400 Section - Understanding What Traumatic Brain Injury Survivors, their Family, and Clinicians Want From Functional Magnetic Resonance Imaging: A Qualitative Study of Key Questions and Information Needs.

Objectives : Traumatic brain injury (TBI) is a leading cause of disability world-wide. Survivors often report receiving limited information about their injury and expected recovery, and in previous studies have highlighted the value, in the development of better tools for clinical assessment and communication. Functional MRI (fMRI) may offer improved diagnostic and prognostic insights; though it is unclear which aspects of fMRI stakeholders consider most important and how such information should be communicated.

Design: A qualitative study was conducted across two sites in Canada, with participants from Calgary, Alberta and Kingston, Ontario. Stakeholders included TBI survivors, family members/carers, and clinicians. Zoom-based semi-structured interviews explored experiences with receiving or providing TBI-related information, perceptions of the potential role of fMRI, and preferences for the format and content of a report template for fMRI. A relativist approach was taken, informed by grounded theory; coding, memo-writing, and constant comparison techniques were applied using NVivo to complete a thematic analysis.

Results: Thirty participants took part between April-November 2025. This included 12 survivors, 5 carers, and 13 clinicians (physicians, nurses, and allied health professionals).

Survivor/carer themes included: (1) personal experience of receiving limited information on their own injury and wanting more clarity (2) interest in fMRI being used to understand the mechanisms behind symptoms and prognosis; (3) desire for choice on the level of detail in a report and flexible report formats; and (4) need for in-person professional explanation of results. Clinician themes included (1) limited familiarity with fMRI; (2) importance of robust evidence in fMRI reporting; (3) key role of patient education in practice; and (4) avoiding patient confusion or harm.

Conclusion: These findings will inform development of a survivor-centered fMRI report template. This template will undergo further focus-group evaluation prior to use in a clinical trial examining the prognostic value of fMRI after acute TBI.