Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children.
Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children.
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DOI：
10.1001/jamapediatrics.2018.2853
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发表时间：
2018-11-01
期刊：
影响因子：
26.1
通讯作者：
Timmons SD
中科院分区：
文献类型：
--
作者：
Lumba-Brown A;Yeates KO;Sarmiento K;Breiding MJ;Haegerich TM;Gioia GA;Turner M;Benzel EC;Suskauer SJ;Giza CC;Joseph M;Broomand C;Weissman B;Gordon W;Wright DW;Moser RS;McAvoy K;Ewing-Cobbs L;Duhaime AC;Putukian M;Holshouser B;Paulk D;Wade SL;Herring SA;Halstead M;Keenan HT;Choe M;Christian CW;Guskiewicz K;Raksin PB;Gregory A;Mucha A;Taylor HG;Callahan JM;DeWitt J;Collins MW;Kirkwood MW;Ragheb J;Ellenbogen RG;Spinks TJ;Ganiats TG;Sabelhaus LJ;Altenhofen K;Hoffman R;Getchius T;Gronseth G;Donnell Z;O'Connor RE;Timmons SD
儿童轻度创伤性脑损伤(MTBI)，或称脑震荡，是一个迅速增长的公共卫生问题，因为流行病学数据表明，在过去十年中，mTBI的急诊科就诊次数显著增加。然而，到目前为止，美国还没有制定出诊断和处理儿童mTBI的循证临床指南。提供一个基于先前文献的系统回顾的指南，以获得和评估证据，为卫生保健专业人员制定与儿童mTBI的诊断、预后和管理/治疗相关的临床建议。疾病控制和预防中心(CDC)国家伤害预防和控制中心科学顾问委员会是一个联邦咨询委员会，成立了儿科轻度创伤性脑损伤指南工作组。工作组根据在系统审查中获得和评估的证据以及相关证据、科学原则和专家推论起草了建议。这些信息包括工作组认为与建议有关的、自进行证据审查以来发表的选定研究。首次文献检索日期为1990年1月1日至2012年11月30日，更新文献检索日期为2012年12月1日至2015年7月31日。美国疾病控制与预防中心的指南包括19组关于儿童mTBI的诊断、预后和管理/治疗的建议，这些建议基于对证据的信心而被分配了一个义务级别(即必须、应该或可能)。建议涉及成像、症状量表、认知测试和诊断的标准化评估；病史和风险因素评估、监测和预后咨询；以及患者/家庭教育、休息、支持、重返学校和治疗的症状管理。该指南根据目前的证据确定了mTBI的最佳实践；应随着证据的增长进行更新。除了制定指南外，疾控中心还编写了简明扼要、可操作的用户友好的指南执行材料。对准则和执行材料的评价对于理解建议的影响至关重要。
Mild traumatic brain injury (mTBI), or concussion, in children is a rapidly growing public health concern because epidemiologic data indicate a marked increase in the number of emergency department visits for mTBI over the past decade. However, no evidence-based clinical guidelines have been developed to date for diagnosing and managing pediatric mTBI in the United States. To provide a guideline based on a previous systematic review of the literature to obtain and assess evidence toward developing clinical recommendations for health care professionals related to the diagnosis, prognosis, and management/treatment of pediatric mTBI. The Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control Board of Scientific Counselors, a federal advisory committee, established the Pediatric Mild Traumatic Brain Injury Guideline Workgroup. The workgroup drafted recommendations based on the evidence that was obtained and assessed within the systematic review, as well as related evidence, scientific principles, and expert inference. This information includes selected studies published since the evidence review was conducted that were deemed by the workgroup to be relevant to the recommendations. The dates of the initial literature search were January 1, 1990, to November 30, 2012, and the dates of the updated literature search were December 1, 2012, to July 31, 2015. The CDC guideline includes 19 sets of recommendations on the diagnosis, prognosis, and management/treatment of pediatric mTBI that were assigned a level of obligation (ie, must, should, or may) based on confidence in the evidence. Recommendations address imaging, symptom scales, cognitive testing, and standardized assessment for diagnosis; history and risk factor assessment, monitoring, and counseling for prognosis; and patient/family education, rest, support, return to school, and symptom management for treatment. This guideline identifies the best practices for mTBI based on the current evidence; updates should be made as the body of evidence grows. In addition to the development of the guideline, CDC has created user-friendly guideline implementation materials that are concise and actionable. Evaluation of the guideline and implementation materials is crucial in understanding the influence of the recommendations.
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DOI：
10.1017/s1355617711000907
发表时间：
2011-09-01
影响因子：
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作者：
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通讯作者：
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