Related Experiment Video
Updated: Apr 28, 2026
Controlled Cortical Impact Model for Traumatic Brain Injury
Published on: August 5, 2014
Experiences and Challenges Updating a Living Evidence-Based Review of Randomized Controlled Trials on Mental Health
Robert Teasell1, Heather M MacKenzie, Cecilia Flores-Sandoval
1Author Affiliations: Lawson Health Research Institute, Lawson Research Institute, London, ON, Canada (Drs Teasell, MacKenzie, Flores-Sandoval, McIntyre, Barua, Mehta, and Bateman); Department of Physical Medicine and Rehabilitation, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada (Dr Teasell, MacKenzie, Mehta, and Bateman); Parkwood Institute, St. Joseph's Health Care London, London, Ontario, Canada (Drs Teasell, MacKenzie, and Bateman); Arthur Labatt School of Nursing, Western University, London, Ontario, Canada (Dr McIntyre); Division of Physical Medicine and Rehabilitation, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada (Dr Bayley); KITE Research Institute, University Health Network, Toronto, Ontario, Canada (Dr Bayley) University Health Network, Toronto Rehabilitation Institute, Toronto, Ontatio, Canada (Dr Bayley).
Objective:
To describe experiences and challenges when updating a living evidence-based review database of randomized controlled trials (RCTs) on mental health and behavioral disorders in moderate to severe traumatic brain injury (MSTBI).
Method:
This commentary derives from our experience developing an extensive database of RCTs on MSTBI that has been conceptualized as a living evidence-based review. Our working group focused on mental health and behavior RCTs and reflected upon their experiences and challenges using the living systematic approach. We discuss challenges associated with metrics of study quality, injury etiology and severity, time post-injury, country of origin, and variability in outcome measures.
Results:
RCTs were conducted almost solely in high income countries, with smaller sample sizes, and most conducted in the chronic phase post-TBI. Issues related to lack of transparency, unclear and incomplete reporting of injury severity, etiology, and time post-injury remain a concern and can lead to challenges associated with interpretation of results, validity, and reliability of the data. There was significant heterogeneity regarding the use of outcome measures and constructs, underscoring the need for standardization.
Conclusion:
Lack of standardization and incomplete reporting of injury characteristics makes it difficult to compare data between RCTs of MSTBI, perform meta-analyses, and generate evidence-based clinical recommendations.
