Archives of Physical Medicine and Rehabilitation journal homepage: www.archives-pmr.org Archives of Physical Medicine and Rehabilitation 2014;95(3 Suppl 2):S101-31
BRIEF REPORT
Systematic Search and Review Procedures: Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis Carol Cancelliere, DC, MPH,a,b J. David Cassidy, PhD, DrMedSc,a,b,c,d Alvin Li, BHSc,e James Donovan, DC,a Pierre Coˆte´, DC, PhD,b,d,f,g Cesar A. Hincapie´, DC, MHSca,d From the aDivision of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; bInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; c Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark; dDivision of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; eDepartment of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; fFaculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada; and gUniversity of Ontario Institute of Technology-Canadian Memorial Chiropractic College Centre for the Study of Disability Prevention and Rehabilitation, Toronto, Ontario, Canada.
Abstract Objectives: To update the last best-evidence synthesis conducted by the World Health Organization Collaborating Centre for Neurotrauma, Prevention, Management and Rehabilitation in 2002; and to describe the course, identify prognostic factors, determine long-term sequelae, identify effects of interventions for mild traumatic brain injury (MTBI), identify knowledge gaps in the literature, and make recommendations for future research. Data Sources: MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health, and SPORTDiscus were searched between 2001 and 2012. Inclusion criteria included published peer-reviewed articles in English and 5 other languages. References were also identified from relevant reviews and meta-analyses and the bibliographies of eligible articles. Study Selection: Controlled trials and cohort and case-control studies were selected according to predefined inclusion/exclusion criteria. Studies had to have at least 30 MTBI cases and assess outcomes relevant to prognosis after MTBI. Data Extraction: Eligible studies were critically appraised using modified Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers independently reviewed each study and extracted data from accepted articles (ie, with a low risk of bias) into evidence tables. Data Synthesis: The evidence was synthesized qualitatively according to modified SIGN criteria and prioritized according to design as exploratory or confirmatory. The evidence was organized into separate articles according to population (eg, adults, children, and athletes) and outcomes (eg, risk of dementia after MTBI). Conclusions: After 77,914 records were screened, 299 articles were eligible and reviewed. Of these, 101 (34%) were accepted as scientifically admissible and form the basis of our findings, which are organized into 10 articles in this supplement. These reviews present the best available evidence on MTBI prognosis, but more research is needed. Archives of Physical Medicine and Rehabilitation 2014;95(3 Suppl 2):S101-31 ª 2014 by the American Congress of Rehabilitation Medicine
Supported by the Ontario Neurotrauma Foundation (grant no. 2010-ABI-MTBIWHO-871). The funder was not involved in the design or preparation of the study protocol or in the management of the project, analysis or interpretation of data, or the preparation of the final article. No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated. The findings and conclusions in this research are those of the authors alone and do not necessarily represent the official views or policies of the Centers for Disease Control and Prevention or any agency of the United States government. Inclusion of individuals, programs, or organizations in this article does not constitute endorsement by the United States government.
The first systematic review to look at mild traumatic brain injury (MTBI) prognosis, the World Health Organization (WHO) Collaborating Centre for Neurotrauma, Prevention, Management and Rehabilitation Task Force,1 found very few good quality studies addressing MTBI. Given their call for better quality research and the increasing amount of attention surrounding the long-term sequelae of MTBI, the International Collaboration on MTBI Prognosis (ICoMP) was formed to update the findings.
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The objectives of this review are to describe the course and identify prognostic factors after MTBI, describe the long-term sequelae, evaluate the effectiveness of clinical interventions, and make clinical and methodologic recommendations for future research.
Methods The review was conducted and reported in compliance with the Preferred Reporting Items for Systematic Reviews and MetaAnalyses statement.2 Our protocol was registered in the international prospective register of systematic reviews3 on July 11, 2011, and was last updated on November 2, 2012 (registration no. CRD42011001410). We also published the detailed protocol.4
Literature search The search strategy was developed in consultation with an information specialist. The electronic databases MEDLINE (OVID), PsycINFO (OVID), Embase (OVID), Cumulative Index to Nursing and Allied Health (EBSCO), and SPORTDiscus were systematically searched from January 1, 2001, to June 30, 2011. These searches were updated on February 10, 2012 (appendix 1). We used 3 search filters (prognosis filter, systematic review filter, and therapy filter), which are a combination of published Health Information Research Unit (at McMaster University) filters and unpublished University Health Network filters. The reference lists of all reviews and meta-analyses related to MTBI and articles meeting the eligibility criteria were screened for additional potentially relevant articles. ICoMP members also undertook 3 original research studies.5-7
Eligibility criteria Articles were screened for eligibility according to the following predefined criteria: language (articles written in English, French, Swedish, Norwegian, Danish, and Spanish), publication type (original research published in peer-reviewed journals), study design (controlled trials, case-control studies, and cohort studies with a minimum of 30 MTBI cases), study population (participants [no age limit] may consist of a mixed group of traumatic brain injury severity [eg, mild, moderate, or severe] only if the results are stratified by severity and the MTBI subjects can be clearly identified), and case definition (studies must clearly state a case definition for MTBI that falls within the definitions provided by the WHO Collaborating Centre Task Force and the Centers for Disease Control and Prevention). The WHO Collaborating Centre Task Force states the following: MTBI is an acute brain injury resulting from mechanical energy to the head from external physical forces. Operational criteria for clinical identification include: (i) one or more of the following: confusion or disorientation, loss of
List of abbreviations: ICoMP MTBI SIGN WHO
International Collaboration on MTBI Prognosis mild traumatic brain injury Scottish Intercollegiate Guidelines Network World Health Organization
consciousness for 30 minutes or less, post-traumatic amnesia for less than 24 hours, and/or other transient neurological abnormalities such as focal signs, seizure, and intracranial lesion not requiring surgery; and (ii) Glasgow Coma Scale score of 13 e 15 after 30 minutes post-injury or later upon presentation for healthcare. These manifestations of MTBI must not be due to drugs, alcohol, medications, caused by other injuries or treatment for other injuries (e.g. systemic injuries, facial injuries or intubation), caused by other problems (e.g. psychological trauma, language barrier or coexisting medical conditions) or caused by penetrating craniocerebral injury.8(p115) Persons with fractured skulls will be included if they fit this case definition. As per the Centers for Disease Control and Prevention, MTBI is recognized among persons with an Abbreviated Injury Score of 2 for the head region or among persons who are assigned certain International Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes (table 1).9 Studies must also have included the study outcomes of selfrated recovery, functional recovery, and improvement in clinical outcomes and risk of long-term sequelae; and have examined modifiable prognostic factors (eg, comorbid conditions, litigation, injury-related pain, stress) and clinical prediction rules for diagnosis or triage of patients with MTBI. Exclusion criteria included the following: (1) publication type of narrative reviews, letters, editorials, commentaries, unpublished manuscripts, dissertations, government reports, books and book chapters, conference proceedings, meeting abstracts, lectures and addresses, and consensus development statements (including guideline statements); (2) study design of crosssectional studies; case reports and series; qualitative studies; reviews and meta-analyses; and cadaveric, biomechanical, and laboratory studies (although we screened reviews and metaanalyses for primary studies, we did not review them); (3) study population of animals; (4) case definition of neck fractures and open or penetrating head injury, nontraumatic brain injury, MTBI because of violence/assault in the civilian population, or child abuse (eg, shaken baby syndrome); (5) outcomes where the frequency of intracranial lesions in MTBI was not viewed as an outcome, but rather as part of the diagnosis; therefore, studies examining only this aspect are considered irrelevant to the prognosis after MTBI for the purposes of this review; and (6) all studies that included any intentional cases of MTBI in the civilian population (eg, from assault). In our view, recovery from assault is complicated by victimization and legal proceedings and to understand their prognosis would require stratifying results by intentional injuries. We excluded studies that did not stratify intentional from unintentional injuries.
