TY  - JOUR
PY  - 2023//
TI  - Clinical practice guideline recommendations in pediatric mild traumatic brain injury: a systematic review
JO  - Annals of emergency medicine
A1  - Moore, Lynne
A1  - Ben Abdeljelil, Anis
A1  - Tardif, Pier-Alexandre
A1  - Zemek, Roger
A1  - Reed, Nick
A1  - Yeates, Keith Owen
A1  - Emery, Carolyn A.
A1  - Gagnon, Isabelle J.
A1  - Yanchar, Natalie
A1  - Bérubé, Mélanie
A1  - Dawson, Jennifer
A1  - Berthelot, Simon
A1  - Stang, Antonia
A1  - Beno, Suzanne
A1  - Beaulieu, Emilie
A1  - Turgeon, Alexis F.
A1  - Labrosse, Melanie
A1  - Lauzier, François
A1  - Pike, Ian
A1  - Macpherson, Alison
A1  - Freire, Gabrielle C.
SP  - ePub
EP  - ePub
VL  - ePub
IS  - ePub
N2  - STUDY OBJECTIVE: Our primary objectives were to identify clinical practice guideline recommendations for children with acute mild traumatic brain injury (mTBI) presenting to an emergency department (ED), appraise their overall quality, and synthesize the quality of evidence and the strength of included recommendations. <br><br>METHODS: We searched MEDLINE, EMBASE, Cochrane Central, Web of Science, and medical association websites from January 2012 to May 2023 for clinical practice guidelines with at least 1 recommendation targeting pediatric mTBI populations presenting to the ED within 48 hours of injury for any diagnostic or therapeutic intervention in the acute phase of care (ED and inhospital). Pairs of reviewers independently assessed overall clinical practice guideline quality using the Appraisal of Guidelines Research and Evaluation (AGREE) II tool. The quality of evidence on recommendations was synthesized using a matrix based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) Evidence-to-Decision framework. <br><br>RESULTS: We included 11 clinical practice guidelines, of which 6 (55%) were rated high quality. These included 101 recommendations, of which 34 (34%) were based on moderate- to high-quality evidence, covering initial assessment, initial diagnostic imaging, monitoring/observation, therapeutic interventions, discharge advice, follow-up, and patient and family support. We did not identify any evidence-based recommendations in high-quality clinical practice guidelines for repeat imaging, neurosurgical consultation, or hospital admission. Lack of strategies and tools to aid implementation and editorial independence were the most common methodological weaknesses. <br><br>CONCLUSIONS: We identified 34 recommendations based on moderate- to high-quality evidence that may be considered for implementation in clinical settings. Our review highlights important areas for future research. This review also underlines the importance of providing strategies to facilitate the implementation of clinical practice guideline recommendations for pediatric mTBI.<p />  <p>Language: en</p>
LA  - en
SN  - 0196-0644
UR  - http://dx.doi.org/10.1016/j.annemergmed.2023.11.012
ID  - ref1
ER  -