Diagnosis and Management of Mild Traumatic Brain Injury in Children: A Systematic Review.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Lumba-Brown Angela, Yeates Keith Owen, Sarmiento Kelly, Breiding Matthew J, Haegerich Tamara M, Gioia Gerard A, Turner Michael, Benzel Edward C, Suskauer Stacy J, Giza Christopher C, Joseph Madeline, Broomand Catherine, Weissman Barbara, Gordon Wayne, Wright David W, Moser Rosemarie Scolaro, McAvoy Karen, Ewing-Cobbs Linda, Duhaime Ann-Christine, Putukian Margot, Holshouser Barbara, Paulk David, Wade Shari L, Herring Stanley A, Halstead Mark, Keenan Heather T, Choe Meeryo, Christian Cindy W, Guskiewicz Kevin, Raksin P B, Gregory Andrew, Mucha Anne, Taylor H Gerry, Callahan James M, DeWitt John, Collins Michael W, Kirkwood Michael W, Ragheb John, Ellenbogen Richard G, Spinks T J, Ganiats Theodore G, Sabelhaus Linda J, Altenhofen Katrina, Hoffman Rosanne, Getchius Tom, Gronseth Gary, Donnell Zoe, O'Connor Robert E, Timmons Shelly D
Аннотация
OBJECTIVE: To conduct a systematic review of the pediatric mTBI literature to serve as the foundation for an evidence-based guideline with clinical recommendations associated with the diagnosis and management of pediatric mTBI.
EVIDENCE REVIEW: Using a modified Delphi process, the authors selected 6 clinical questions on diagnosis, prognosis, and management or treatment of pediatric mTBI. Two consecutive searches were conducted on PubMed, Embase, ERIC, CINAHL, and SportDiscus. The first included the dates January 1, 1990, to November 30, 2012, and an updated search included December 1, 2012, to July 31, 2015. The initial search was completed from December 2012 to January 2013; the updated search, from July 2015 to August 2015. Two authors worked in pairs to abstract study characteristics independently for each article selected for inclusion. A third author adjudicated disagreements. The risk of bias in each study was determined using the American Academy of Neurology Classification of Evidence Scheme. Conclusion statements were developed regarding the evidence within each clinical question, and a level of confidence in the evidence was assigned to each conclusion using a modified GRADE methodology. Data analysis was completed from October 2014 to May 2015 for the initial search and from November 2015 to April 2016 for the updated search.
FINDINGS: Validated tools are available to assist clinicians in the diagnosis and management of pediatric mTBI. A significant body of research exists to identify features that are associated with more serious TBI-associated intracranial injury, delayed recovery from mTBI, and long-term sequelae. However, high-quality studies of treatments meant to improve mTBI outcomes are currently lacking.
CONCLUSIONS AND RELEVANCE: This systematic review was used to develop an evidence-based clinical guideline for the diagnosis and management of pediatric mTBI. While an increasing amount of research provides clinically useful information, this systematic review identified key gaps in diagnosis, prognosis, and management.