Screening For the first level of screening, 1 reviewer read the titles of all the citations retrieved from the electronic database searches and removed all those that were clearly not related to traumatic brain injury. The second level of screening involved abstract review. Full text articles were obtained for all abstracts except for those that clearly did not meet the eligibility criteria. If after analyzing the full text the eligibility of an article was still uncertain, a second reviewer undertook a full text analysis to determine eligibility. A third reviewer was consulted in the event of any disagreements. www.archives-pmr.org
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ICD-9-CM codes for MTBI
ICD-9-CM First Four Digits
ICD-9-CM Fifth Digit*
800.0, 800.5, 801.0, 801.5, 803.0, 803.5, 804.0, 804.5, 850.0, 850.1, 850.5, or 850.9 854.0 959.0y
0, 1, 2, 6, 9, or missing
1, 2, 6, 9, or missing 1
Abbreviation: ICD-9-CM, International Classification of Diseases, 9th Revision, Clinical Modification. * Sometimes a fifth digit is provided in the code (eg, ICD-9-CM 800.00). y The current inclusion of code 959.01 is provisional.
Critical appraisal of the literature Eligible articles were independently reviewed by 2 reviewers using modified Scottish Intercollegiate Guidelines Network (SIGN) criteria (appendices 2 and 3).10 Permission was given to modify the SIGN criteria. ICoMP members not involved with the studies independently reviewed the 3 original ICoMP projects. A consensus method was used to solve disagreements about risk of bias assessment. A third reviewer was consulted if disagreements persisted.
Data extraction Data from admissible articles (ie, those with a low risk of bias) were extracted by 2 reviewers independently and were entered into evidence tables after consensus was reached. A third reviewer was consulted if there was disagreement. The data extracted were (1) authors and publication date, (2) study design and phase according to Coˆte´ et al,11 (3) country of publication, (4) source population, (5) follow-up periods, (6) MTBI case definition, (7) inclusion/exclusion criteria, (8) prognostic factors/outcomes, and (9) key findings.
A total of 92,022 citations were identified from the electronic databases, and 138 citations were identified from other sources (ie, reference lists and original ICoMP studies) (fig 1). After duplicates were removed, 77,914 titles remained. After applying the inclusion and exclusion criteria to titles and abstracts, 75,744 records were excluded and 2170 full-text articles were assessed for eligibility. Of these, 299 articles were determined to be eligible and were critically reviewed, and 101 (34%) were deemed scientifically admissible. These form the basis of our findings in this supplement and consist of 4 RCTs, 1 nonrandomized experiment, 88 cohort studies (8 phase III, 46 phase II, 34 phase I), and 8 case-control studies (2 phase III, 5 phase II, 1 phase I). These include the 3 original ICoMP studies previously carried out by reviewers.5-7 We also identified 32 non-English articles (18 Spanish, 10 French, 2 Danish, 1 Norwegian, and 1 Swedish). Of these, only 1 Spanish article was reviewed because it was the only one that met our eligibility criteria. However, it was subsequently rejected because of a high risk of bias.13 That is, selection bias, information bias, and issues of confounding were present.14
Discussion We critically reviewed 299 articles relating to the prognosis of MTBI in order to update the WHO Collaborating Centre Task Force findings. We accepted 101 (34%) of these as scientifically admissible and based our findings on them. We believe our review has several strengths. The investigative team includes international experts on clinical and methodologic issues in the field of traumatic brain injury. We developed a comprehensive and sensitive search strategy. We performed in-depth reviews of the methodologic quality of the studies and based our best-evidence synthesis on studies of better quality. We modified the SIGN checklists to more clearly assess the presence of biases specific to prognostic studies as opposed to intervention studies, which are the main focus of the SIGN criteria.
Data synthesis Study limitations Data from accepted studies (ie, those with a low risk of bias) were entered into evidence tables and linked to our statements regarding the evidence.12 A meta-analysis was not carried out because the study populations and methods were not sufficiently comparable across studies. We also prioritized the evidence on prognostic factors using a framework described by Coˆte´ et al.11 Phase I studies are hypothesis-generating investigations that explore the associations between potential prognostic factors and disease outcomes in a descriptive or univariate way. Phase II studies are extensive exploratory analyses that focus on particular sets of prognostic factors or attempt to discover which factors have the highest prognostic value. Phase III studies are large confirmatory studies of explicit prestated hypotheses that allow for a focused examination of the strength, direction, and independence of the proposed relation between a prognostic factor and the outcome of interest. Information from accepted phase III studies is considered the strongest evidence followed by evidence from phase II studies. Phase I studies explore the relations between single factors and outcomes and provide more limited preliminary evidence. www.archives-pmr.org
Our study has important limitations. Publication bias is possible because we only reviewed studies that were published in peerreviewed journals between 2001 and 2012 and in specific languages in which 1 or more reviewers are fluent. Therefore, potentially relevant studies may have been missed. Another potential source of bias is that some retrospective cohort studies may have been missed during screening because the abstract indicated they were cross sectional. In some cross-sectional studies, past MTBI is assessed retrospectively, and some of the prognostic factors are not modifiable (eg, age and sex). Therefore, the distinction between cross-sectional and retrospective cohort design is blurred. Finally, because of funding and time constraints, only 1 reviewer assessed the eligibility of the studies and consulted with a second reviewer only in cases of uncertainty; therefore, some relevant studies may have been missed. Several different review teams assessed studies for eligibility and quality. There is a certain amount of subjectivity involved with this process. As such, some teams may have rejected articles that others would have deemed admissible and vice versa. Similarly,
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Fig 1
Flow diagram of literature search.
