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Strengthening the Evidence Base: Recommendations for Future Research Identified Through the Development of CDC's
Stacy J Suskauer1, Keith Owen Yeates, Kelly Sarmiento
1Kennedy Krieger Institute, and Johns Hopkins University School of Medicine, Baltimore, Maryland (Dr Suskauer); University of Calgary, Alberta, Canada (Dr Yeates); Centers for Disease Control and Prevention, Atlanta, Georgia (Ms Sarmiento and Drs Breiding and Haarbauer-Krupa); Cleveland Clinic, Ohio (Dr Benzel); Goodman Campbell Brain & Spine, Indianapolis, Indiana (Dr Turner); Emory University School of Medicine, Atlanta, Georgia (Dr Weissman); and Stanford University School of Medicine, California (Dr Lumba-Brown). Dr Broomand is retired.
Insights
The Centers for Disease Control and Prevention guideline identifies critical gaps in pediatric mild traumatic brain injury (mTBI) research. Addressing these limitations will improve future studies and clinical guidelines for children with mTBI.
Area of Science:
- Pediatric Neurology
- Neuroscience
- Public Health
Background:
- A recent evidence-based guideline for pediatric mild traumatic brain injury (mTBI) was developed by the Centers for Disease Control and Prevention.
- The guideline involved an extensive review of existing scientific literature on pediatric mTBI.
- This review highlighted significant limitations in current research methodologies and reporting.
Purpose of the Study:
- To summarize identified limitations in pediatric mild traumatic brain injury (mTBI) research.
- To provide a framework for enhancing the quality of future research conduct and reporting in pediatric mTBI.
- To guide improvements in diagnostic accuracy, screening, prognostication, and therapeutic interventions for pediatric mTBI.
Main Methods:
- Systematic literature review of pediatric mild traumatic brain injury (mTBI) studies.
- Expert identification and analysis of research limitations across various domains.
- Development of a framework for optimizing future research quality.
Main Results:
- Identified limitations in pediatric mTBI research include study setting, generalizability, injury mechanism, cohort age, control groups, confounding factors, measurement issues, and reporting standards.
- Specific recommendations are provided for improving diagnostic accuracy, population screening, prognostic accuracy, and therapeutic interventions.
- The identified limitations impact the quality and applicability of current pediatric mTBI evidence.
Conclusions:
- Addressing the identified research limitations is crucial for advancing the field of pediatric mild traumatic brain injury (mTBI).
- Implementing the proposed framework will enhance the quality and consistency of pediatric mTBI research.
- Improved research quality will facilitate the development of more robust systematic reviews and clinical guidelines for pediatric mTBI, ultimately benefiting patient care.
Objective:
The recently published Centers for Disease Control and Prevention evidence-based guideline on pediatric mild traumatic brain injury (mTBI) was developed following an extensive review of the scientific literature. Through this review, experts identified limitations in existing pediatric mTBI research related to study setting and generalizability, mechanism of injury and age of cohorts studied, choice of control groups, confounding, measurement issues, reporting of results, and specific study design considerations. This report summarizes those limitations and provides a framework for optimizing the future quality of research conduct and reporting.
Results:
Specific recommendations are provided related to diagnostic accuracy, population screening, prognostic accuracy, and therapeutic interventions.
Conclusion:
Incorporation of the recommended approaches will increase the yield of eligible research for inclusion in future systematic reviews and guidelines for pediatric mTBI.
