and decreases hospital charges. J Trauma. 2004;56:492–500. doi: 10.1097/01.ta.0000115650.07193.66. [DOI] [PubMed] [Google Scholar] source
plaindirect- Asserted: passes — The authors put it forward as true.
- Checkable: passes — It can be checked against evidence.
- Load-bearing: fails — The paper’s conclusions may not depend on it.
- Based: passes — The paper gives a reason why it holds.
Probably not a substantial claim. The paper’s conclusions may not depend on it.
The paper relies on this without support.
The actual social and economic costs associated with TBI are largely unknown in Missouri.
“Despite the known burden due to TBI, the actual social and economic costs associated with TBI are largely unknown in Missouri.”
The paper relies on this without support.
Unintentional falls are easily preventable types of injuries.
“Although all types of falls were the most common cause of TBI, for this analysis we included the mortality and indirect costs for only unintentional falls to ascertain easily preventable types of injuries in this category.”
The paper relies on this without support.
Motorcycle crashes have great potential to prevent TBI caused by motorcycle crashes in Missouri.
“We considered motorcycle crashes a separate category due to the safety issue related to helmet laws and the great potential to prevent TBI caused by motorcycle crashes in Missouri.”
The paper relies on this without support.
National estimates of present discounted value of future earnings for 2000 are applicable to Missouri for estimating productivity losses.
“Because the Missouri-specific estimates of present discounted value of future earnings (PDVFE) were unavailable, we used the national estimates for 2000.”
The paper relies on this without support.
The 2003 abridged life table values are representative of 2001–2005 for computing years of potential life lost.
“The changes in abridged life tables for the years 2001–2005 were minimal; hence, we used the 2003 (midpoint) abridged life table values to compute the YPLL.”
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Rated major: it would touch a result — a value a result rests on, reported and recomputed p-values on opposite sides of the significance level, two passages that conflict with no sign which is right, or a cited work retracted before this paper was published.
In the paper
“with a three times higher rate for males ($31.7 million) than for females ($6.5 million) (Table 4).”
Reported 3 · recomputed 4.876923
Rated minor: it would not touch a result — a value no result rests on, a p-value that stays on the same side of the significance level, or a conflict that is clerical, resolved elsewhere in the paper, or outside its own findings.
In the paper
§ Results
“Four major causes—unintentional falls, motor vehicle traffic crashes, motorcycle crashes, and firearms—accounted for 88% of all TBI deaths.”
§ RESULTS
“Four major causes accounted for 89% of all TBI deaths: motor vehicle traffic crashes (39%), firearms (32%), unintentional falls (15%), and motorcycle crashes (3%).”
Citations
Cites
National Center for Injury Prevention and Control (U.S.). Division of Injury Response., Faul, M., Wald, M. M., Wu, L., & Coronado, V. G. (2010) · doi:10.15620/cdc.5571 · Cited by 3,494
Langlois, J., Rutland-Brown, W., & Thomas, K. (2006) · PsycEXTRA Dataset · doi:10.1037/e721222007-001 · Cited by 3,003
(1999) · doi:10.1097/00001199-199912000-00009 · Cited by 1,387
The Distinction Between Cost and Charges
Finkler, S. A. (1982) · Annals of Internal Medicine · doi:10.7326/0003-4819-96-1-102 · Cited by 1,052
Prevention effectiveness : a guide to decision analysis and economic evaluation
Haddix, A. C. (1996) · Cited by 574
(2004) · doi:10.1097/01.ta.0000115650.07193.66 · Cited by 382
(2007) · doi:10.1097/ta.0b013e3181493080 · Cited by 217
(2002) · doi:10.1097/00005373-200212000-00020 · Cited by 192
Borg, J., Holm, L., Peloso, P., Cassidy, J. D., Carroll, L., von Holst, H., Paniak, C., & Yates, D. (2004) · Journal of Rehabilitation Medicine · doi:10.1080/16501960410023840 · Cited by 175
Research works printed but not linked: 5
- Missouri Department of Health and Senior Services, 1999, Patient Abstract System
- Centers for Disease Control and Prevention, National Center for Health Statistics (US), Classifications of diseases and functioning & disability
- Office of the Federal Register, 2001, Federal Register, 66, 22727
- 1997, MMWR Morb Mortal Wkly Rep, 46, 8
- Homan SG, 2006, The public health burden of traumatic brain injuries in Missouri
Cited by
Sorted by citations
The costs of traumatic brain injury: a literature review
Humphreys, I., Wood, R., Phillips, C., & Macey, S. (2013) · ClinicoEconomics and Outcomes Research · doi:10.2147/ceor.s44625 · Cited by 296
“Rockhill et al’s 2010 study 26 examined the associated health-care costs of mild TBI and psychological distress in children and adolescents.”