certain studies could have been excluded that other teams may have deemed eligible. We attempted to guard against this by having 2 reviewers independently assess studies using explicit criteria for inclusion and exclusion and standard SIGN criteria. We also paired clinicians with methodologists to ensure a more comprehensive view of the literature. Reviewers were able to reach consensus on all articles. On a few occasions, a third reviewer was consulted to help reach consensus.
experiment, 88 cohort studies (8 phase III, 46 phase II, 34 phase I), and 8 case-control studies (2 phase III, 5 phase II, 1 phase I). More methodologically rigorous studies are needed to better understand the prognosis after MTBI because very few confirmatory (phase III) studies were identified. Our results are presented in 10 separate articles in this supplement. We also include an introductory article outlining the importance of prognosis and an article on research recommendations.
Conclusions
Keywords
We reviewed 299 articles and accepted 101 (34%), which form the basis of our findings. These consist of 4 RCTs, 1 nonrandomized
Craniocerebral trauma; Disabled persons; Morbidity; Prognosis; Recovery of function; Rehabilitation www.archives-pmr.org
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Corresponding author Carol Cancelliere, DC, MPH, Toronto Western Research Institute, University Health Network, University of Toronto, LuCliff Place, 700 Bay St, Ste 200, Toronto, ON, Canada, M5G 1Z6. E-mail address: [email protected].
Acknowledgments We thank the other members of ICoMP: Jean-Luc af Geijerstam, MD, PhD, Jo¨rgen Borg, MD, PhD, Eleanor Boyle, PhD, Linda J. Carroll, PhD, Victor G. Coronado, MD, MPH, Alison K. Godbolt, MBChB, MD, Jan Hartvigsen, DC, PhD, Lena W. Holm, DrMedSc, Ryan Hung, MD, MSc, Michelle Keightley, PhD, Vicki L. Kristman, PhD, Connie Marras, MD, PhD, Catharina Nygren-de Boussard, MD, PhD, Peter Rumney, MD, and Britt-Marie Sta˚lnacke, MD, PhD. We also thank Panos Lambiris, MSc, Information Scientist, University Health Network, University of Toronto, for assisting in developing, testing, and updating the search strategies. We thank Meijia Zhou, BSc, for assistance with retrieving and screening articles.
Appendix 1 MEDLINE Search Strategy Database: Ovid MEDLINE In-Process and Other Non-Indexed Citations and Ovid MEDLINE Search strategy: —————————————————— 1 exp Brain Edema/ (11614) 2 exp Cerebrovascular Trauma/ (4977) 3 exp Craniocerebral Trauma/ (113937) 4 exp Coma/ (17122) 5 exp Glasgow Outcome Scale/ (1051) 6 exp Glasgow Coma Scale/ (6087) 7 ((brain* or capitis or cerebr* or crani* or hemispher* or inter-crani* or intra-crani* or skull*) adj4 (contusion* or damag* or fractur* or injur* or trauma* or wound*)).ab,ti. (76692) 8 ((brain or crani* or cerebr* or head or inter-cran* or intracran*) adj4 (bleed* or haematoma* or haemorrhag* or hematoma* or hemorrhag* or pressure)).ti,ab. (23878) 9 (Glasgow adj (coma or outcome) adj (scale* or score*)).ab,ti. (7471) 10 ‘Rancho Los Amigos Scale’.ti,ab. (31) 11 diffuse axonal injur*.ti,ab. (757) 12 ((brain or cerebral or intracranial) adj3 (edema or oedema or swell*)).ab,ti. (11335) 13 ((coma* or concuss* or unconscious* or ‘persistent vegetative state’) adj2 (damag* or fractur* or injur* or trauma* or wound*)).ti,ab. (1679) 14 (mtbi or "mild trauma*" or "mild injur*" or "minor trauma*" or "minor injur*").tw. (4726) 15 or/1-14 (212141) 16 exp Rehabilitation, Vocational/ (8858) 17 exp Employment/ (50013) 18 exp Work/ (12325) 19 exp Sick Leave/ (3381) 20 exp Absenteeism/ (6888) 21 exp Occupational Health/ (23000) 22 exp Occupational Medicine/ (21529) 23 exp Disabled Persons/ (43287) 24 exp "Recovery of Function"/ (26090) 25 exp human activities/ (291817) www.archives-pmr.org
S105 26 exp self care/ (36525) 27 activities of daily living.tw. (13258) 28 (dressing or feeding or eating or toilet$ or bathing or mobil$ or driving or public transport$).tw. (408889) 29 ((daily or domestic or house or home) adj5 (activit$ or task$ or skill$ or chore$)).tw. (34441) 30 ("work status" or "work capacity").tw. (4933) 31 (unemployment or re-employment or underemployment or "job retention").ti,ab. (6218) 32 (return* adj2 school).tw. (431) 33 or/16-32 (885329) 34 exp Dementia/ (109526) 35 Delirium/ or exp Delirium, Dementia, Amnestic, Cognitive Disorders/ (165539) 36 dement*.mp. or alzheimer*.tw. (137612) 37 exp Parkinsonian Disorders/ (53508) 38 parkinson*.tw. (67863) 39 or/34-38 (263372) 40 exp Brain Neoplasms/ (111148) 41 (cancer* or neoplasm* or tumor* or malign*).mp. and brain.tw. (75523) 42 exp Glioma/ (55590) 43 or/40-42 (163467) 44 exp Pain/ (283120) 45 exp Chronic Disease/ (210827) 46 44 and 45 (20057) 47 (chronic* adj3 pain*).mp. (33004) 48 46 or 47 (41033) 49 exp sports/ (100665) 50 exp Recreation/ (116297) 51 (return* adj3 play*).tw. (804) 52 or/49-51 (116759) 53 exp Mental Disorders/ (880297) 54 exp Disability Evaluation/ (36033) 