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Published on: August 16, 2019
Adaptation of Traumatic Brain Injury Guidelines in Iran
Shayan Abdollah Zadegan1, Seyed Mohammad Ghodsi2, Jalil Arabkheradmand3
1Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, IR Iran; Research Centre for Neural Repair, Tehran University, Tehran, IR Iran.
Context:
The National institute for health and care excellence (NICE) and scottish intercollegiate guidelines network (SIGN) are two well-known sources of clinical guideline development. In the past years, they have developed clinical guidelines for the management of head injury. In this report, we will highlight our modifications to these guidelines according to the domestic situation in a developing country.
Evidence Acquisition:
The guidelines were appraised using the appraisal of guidelines for research and evaluation (AGREE) instrument. All key recommendations were reviewed by 14 prominent Iranian neurosurgeons; levels of evidence were evaluated and items with limited evidence were determined. Available evidence for selected items were reviewed and discussed.
Results:
The following items were the most challenging when accounting for the domestic situation in Iran: age as a risk factor for referral, computed tomography scan, the impact of medical comorbidities, pregnancy, consultation, referral to a neurosurgical unit, and teleconsulting and observation before discharge.
Conclusions:
The evidence in the discussed topics was limited and controversial. This report is important because it exposes the current knowledge gap in head trauma studies in Iran.
