Retropharyngeal ectopic parathyroid adenoma versus lymph node: Problem solving with CT neck angiogram.

BACKGROUND

Psychosocial difficulties or reduced functioning in social-cognitive, emotional/mental health, or behavioural domains are common following moderate-to-severe traumatic brain injury. However, there is currently no Australian-based guideline for management of these difficulties. To inform development of such a guideline, we aimed to integrate evidence available with stakeholder input to establish the guideline scope.

METHODS

Overarching governance for the project was provided through an established Guideline Development Group who oversaw the four key steps of the scoping process: (1) initial areas of relevance were generated; (2a) scoping reviews were conducted to establish the availability of evidence; (2b) priority surveys with health professionals (n = 86) and individuals with lived experience of traumatic brain injury or close others (n = 55) were completed; (3) a panel comprising 26 experts convened at a 1-day workshop to conceptualise the initial guideline scope; and (4) the scope was then iteratively refined, leading to a scoping document specifying the key clinical questions, difficulties/disorders and treatment outcomes the guideline would address.

RESULTS

The scoping reviews identified intervention studies across mental health (n = 74), behaviour (n = 55) and social cognition (n = 19). Survey results prioritised most psychosocial difficulties and identified key treatment outcomes. The final guideline scope included one key clinical question relating to treatment effectiveness, four sub-questions related to treatment decisions for specific groups and circumstances, and two areas of additional commentary to supplement recommendations.

CONCLUSIONS

The methodology used to establish the guideline scope will facilitate the development of a clinical practice guideline for the management of psychosocial difficulties in adults with moderate-to-severe traumatic brain injury.