55 exp "Outcome Assessment (Health Care)"/ (608539) 56 disab*.tw. (119150) 57 54 or 55 or 56 (732078) 58 exp Cohort Studies/ (1217192) 59 exp Prognosis/ (971066) 60 exp Morbidity/ (329108) 61 exp Mortality/ (256333) 62 exp Meta-Analysis as Topic/ (12471) 63 exp Meta-Analysis/ (36882) 64 exp Survival Analysis/ (158750) 65 exp Models, Statistical/ (231835) 66 prognos*.tw. (324915) 67 course*.tw. (428180) 68 diagnosed.tw. (303965) 69 cohort.tw. (201191) 70 death.tw. (417135) 71 predict*.tw. (810652) 72 cohort*.mp. (282399) 73 or/58-72 (3774973) 74 randomized controlled trial/ (339068) 75 Randomized Controlled Trials as Topic/ (83675) 76 randomized controlled trial.pt. (339068) 77 Double-Blind Method/ (117570) 78 clinical trial.pt. (474965) 79 "double blind*".mp. (144074) 80 placebos/ (31433) 81 placebo*.mp. (158720) 82 random.mp. (225216)
S106 83 or/74-82 (909075) 84 review/ (1743334) 85 (medline or medlars or pubmed or grateful med or CINAHL or scisearch or psychinfo or psycinfo or psychlit or psyclit or handsearch* or hand search* or manual* search* or electronic database* or bibliographic database* or embase or lilacs or scopus or web of science).mp. (75144) 86 84 and 85 (48655) 87 meta-analysis.mp. (59897) 88 meta-analysis as topic/ (12471) 89 meta-analysis/ (36882) 90 systematic review*.tw. (38367) 91 cochrane database*.jn. (9141) 92 or/86-91 (113398) 93 15 and 33 (12663) 94 15 and 39 (10707) 95 15 and 43 (9673) 96 15 and 48 (391) 97 15 and 52 (3934) 98 15 and 57 (17864) 99 15 and 73 (68813) 100 15 and 83 (7952)
C. Cancelliere et al 101 15 and 92 (1471) 102 or/93-101 (93576) 103 animals/ not (humans/ and animals/) (3699389) 104 102 not 103 (83518) 105 limit 104 to (danish or english or french or norwegian or spanish or swedish) (71594) 106 limit 105 to yrZ"2001 -Current" (40890) *************************** Unique Identifier 23026577 Authors Salvalaggio PR. Ferraz-Neto BH. Authors Full Name Salvalaggio, P R. Ferraz-Neto, B H. Title Liver grafts procured by other transplant teams do not affect posttransplantation outcomes. Source Transplantation Proceedings. 44(8):2293-6, 2012 Oct. Publication Type Journal Article.
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References 1. Carroll LJ, Cassidy JD, Peloso PM, et al. Prognosis for mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med 2004;36(43 Suppl):84-105. 2. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097. 3. University of York Centre for Reviews and Dissemintation. International prospective register of systematic reviews (PROSPERO). Available at: http://www.crd.york.ac.uk/prospero/. Accessed July 11, 2011. 4. Cancelliere C, Cassidy JD, Coˆte´ P, et al. Protocol for a systematic review of prognosis after mild traumatic brain injury: an update of the WHO Collaborating Centre Task Force findings. Syst Rev 2012;1:17. 5. Cassidy JD, Boyle E, Carroll LJ. Population-based, inception cohort study of the incidence, course, and prognosis of mild traumatic brain injury after motor vehicle collisions. Arch Phys Med Rehabil 2014; 95(3 Suppl 2):S278-85. 6. Hartvigsen J, Boyle E, Cassidy JD, Carroll LJ. Mild traumatic brain injury after motor vehicle collisions: what are the symptoms and who treats them? A population-based 1-year inception cohort study. Arch Phys Med Rehabil 2014;95(3 Suppl 2):S286-94. 7. Kristman VL, Coˆte´ P, Yang X, Hogg-Johnson S, Vidmar M, Rezai M. Health care utilization of workers’ compensation claimants associated with mild traumatic brain injury: a historical population-based cohort
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8.
9.
10. 11.
12. 13.
14.
study of workers injured in 1997-1998. Arch Phys Med Rehabil 2014; 95(3 Suppl 2):S295-302. Carroll LJ, Cassidy JD, Holm L, Kraus J, Coronado VG; WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Methodological issues and research recommendations for mild traumatic brain injury: the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med 2004;36(43 Suppl):113-25. National Center for Injury Prevention and Control. Report to Congress on mild traumatic brain injury in the United States: steps to prevent a serious public health problem. Atlanta: Centers for Disease Control and Prevention; 2003. Healthcare Improvement Scotland. SIGN. Available at: http://www. sign.ac.uk/. Accessed September 10, 2011. Coˆte´ P, Cassidy JD, Carroll L, Frank JW, Bombardier C. A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature. Spine 2001;26:E445-58. Slavin RE. Best evidence synthesis: an intelligent alternative to metaanalysis. J Clin Epidemiol 1995;48:9-18. Bello Pedrosa O, Prego Petit J, Stewart Davies J, Robuschi Lestouquet F. Tratamiento del traumatismo craneoencefalico aislado leve. Estudio multicentrico. An Pediatr 2006;65:44-50. Kristman VL, Borg J, Godbolt AK, et al. Methodological issues and research recommendations for prognosis after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehab 2014;95(3 Suppl 2): S265-77.
