TY - JOUR
T1 - Priority Clinical Actions for Outpatient Management of Nonhospitalized Traumatic Brain Injury
AU - On behalf of the Action Collaborative on TBI Care
AU - Silverberg, Noah D.
AU - Lee, Kathy
AU - Mikolić, Ana
AU - Bayley, Mark T.
AU - Brody, David L.
AU - Ely, E. Wesley
AU - Giacino, Joseph T.
AU - Halabi, Cathra
AU - Hammond, Flora M.
AU - Ignacio, Daniel A.
AU - Mosti, Caterina
AU - van der Naalt, Joukje
AU - Pappadis, Monique R.
AU - Tenovuo, Olli
AU - Wang, Vincent Y.
AU - Verduzco-Gutierrez, Monica
AU - Manley, Geoffrey T.
N1 - Publisher Copyright:
Copyright 2025, Mary Ann Liebert, Inc., publishers.
PY - 2025
Y1 - 2025
N2 - Outpatient care following nonhospitalized traumatic brain injury (TBI) is variable, and often sparse. The National Academies of Sciences, Engineering, and Medicine’s 2022 report on Traumatic Brain Injury: A Roadmap for Accelerating Progress highlighted the need to improve the consistency and quality of TBI care in the community. In response, the present study aimed to identify existing evidence-based guidance and specific clinical actions over the days to months following nonhospitalized TBI that should be prioritized for implementation in primary care. In systematic literature searches, 17 clinical practice guidelines met our eligibility criteria and an additional expert consensus statement was considered highly relevant. We extracted 73 topics covered by one or more existing clinical practice guidelines. After removing redundant and out-of-scope topics, those deemed essential (not requiring prioritization), 42 topics were subjected to a prioritization exercise. Experts from the author group (n = 14), people with lived experience (n = 112), and clinicians in the community (n = 99) selected and ranked topics they considered most important. There were areas of agreement (e.g., early education was ranked highly by all groups) and discordance (e.g., people with lived experience perceived diagnostic tests/investigations as more important than the other groups). We synthesized the prioritization survey results into a top-10 list of the highest priority clinical actions. This list will inform implementation efforts aimed at improving post-acute care for nonhospitalized TBI.
AB - Outpatient care following nonhospitalized traumatic brain injury (TBI) is variable, and often sparse. The National Academies of Sciences, Engineering, and Medicine’s 2022 report on Traumatic Brain Injury: A Roadmap for Accelerating Progress highlighted the need to improve the consistency and quality of TBI care in the community. In response, the present study aimed to identify existing evidence-based guidance and specific clinical actions over the days to months following nonhospitalized TBI that should be prioritized for implementation in primary care. In systematic literature searches, 17 clinical practice guidelines met our eligibility criteria and an additional expert consensus statement was considered highly relevant. We extracted 73 topics covered by one or more existing clinical practice guidelines. After removing redundant and out-of-scope topics, those deemed essential (not requiring prioritization), 42 topics were subjected to a prioritization exercise. Experts from the author group (n = 14), people with lived experience (n = 112), and clinicians in the community (n = 99) selected and ranked topics they considered most important. There were areas of agreement (e.g., early education was ranked highly by all groups) and discordance (e.g., people with lived experience perceived diagnostic tests/investigations as more important than the other groups). We synthesized the prioritization survey results into a top-10 list of the highest priority clinical actions. This list will inform implementation efforts aimed at improving post-acute care for nonhospitalized TBI.
KW - clinical practice guideline
KW - craniocerebral trauma
KW - priorities
KW - survey
KW - traumatic brain injury
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U2 - 10.1089/neu.2024.0414
DO - 10.1089/neu.2024.0414
M3 - Article
C2 - 39761000
AN - SCOPUS:85215686528
SN - 0897-7151
JO - Journal of neurotrauma
JF - Journal of neurotrauma
ER -