Methodological issues and research recommendations for prognosis after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis.
Methodological issues and research recommendations for prognosis after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis.
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DOI：
10.1016/j.apmr.2013.04.026
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发表时间：
2014-03-01
影响因子：
4.3
通讯作者：
Cassidy, J David
中科院分区：
文献类型：
--
作者：
Kristman, Vicki L;Borg, Jorgen;Cassidy, J David
轻度创伤性脑损伤（MTBI）预后国际合作组织对2001年至2012年的文献进行了全面检索和批判性审查，以更新世界卫生组织神经创伤、预防、管理和康复工作组合作中心2002年对MTBI预后进行的最佳证据合成。在299项相关研究中，有101项被认为具有科学上的可接受性。自2002年工作组报告以来，关于MTBI预后的研究文献的方法学质量没有提高。文献中仍然存在许多方法论问题和知识差距。在这里，我们就如何避免MTBI预后研究中发现的方法学缺陷提出报告和建议。此外，我们讨论了MTBI定义的问题，并确定了需要进一步研究的主题领域，以促进对MTBI后预后的理解。优先研究领域包括但不限于使用验证性设计，测量有效性研究，关注老年人，关注诉讼/赔偿问题，开发有效的临床预测规则，使用MTBI人群而不是住院，继续研究反复脑震荡的影响，纵向研究中更长的随访时间和更多的测量周期，对成人和儿童之间差异的评估，以及对反向因果关系和差异回忆偏差的解释。在这些领域进行良好的研究将有助于我们了解MTBI预后，并协助临床医生教育和治疗他们的MTBI患者。
The International Collaboration on Mild Traumatic Brain Injury (MTBI) Prognosis performed a comprehensive search and critical review of the literature from 2001 to 2012 to update the 2002 best-evidence synthesis conducted by the World Health Organization Collaborating Centre for Neurotrauma, Prevention, Management and Rehabilitation Task Force on the prognosis of MTBI. Of 299 relevant studies, 101 were accepted as scientifically admissible. The methodological quality of the research literature on MTBI prognosis has not improved since the 2002 Task Force report. There are still many methodological concerns and knowledge gaps in the literature. Here we report and make recommendations on how to avoid methodological flaws found in prognostic studies of MTBI. Additionally, we discuss issues of MTBI definition and identify topic areas in need of further research to advance the understanding of prognosis after MTBI. Priority research areas include but are not limited to the use of confirmatory designs, studies of measurement validity, focus on the elderly, attention to litigation/compensation issues, the development of validated clinical prediction rules, the use of MTBI populations other than hospital admissions, continued research on the effects of repeated concussions, longer follow-up times with more measurement periods in longitudinal studies, an assessment of the differences between adults and children, and an account for reverse causality and differential recall bias. Well-conducted studies in these areas will aid our understanding of MTBI prognosis and assist clinicians in educating and treating their patients with MTBI.