BRIEF REPORT
Systematic Search and Review Procedures: Results of the International Collaboration on Mild Traumatic Brain Injury Prognosis Carol Cancelliere, DC, MPH,a,b J. David Cassidy, PhD, DrMedSc,a,b,c,d Alvin Li, BHSc,e James Donovan, DC,a Pierre Coˆte´, DC, PhD,b,d,f,g Cesar A. Hincapie´, DC, MHSca,d From the aDivision of Health Care and Outcomes Research, Toronto Western Research Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada; bInstitute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada; c Institute of Sports Science and Clinical Biomechanics, Faculty of Health, University of Southern Denmark, Odense, Denmark; dDivision of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; eDepartment of Epidemiology and Biostatistics, Western University, London, Ontario, Canada; fFaculty of Health Sciences, University of Ontario Institute of Technology, Oshawa, Ontario, Canada; and gUniversity of Ontario Institute of Technology-Canadian Memorial Chiropractic College Centre for the Study of Disability Prevention and Rehabilitation, Toronto, Ontario, Canada.
Abstract Objectives: To update the last best-evidence synthesis conducted by the World Health Organization Collaborating Centre for Neurotrauma, Prevention, Management and Rehabilitation in 2002; and to describe the course, identify prognostic factors, determine long-term sequelae, identify effects of interventions for mild traumatic brain injury (MTBI), identify knowledge gaps in the literature, and make recommendations for future research. Data Sources: MEDLINE, Embase, PsycINFO, Cumulative Index to Nursing and Allied Health, and SPORTDiscus were searched between 2001 and 2012. Inclusion criteria included published peer-reviewed articles in English and 5 other languages. References were also identified from relevant reviews and meta-analyses and the bibliographies of eligible articles. Study Selection: Controlled trials and cohort and case-control studies were selected according to predefined inclusion/exclusion criteria. Studies had to have at least 30 MTBI cases and assess outcomes relevant to prognosis after MTBI. Data Extraction: Eligible studies were critically appraised using modified Scottish Intercollegiate Guidelines Network (SIGN) criteria. Two reviewers independently reviewed each study and extracted data from accepted articles (ie, with a low risk of bias) into evidence tables. Data Synthesis: The evidence was synthesized qualitatively according to modified SIGN criteria and prioritized according to design as exploratory or confirmatory. The evidence was organized into separate articles according to population (eg, adults, children, and athletes) and outcomes (eg, risk of dementia after MTBI). Conclusions: After 77,914 records were screened, 299 articles were eligible and reviewed. Of these, 101 (34%) were accepted as scientifically admissible and form the basis of our findings, which are organized into 10 articles in this supplement. These reviews present the best available evidence on MTBI prognosis, but more research is needed. Archives of Physical Medicine and Rehabilitation 2014;95(3 Suppl 2):S101-31 ª 2014 by the American Congress of Rehabilitation Medicine
Supported by the Ontario Neurotrauma Foundation (grant no. 2010-ABI-MTBIWHO-871). The funder was not involved in the design or preparation of the study protocol or in the management of the project, analysis or interpretation of data, or the preparation of the final article. No commercial party having a direct financial interest in the results of the research supporting this article has conferred or will confer a benefit on the authors or on any organization with which the authors are associated. The findings and conclusions in this research are those of the authors alone and do not necessarily represent the official views or policies of the Centers for Disease Control and Prevention or any agency of the United States government. Inclusion of individuals, programs, or organizations in this article does not constitute endorsement by the United States government.
The first systematic review to look at mild traumatic brain injury (MTBI) prognosis, the World Health Organization (WHO) Collaborating Centre for Neurotrauma, Prevention, Management and Rehabilitation Task Force,1 found very few good quality studies addressing MTBI. Given their call for better quality research and the increasing amount of attention surrounding the long-term sequelae of MTBI, the International Collaboration on MTBI Prognosis (ICoMP) was formed to update the findings.
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The objectives of this review are to describe the course and identify prognostic factors after MTBI, describe the long-term sequelae, evaluate the effectiveness of clinical interventions, and make clinical and methodologic recommendations for future research.
Methods The review was conducted and reported in compliance with the Preferred Reporting Items for Systematic Reviews and MetaAnalyses statement.2 Our protocol was registered in the international prospective register of systematic reviews3 on July 11, 2011, and was last updated on November 2, 2012 (registration no. CRD42011001410). We also published the detailed protocol.4
Literature search The search strategy was developed in consultation with an information specialist. The electronic databases MEDLINE (OVID), PsycINFO (OVID), Embase (OVID), Cumulative Index to Nursing and Allied Health (EBSCO), and SPORTDiscus were systematically searched from January 1, 2001, to June 30, 2011. These searches were updated on February 10, 2012 (appendix 1). We used 3 search filters (prognosis filter, systematic review filter, and therapy filter), which are a combination of published Health Information Research Unit (at McMaster University) filters and unpublished University Health Network filters. The reference lists of all reviews and meta-analyses related to MTBI and articles meeting the eligibility criteria were screened for additional potentially relevant articles. ICoMP members also undertook 3 original research studies.5-7
Eligibility criteria Articles were screened for eligibility according to the following predefined criteria: language (articles written in English, French, Swedish, Norwegian, Danish, and Spanish), publication type (original research published in peer-reviewed journals), study design (controlled trials, case-control studies, and cohort studies with a minimum of 30 MTBI cases), study population (participants [no age limit] may consist of a mixed group of traumatic brain injury severity [eg, mild, moderate, or severe] only if the results are stratified by severity and the MTBI subjects can be clearly identified), and case definition (studies must clearly state a case definition for MTBI that falls within the definitions provided by the WHO Collaborating Centre Task Force and the Centers for Disease Control and Prevention). The WHO Collaborating Centre Task Force states the following: MTBI is an acute brain injury resulting from mechanical energy to the head from external physical forces. Operational criteria for clinical identification include: (i) one or more of the following: confusion or disorientation, loss of
List of abbreviations: ICoMP MTBI SIGN WHO
International Collaboration on MTBI Prognosis mild traumatic brain injury Scottish Intercollegiate Guidelines Network World Health Organization
consciousness for 30 minutes or less, post-traumatic amnesia for less than 24 hours, and/or other transient neurological abnormalities such as focal signs, seizure, and intracranial lesion not requiring surgery; and (ii) Glasgow Coma Scale score of 13 e 15 after 30 minutes post-injury or later upon presentation for healthcare. These manifestations of MTBI must not be due to drugs, alcohol, medications, caused by other injuries or treatment for other injuries (e.g. systemic injuries, facial injuries or intubation), caused by other problems (e.g. psychological trauma, language barrier or coexisting medical conditions) or caused by penetrating craniocerebral injury.8(p115) Persons with fractured skulls will be included if they fit this case definition. As per the Centers for Disease Control and Prevention, MTBI is recognized among persons with an Abbreviated Injury Score of 2 for the head region or among persons who are assigned certain International Classification of Diseases, 9th Revision, Clinical Modification diagnostic codes (table 1).9 Studies must also have included the study outcomes of selfrated recovery, functional recovery, and improvement in clinical outcomes and risk of long-term sequelae; and have examined modifiable prognostic factors (eg, comorbid conditions, litigation, injury-related pain, stress) and clinical prediction rules for diagnosis or triage of patients with MTBI. Exclusion criteria included the following: (1) publication type of narrative reviews, letters, editorials, commentaries, unpublished manuscripts, dissertations, government reports, books and book chapters, conference proceedings, meeting abstracts, lectures and addresses, and consensus development statements (including guideline statements); (2) study design of crosssectional studies; case reports and series; qualitative studies; reviews and meta-analyses; and cadaveric, biomechanical, and laboratory studies (although we screened reviews and metaanalyses for primary studies, we did not review them); (3) study population of animals; (4) case definition of neck fractures and open or penetrating head injury, nontraumatic brain injury, MTBI because of violence/assault in the civilian population, or child abuse (eg, shaken baby syndrome); (5) outcomes where the frequency of intracranial lesions in MTBI was not viewed as an outcome, but rather as part of the diagnosis; therefore, studies examining only this aspect are considered irrelevant to the prognosis after MTBI for the purposes of this review; and (6) all studies that included any intentional cases of MTBI in the civilian population (eg, from assault). In our view, recovery from assault is complicated by victimization and legal proceedings and to understand their prognosis would require stratifying results by intentional injuries. We excluded studies that did not stratify intentional from unintentional injuries.
