Adaptation of Traumatic Brain Injury Guidelines in Iran

Abstract

ContextThe 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 AcquisitionThe 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.ResultsThe 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.ConclusionsThe 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.

National Guidelines for Cognitive Assessment and Rehabilitation of Iranian Traumatic Brain Injury Patients

“…The committee members were researchers and/or clinicians with previous experience in cognitive assessment and rehabilitation of TBI patients; two members (S.A.Z and V.R-M) had previously adapted international CPGs for early management of Iranian TBI patients. 14 All the members received special training in guideline adaption. The executive committee performed steps 1 to 6, managed the decision-making (step 7), and summed up the results.…”