Paul M. Peloso ^A1, Linda J. Carroll ^A2, J. David Cassidy ^A2, Jörgen Borg ^A5, Hans von Holst ^A6, Lena Holm ^A4, David Yates ^A7
A1 Department of Internal Medicine University of Iowa Health Center Iowa City Iowa USA
^A2 Alberta Centre for Injury Control and Research, Department of Public Health Sciences University of Alberta Edmonton Alberta Canada
^A3 Department of Medicine University of Alberta Edmonton Alberta Canada
^A4 Section for Personal Injury Prevention, Department of Clinical Neurosciences Karolinska Institutet Stockholm Sweden
^A5 Department Neuroscience, Rehabilitation Medicine Uppsala University Uppsala Sweden
^A6 Department of Neurosurgery Karolinska Institutet Stockholm Swede
^A7 Emergency Department, Hope Hospital University of Manchester Manchester UK

DOI: 10.1080/16501960410023868

The purpose of guidelines is to reduce practice variability, but they need to be evidence-based. We examine current mild traumatic brain injury guidelines, critique their basis in evidence and examine their variability in recommendations. A systematic search of the literature found 38,806 abstracts, with 41 guidelines. There were 18 sports-related guidelines, 13 related to admission policies, 12 related to imaging and 5 related to neuropsychological assessment. Some guidelines addressed several areas. Only 5 guidelines reported a methodology for the assembly of evidence used to develop the guideline. After appraising the guidelines against a validated index, we found that 3 of the 41 guidelines could be categorized as evidence-based. Two of these focused on paediatric patients and 1 on adult patients. Limited methodological quality in the current guidelines results in conflicting recommendations amongst them.