Health Technology Assessment (HTA) of point-of-care Glial Fibrillary Acidic Protein (GFAP) and Ubiquitin C-terminal Hydrolase L1(UCH-L1) biomarkers screening for optimizing triage of Traumatic Brain and Spinal Cord Injuries: A Cost-Effectiveness Study in Tertiary Care

Traumatic Brain Injury and Spinal Cord Injury are major public health concerns that require rapid and accurate triage to reduce morbidity, mortality, and healthcare costs. Conventional diagnosis depends on computed tomography and magnetic resonance imaging, which increase resource use and radiation exposure in tertiary care. Point-of-care testing for Glial Fibrillary Acidic Protein and Ubiquitin C-terminal Hydrolase L1 has emerged as a promising biomarker-based tool for early identification of neurotrauma. This prospective, comparative, cohort study will evaluate the diagnostic accuracy and cost-effectiveness of point-of-care GFAP and UCHL1 testing compared with standard imaging-based triage among adults presenting within six hours of suspected traumatic brain or spinal cord injury. The study will measure diagnostic performance parameters such as sensitivity, specificity, positive and negative predictive values, and area under the ROC curve using CT or MRI findings as the reference standard. Cost-effectiveness will be assessed through incremental cost per quality-adjusted life year gained, together with reduction in imaging use, time to diagnosis, and hospital stay. Patient-centred outcomes including readmission rates and satisfaction will be recorded up to thirty days. The expected outcome is to establish evidence that biomarker-guided triage can safely and economically reduce unnecessary imaging, support faster decision making, and provide policy-relevant data for large-scale adoption of health technology assessment frameworks in emergency neurotrauma care.