Screening For the first level of screening, 1 reviewer read the titles of all the citations retrieved from the electronic database searches and removed all those that were clearly not related to traumatic brain injury. The second level of screening involved abstract review. Full text articles were obtained for all abstracts except for those that clearly did not meet the eligibility criteria. If after analyzing the full text the eligibility of an article was still uncertain, a second reviewer undertook a full text analysis to determine eligibility. A third reviewer was consulted in the event of any disagreements. www.archives-pmr.org
Systematic search and review procedures Table 1
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ICD-9-CM codes for MTBI
ICD-9-CM First Four Digits
ICD-9-CM Fifth Digit*
800.0, 800.5, 801.0, 801.5, 803.0, 803.5, 804.0, 804.5, 850.0, 850.1, 850.5, or 850.9 854.0 959.0y
0, 1, 2, 6, 9, or missing
1, 2, 6, 9, or missing 1
Abbreviation: ICD-9-CM, International Classification of Diseases, 9th Revision, Clinical Modification. * Sometimes a fifth digit is provided in the code (eg, ICD-9-CM 800.00). y The current inclusion of code 959.01 is provisional.
Critical appraisal of the literature Eligible articles were independently reviewed by 2 reviewers using modified Scottish Intercollegiate Guidelines Network (SIGN) criteria (appendices 2 and 3).10 Permission was given to modify the SIGN criteria. ICoMP members not involved with the studies independently reviewed the 3 original ICoMP projects. A consensus method was used to solve disagreements about risk of bias assessment. A third reviewer was consulted if disagreements persisted.
Data extraction Data from admissible articles (ie, those with a low risk of bias) were extracted by 2 reviewers independently and were entered into evidence tables after consensus was reached. A third reviewer was consulted if there was disagreement. The data extracted were (1) authors and publication date, (2) study design and phase according to Coˆte´ et al,11 (3) country of publication, (4) source population, (5) follow-up periods, (6) MTBI case definition, (7) inclusion/exclusion criteria, (8) prognostic factors/outcomes, and (9) key findings.
A total of 92,022 citations were identified from the electronic databases, and 138 citations were identified from other sources (ie, reference lists and original ICoMP studies) (fig 1). After duplicates were removed, 77,914 titles remained. After applying the inclusion and exclusion criteria to titles and abstracts, 75,744 records were excluded and 2170 full-text articles were assessed for eligibility. Of these, 299 articles were determined to be eligible and were critically reviewed, and 101 (34%) were deemed scientifically admissible. These form the basis of our findings in this supplement and consist of 4 RCTs, 1 nonrandomized experiment, 88 cohort studies (8 phase III, 46 phase II, 34 phase I), and 8 case-control studies (2 phase III, 5 phase II, 1 phase I). These include the 3 original ICoMP studies previously carried out by reviewers.5-7 We also identified 32 non-English articles (18 Spanish, 10 French, 2 Danish, 1 Norwegian, and 1 Swedish). Of these, only 1 Spanish article was reviewed because it was the only one that met our eligibility criteria. However, it was subsequently rejected because of a high risk of bias.13 That is, selection bias, information bias, and issues of confounding were present.14
Discussion We critically reviewed 299 articles relating to the prognosis of MTBI in order to update the WHO Collaborating Centre Task Force findings. We accepted 101 (34%) of these as scientifically admissible and based our findings on them. We believe our review has several strengths. The investigative team includes international experts on clinical and methodologic issues in the field of traumatic brain injury. We developed a comprehensive and sensitive search strategy. We performed in-depth reviews of the methodologic quality of the studies and based our best-evidence synthesis on studies of better quality. We modified the SIGN checklists to more clearly assess the presence of biases specific to prognostic studies as opposed to intervention studies, which are the main focus of the SIGN criteria.
