Methodological issues and research recommendations for mild traumatic brain injury: the who collaborating centre task force on mild traumatic brain injury
Linda J Carroll A1, J. David Cassidy A1, Lena Holm A3, Jess Kraus A4, Victor G. Coronado A5
A1 Alberta Centre for Injury Control and Research, Department of Public Health Sciences University of Alberta Edmonton Alberta Canada
A2 Department of Medicine University of Alberta Edmonton Alberta Canada
A3 Section for Personal Injury Prevention, Department of Clinical Neurosciences Karolinska Institutet Stockholm Sweden
A4 Division of Epidemiology School of Public Health University of California Los Angeles California USA
A5 National Center for Injury Prevention and Control Centers for Disease Control and Prevention Atlanta USA
The WHO Collaborating Centre for Neurotrauma Task Force on Mild Traumatic Brain Injury performed a comprehensive search and critical review of the literature published between 1980 and 2002 to assemble the best evidence on the epidemiology, diagnosis, prognosis and treatment of mild traumatic brain injury. Of 743 relevant studies, 313 were accepted on scientific merit and comprise our best-evidence synthesis. The current literature on mild traumatic brain injury is of variable quality and we report the most common methodological flaws. We make recommendations for avoiding the shortcomings evident in much of the current literature and identify topic areas in urgent need of further research. This includes the need for large, well-designed studies to support evidence-based guidelines for emergency room triage of children with mild traumatic brain injury and to explore more fully the issue of prognosis after mild traumatic brain injury in the elderly population. We also advocate use of standard criteria for defining mild traumatic brain injury and propose a definition.