The Rise of Concussions in the Adolescent Population
Zhang, A. L., Sing, D. C., Rugg, C. M., Feeley, B. T., & Senter, C. (2016) · Orthopaedic Journal of Sports Medicine · doi:10.1177/2325967116662458 · Cited by 140
“Acutely, these injuries can lead to time lost from sport, work, and school as well as significant medical costs.(18,42) Alarmingly, the CDC reported increasing rates of TBI-related emergency department (ED) visits from 2001 through 2010, with mild TBI representing 75% of the visits.”
BackgroundDirect cost associated with acquired brain injury in Ontario
Chen, A., Bushmeneva, K., Zagorski, B., Colantonio, A., Parsons, D., & Wodchis, W. P. (2012) · BMC Neurology · doi:10.1186/1471-2377-12-76 · Cited by 118
Traumatic Brain Injury in the Netherlands: Incidence, Costs and Disability-Adjusted Life Years
Scholten, A. C., Haagsma, J. A., Panneman, M. J. M., van Beeck, E. F., & Polinder, S. (2014) · PLoS ONE · doi:10.1371/journal.pone.0110905 · Cited by 112
“Estimates from the US are however more than two times the estimates in our present study: about J23,500 acute hospital charges per TBI [15], J6,200 per TBI in Missouri [17], and J8,500 to J35,000 for mild to severe hospitalized patients [6] - all scaled to 2012 price levels and 2012 Euro.”
BackgroundResultInfluentialThe impact of acquired brain damage in terms of epidemiology, economics and loss in quality of life
Mar, J., Arrospide, A., Begiristáin, J. M., Larrañaga, I., Elosegui, E., & Oliva, J. (2011) · BMC Neurology · doi:10.1186/1471-2377-11-46 · Cited by 84
“In the case of acute lesions and diseases that affect the brain, there is plenty of work in the literature analysing their causes, including stroke and traumatic brain injury (TBI) [2-6].”
Background
Metadata
- Authors
- Kayani, N. A., Homan, S., Yun, S., & Zhu, B. P.
- Affiliations
- Missouri Department of Health and Senior Services (US)
- Corresponding author
- Kayani, Noaman A.
- ORCID
- Zhu, Bao Ping
- Venue
- Public Health Reports®
- Publisher
- SAGE Publications
- Published
- 2009-07
- Volume
- 124
- Issue
- 4
- Pages
- 551-560
- ISSN
- 0033-3549 (ISSN-L)
- 1468-2877
- PMC
- PMC2693169
- OpenAlex
- W2106676373
- Semantic Scholar
- cfdfa745ea0246b206ec61d5831decad99438337
- Cited by
- 49
- References
- 15
- Citations by year
- 2023: 3 · 2022: 6 · 2021: 5 · 2020: 4 · 2019: 6 · 2018: 1 · 2017: 1 · 2016: 4 · 2015: 4 · 2014: 3 · 2013: 2 · 2012: 7
- FWCI
- 2.06
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Public Health Reports (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (submittedVersion)
- PubMed Central (submittedVersion)
- Funders
- Missouri Department of Health and Senior Services
- Topics
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Emergency Medicine › Trauma and Emergency Care Studies
- Keywords
- traumatic brain injury, economic burden, health burden, TBI mortality, years of potential life lost, direct medical costs, falls, traffic accidents, motorcycle accidents, firearm injuries, Missouri
- MeSH terms
- Adolescent, Adult, Aged, Aged, 80 and over, Brain Injuries, Child, Death Certificates, Emergency Service, Hospital, Female, Hospitalization, Humans, Male, Middle Aged, Missouri, Mortality, Life Tables, Cost of Illness, Young Adult
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
A language model drew the claims from the paper on 2026-10-27, under version 3 of the claim definition (model deepseek-v4.1-flash, prompt extract-v3).
A second model labelled each claim on 2026-10-27 (model jev-1.13-20260917, definition revision gold-guideline-v0.2).
Cited sources are checked with a language model’s help (gpt-6-sol).
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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How to cite
Cite CoChat for the checks on this page, and the paper for its own findings.
- This page
- CoChat. (2026). Citation check: Health and Economic Burden of Traumatic Brain Injury: Missouri, 2001–2005. https://app.cochat.ai/papers/10.1177/003335490912400412
- The paper
- Kayani, N. A., Homan, S., Yun, S., & Zhu, B. P. (2009). Health and Economic Burden of Traumatic Brain Injury: Missouri, 2001–2005. Public Health Reports®. https://doi.org/10.1177/003335490912400412