Data synthesis Study limitations Data from accepted studies (ie, those with a low risk of bias) were entered into evidence tables and linked to our statements regarding the evidence.12 A meta-analysis was not carried out because the study populations and methods were not sufficiently comparable across studies. We also prioritized the evidence on prognostic factors using a framework described by Coˆte´ et al.11 Phase I studies are hypothesis-generating investigations that explore the associations between potential prognostic factors and disease outcomes in a descriptive or univariate way. Phase II studies are extensive exploratory analyses that focus on particular sets of prognostic factors or attempt to discover which factors have the highest prognostic value. Phase III studies are large confirmatory studies of explicit prestated hypotheses that allow for a focused examination of the strength, direction, and independence of the proposed relation between a prognostic factor and the outcome of interest. Information from accepted phase III studies is considered the strongest evidence followed by evidence from phase II studies. Phase I studies explore the relations between single factors and outcomes and provide more limited preliminary evidence. www.archives-pmr.org
Our study has important limitations. Publication bias is possible because we only reviewed studies that were published in peerreviewed journals between 2001 and 2012 and in specific languages in which 1 or more reviewers are fluent. Therefore, potentially relevant studies may have been missed. Another potential source of bias is that some retrospective cohort studies may have been missed during screening because the abstract indicated they were cross sectional. In some cross-sectional studies, past MTBI is assessed retrospectively, and some of the prognostic factors are not modifiable (eg, age and sex). Therefore, the distinction between cross-sectional and retrospective cohort design is blurred. Finally, because of funding and time constraints, only 1 reviewer assessed the eligibility of the studies and consulted with a second reviewer only in cases of uncertainty; therefore, some relevant studies may have been missed. Several different review teams assessed studies for eligibility and quality. There is a certain amount of subjectivity involved with this process. As such, some teams may have rejected articles that others would have deemed admissible and vice versa. Similarly,
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Fig 1
Flow diagram of literature search.
certain studies could have been excluded that other teams may have deemed eligible. We attempted to guard against this by having 2 reviewers independently assess studies using explicit criteria for inclusion and exclusion and standard SIGN criteria. We also paired clinicians with methodologists to ensure a more comprehensive view of the literature. Reviewers were able to reach consensus on all articles. On a few occasions, a third reviewer was consulted to help reach consensus.
experiment, 88 cohort studies (8 phase III, 46 phase II, 34 phase I), and 8 case-control studies (2 phase III, 5 phase II, 1 phase I). More methodologically rigorous studies are needed to better understand the prognosis after MTBI because very few confirmatory (phase III) studies were identified. Our results are presented in 10 separate articles in this supplement. We also include an introductory article outlining the importance of prognosis and an article on research recommendations.
Conclusions
Keywords
We reviewed 299 articles and accepted 101 (34%), which form the basis of our findings. These consist of 4 RCTs, 1 nonrandomized
Craniocerebral trauma; Disabled persons; Morbidity; Prognosis; Recovery of function; Rehabilitation www.archives-pmr.org
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Corresponding author Carol Cancelliere, DC, MPH, Toronto Western Research Institute, University Health Network, University of Toronto, LuCliff Place, 700 Bay St, Ste 200, Toronto, ON, Canada, M5G 1Z6. E-mail address: [email protected].
Acknowledgments We thank the other members of ICoMP: Jean-Luc af Geijerstam, MD, PhD, Jo¨rgen Borg, MD, PhD, Eleanor Boyle, PhD, Linda J. Carroll, PhD, Victor G. Coronado, MD, MPH, Alison K. Godbolt, MBChB, MD, Jan Hartvigsen, DC, PhD, Lena W. Holm, DrMedSc, Ryan Hung, MD, MSc, Michelle Keightley, PhD, Vicki L. Kristman, PhD, Connie Marras, MD, PhD, Catharina Nygren-de Boussard, MD, PhD, Peter Rumney, MD, and Britt-Marie Sta˚lnacke, MD, PhD. We also thank Panos Lambiris, MSc, Information Scientist, University Health Network, University of Toronto, for assisting in developing, testing, and updating the search strategies. We thank Meijia Zhou, BSc, for assistance with retrieving and screening articles.
Appendix 1 MEDLINE Search Strategy Database: Ovid MEDLINE In-Process and Other Non-Indexed Citations and Ovid MEDLINE Search strategy: —————————————————— 1 exp Brain Edema/ (11614) 2 exp Cerebrovascular Trauma/ (4977) 3 exp Craniocerebral Trauma/ (113937) 4 exp Coma/ (17122) 5 exp Glasgow Outcome Scale/ (1051) 6 exp Glasgow Coma Scale/ (6087) 7 ((brain* or capitis or cerebr* or crani* or hemispher* or inter-crani* or intra-crani* or skull*) adj4 (contusion* or damag* or fractur* or injur* or trauma* or wound*)).ab,ti. (76692) 8 ((brain or crani* or cerebr* or head or inter-cran* or intracran*) adj4 (bleed* or haematoma* or haemorrhag* or hematoma* or hemorrhag* or pressure)).ti,ab. (23878) 9 (Glasgow adj (coma or outcome) adj (scale* or score*)).ab,ti. (7471) 10 ‘Rancho Los Amigos Scale’.ti,ab. (31) 11 diffuse axonal injur*.ti,ab. (757) 12 ((brain or cerebral or intracranial) adj3 (edema or oedema or swell*)).ab,ti. (11335) 13 ((coma* or concuss* or unconscious* or ‘persistent vegetative state’) adj2 (damag* or fractur* or injur* or trauma* or wound*)).ti,ab. (1679) 14 (mtbi or "mild trauma*" or "mild injur*" or "minor trauma*" or "minor injur*").tw. (4726) 15 or/1-14 (212141) 16 exp Rehabilitation, Vocational/ (8858) 17 exp Employment/ (50013) 18 exp Work/ (12325) 19 exp Sick Leave/ (3381) 20 exp Absenteeism/ (6888) 21 exp Occupational Health/ (23000) 22 exp Occupational Medicine/ (21529) 23 exp Disabled Persons/ (43287) 24 exp "Recovery of Function"/ (26090) 25 exp human activities/ (291817) www.archives-pmr.org
