Advancing Brain Injury Diagnosis: An interview with Walid Chayoua, Clinical Chemistry Resident at Unilabs Netherlands

Each year, approximately 60,000 individuals in the Netherlands find themselves in emergency rooms due to mild traumatic brain injuries (mTBI), commonly known as concussions. Despite efforts to improve diagnostic accuracy, identifying which patients require CT scans remains challenging, with abnormalities detected in only 6-38% of cases. However, recent strides in medical technology bring hope for more precise and efficient diagnostics.

Walid Chayoua, Clinical Chemistry Resident at Unilabs Netherlands, investigated whether biomarkers can predict brain injuries. We spoke to him to delve into the details of his innovative research and its potential impact on healthcare.

How did the opportunity to conduct this study arise?

The opportunity to conduct this study emerged from a collaboration with two prominent Dutch hospitals, within the framework of the Acute Injury Markers in mTBI (AIM-TBI) study. By leveraging the expertise of clinical chemists and clinicians, alongside the resources provided by the manufacturer, we were able to implement our study protocols effectively.

Can you provide some background on your study and its objectives?

Our study aimed to evaluate the effectiveness of Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin C-terminal Hydrolase-L1 (UCH-L1) biomarkers in predicting brain injuries visible on CT scans in patients with mTBI. We sought to determine if these biomarkers could help clinicians make more informed decisions about the necessity of CT scans, ultimately improving patient care and reducing healthcare costs.

Can you share some key findings from your research?

We discovered that by measuring GFAP and UCH-L1 levels, we could rule out brain injuries visible on CT scans with high certainty. Additionally, incorporating clinical information alongside biomarker analysis could further enhance diagnostic performance. These findings suggest that GFAP and UCH-L1 testing could revolutionise the way we diagnose brain injuries in patients with mTBI, offering a more efficient and cost-effective approach.

How do you envision the implementation of this POC test in clinical practice?

We believe that integrating this POC test into emergency room settings could significantly reduce unnecessary CT scans consequently minimize radiation exposure, reducing length of stay in the ED and result in a reduction of healthcare costs. 

Implementation of biomarkers could prove particularly advantageous if results can be obtained shortly after admission to the ED using whole blood instead of blood plasma. Additionally, whole–blood POC testing may extend beyond traditional clinical settings, allowing for triaging decisions to be made in diverse environments such as sports or military settings.

Are there plans to conduct further studies or trials to validate the effectiveness and reliability of GFAP and UCH-L1 biomarkers in different patient populations or clinical settings?

Initiatives are made to implement these biomarkers in a Dutch hospital to predict brain injuries visible on CT scans in patients with mTBI, that are admitted to the ER. Hopefully, national guidelines will include the use of biomarkers as a screening tool to exclude CT scanning in mTBI patients in the near future.

How has your experience at Unilabs contributed to fostering a research environment where groundbreaking studies like this one on brain injury diagnostics can thrive?

The advantage of the cooperation with Unilabs and the hospitals is that our laboratory is deeply embedded within the hospital with a strong connection between laboratory professionals and clinicians which are both open to trying new stuff. This level of customer intimacy and focus on innovation has been pivotal in initiating such studies.