S105 26 exp self care/ (36525) 27 activities of daily living.tw. (13258) 28 (dressing or feeding or eating or toilet$ or bathing or mobil$ or driving or public transport$).tw. (408889) 29 ((daily or domestic or house or home) adj5 (activit$ or task$ or skill$ or chore$)).tw. (34441) 30 ("work status" or "work capacity").tw. (4933) 31 (unemployment or re-employment or underemployment or "job retention").ti,ab. (6218) 32 (return* adj2 school).tw. (431) 33 or/16-32 (885329) 34 exp Dementia/ (109526) 35 Delirium/ or exp Delirium, Dementia, Amnestic, Cognitive Disorders/ (165539) 36 dement*.mp. or alzheimer*.tw. (137612) 37 exp Parkinsonian Disorders/ (53508) 38 parkinson*.tw. (67863) 39 or/34-38 (263372) 40 exp Brain Neoplasms/ (111148) 41 (cancer* or neoplasm* or tumor* or malign*).mp. and brain.tw. (75523) 42 exp Glioma/ (55590) 43 or/40-42 (163467) 44 exp Pain/ (283120) 45 exp Chronic Disease/ (210827) 46 44 and 45 (20057) 47 (chronic* adj3 pain*).mp. (33004) 48 46 or 47 (41033) 49 exp sports/ (100665) 50 exp Recreation/ (116297) 51 (return* adj3 play*).tw. (804) 52 or/49-51 (116759) 53 exp Mental Disorders/ (880297) 54 exp Disability Evaluation/ (36033) 55 exp "Outcome Assessment (Health Care)"/ (608539) 56 disab*.tw. (119150) 57 54 or 55 or 56 (732078) 58 exp Cohort Studies/ (1217192) 59 exp Prognosis/ (971066) 60 exp Morbidity/ (329108) 61 exp Mortality/ (256333) 62 exp Meta-Analysis as Topic/ (12471) 63 exp Meta-Analysis/ (36882) 64 exp Survival Analysis/ (158750) 65 exp Models, Statistical/ (231835) 66 prognos*.tw. (324915) 67 course*.tw. (428180) 68 diagnosed.tw. (303965) 69 cohort.tw. (201191) 70 death.tw. (417135) 71 predict*.tw. (810652) 72 cohort*.mp. (282399) 73 or/58-72 (3774973) 74 randomized controlled trial/ (339068) 75 Randomized Controlled Trials as Topic/ (83675) 76 randomized controlled trial.pt. (339068) 77 Double-Blind Method/ (117570) 78 clinical trial.pt. (474965) 79 "double blind*".mp. (144074) 80 placebos/ (31433) 81 placebo*.mp. (158720) 82 random.mp. (225216)
S106 83 or/74-82 (909075) 84 review/ (1743334) 85 (medline or medlars or pubmed or grateful med or CINAHL or scisearch or psychinfo or psycinfo or psychlit or psyclit or handsearch* or hand search* or manual* search* or electronic database* or bibliographic database* or embase or lilacs or scopus or web of science).mp. (75144) 86 84 and 85 (48655) 87 meta-analysis.mp. (59897) 88 meta-analysis as topic/ (12471) 89 meta-analysis/ (36882) 90 systematic review*.tw. (38367) 91 cochrane database*.jn. (9141) 92 or/86-91 (113398) 93 15 and 33 (12663) 94 15 and 39 (10707) 95 15 and 43 (9673) 96 15 and 48 (391) 97 15 and 52 (3934) 98 15 and 57 (17864) 99 15 and 73 (68813) 100 15 and 83 (7952)
C. Cancelliere et al 101 15 and 92 (1471) 102 or/93-101 (93576) 103 animals/ not (humans/ and animals/) (3699389) 104 102 not 103 (83518) 105 limit 104 to (danish or english or french or norwegian or spanish or swedish) (71594) 106 limit 105 to yrZ"2001 -Current" (40890) *************************** Unique Identifier 23026577 Authors Salvalaggio PR. Ferraz-Neto BH. Authors Full Name Salvalaggio, P R. Ferraz-Neto, B H. Title Liver grafts procured by other transplant teams do not affect posttransplantation outcomes. Source Transplantation Proceedings. 44(8):2293-6, 2012 Oct. Publication Type Journal Article.
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References 1. Carroll LJ, Cassidy JD, Peloso PM, et al. Prognosis for mild traumatic brain injury: results of the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med 2004;36(43 Suppl):84-105. 2. Moher D, Liberati A, Tetzlaff J, Altman DG; PRISMA Group. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. PLoS Med 2009;6:e1000097. 3. University of York Centre for Reviews and Dissemintation. International prospective register of systematic reviews (PROSPERO). Available at: http://www.crd.york.ac.uk/prospero/. Accessed July 11, 2011. 4. Cancelliere C, Cassidy JD, Coˆte´ P, et al. Protocol for a systematic review of prognosis after mild traumatic brain injury: an update of the WHO Collaborating Centre Task Force findings. Syst Rev 2012;1:17. 5. Cassidy JD, Boyle E, Carroll LJ. Population-based, inception cohort study of the incidence, course, and prognosis of mild traumatic brain injury after motor vehicle collisions. Arch Phys Med Rehabil 2014; 95(3 Suppl 2):S278-85. 6. Hartvigsen J, Boyle E, Cassidy JD, Carroll LJ. Mild traumatic brain injury after motor vehicle collisions: what are the symptoms and who treats them? A population-based 1-year inception cohort study. Arch Phys Med Rehabil 2014;95(3 Suppl 2):S286-94. 7. Kristman VL, Coˆte´ P, Yang X, Hogg-Johnson S, Vidmar M, Rezai M. Health care utilization of workers’ compensation claimants associated with mild traumatic brain injury: a historical population-based cohort
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8.
9.
10. 11.
12. 13.
14.
study of workers injured in 1997-1998. Arch Phys Med Rehabil 2014; 95(3 Suppl 2):S295-302. Carroll LJ, Cassidy JD, Holm L, Kraus J, Coronado VG; WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. Methodological issues and research recommendations for mild traumatic brain injury: the WHO Collaborating Centre Task Force on Mild Traumatic Brain Injury. J Rehabil Med 2004;36(43 Suppl):113-25. National Center for Injury Prevention and Control. Report to Congress on mild traumatic brain injury in the United States: steps to prevent a serious public health problem. Atlanta: Centers for Disease Control and Prevention; 2003. Healthcare Improvement Scotland. SIGN. Available at: http://www. sign.ac.uk/. Accessed September 10, 2011. Coˆte´ P, Cassidy JD, Carroll L, Frank JW, Bombardier C. A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature. Spine 2001;26:E445-58. Slavin RE. Best evidence synthesis: an intelligent alternative to metaanalysis. J Clin Epidemiol 1995;48:9-18. Bello Pedrosa O, Prego Petit J, Stewart Davies J, Robuschi Lestouquet F. Tratamiento del traumatismo craneoencefalico aislado leve. Estudio multicentrico. An Pediatr 2006;65:44-50. Kristman VL, Borg J, Godbolt AK, et al. Methodological issues and research recommendations for prognosis after mild traumatic brain injury: results of the International Collaboration on Mild Traumatic Brain Injury Prognosis. Arch Phys Med Rehab 2014;95(3 Suppl 2): S265-77.
