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Progress and Report of the ACRM Measurement Networking Group Applied Cognition Task Force (MNG ACTF):  Traumatic Brain Injury Workgroup
Rusk Rehabilitation, New York, USA.
USA.
USA.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation.
Show others and affiliations
2016 (English)Conference paper, (Refereed)
Abstract [en]

This symposium will provide an overview of the progress of the ACRM Measurement Networking Group Applied Cognition Task Force (ACTF) – the Traumatic Brain Injury (TBI) Workgroup.

 

The ACRM MNG ACTF TBI Workgroup is conducting a comprehensive overview of systematic reviews that evaluate the impact of pharmacological treatments on behavioral, psychological and adverse event outcomes.  Considerable interest in the effectiveness of pharmacological treatments to improve cognitive and behavioral outcomes for individuals with TBI exists.  Of great importance in this capacity is the timeframe and type of agent administered according to the trauma stage and symptom severity.  Guidelines from randomized clinical trials (RCTs), systematic reviews and meta-analyses may be used in an attempt to increase the use of evidence-based treatments among healthcare professionals or to stimulate healthcare professionals to adopt such evidence to make better decisions about the appropriate treatment for their TBI patient. There are a large number of published systematic reviews and meta-analyses describing the effects of various types of pharmacological treatments on behavioral and cognitive outcomes of patients with TBI.  The workgroup reviewed the literature and discovered significant limitations related to current pharmacological treatments for TBI. As a result, the group formulated the following questions: 1) what are the levels of evidence supporting pharmacological RCTs on outcomes of cognitive function and related behavioral outcomes for individuals with TBI? 2) how do pharmacological RCTs compare with placebo trials and with other RCTs in achieving long-term effects (six months or longer)?; 3) how do the risks of adverse and serious adverse events compare between the treatments? And, 4) are there instances where the harms outweigh the benefits?

 

This symposium provides an update on the methods used and systems developed to

perform the comprehensive evidence-based recommendation reports, and preliminary data. By using search strategies (registered in PROSPERO [CRD42015017355] that can be accessed at:

http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015017355),

a large number of peer-reviewed studies were identified and underwent rigorous evaluation  for inclusion criteria  and comprehensive review by the workgroup team.  Currently the review data [plural] show the studies are primarily of mixed design and cover a full range of TBI severity, including a wide range of years post-injury as well as pharmacological treatments. 

                                                                                                               

The focus of our symposium is on the results and the quality of evidence derived from the collective data, as well as on preliminary conclusions that may be drawn based on what the data demonstrate about the efficacy and effectiveness of pharmacological interventions post-TBI.   The symposium  will cover 1) method and system 2) drugs that appear in the literature; 3) outcome measures of pharmacological treatment for cognitive, emotional, neurobehavioral symptoms and quality of life (QOL) post-TBI.

 

Key Words: TBI, Cognition, pharmacological outcomes, RCT, systematic reviews, meta-analysis

 

 

PRESENTATION OUTLINE

 

Presentation 1, Introduction: Allen Heinemann and Sonya Kim                     (5 minutes)                                                                

Presentation 1I, Review Methods:  Lilian Hoffecker (10 min)  

                                                                

Presentation III, Pharmacology and TBI: Xiaolei Hu  (15 min)

We examine the prevalence of particular drugs that appear in the literature and explore their usefulness in terms of beneficial effects, dosage and frequency as a way to guide clinical application in the future.

 

Presentation 1V, Results:  Outcomes of pharmacologic treatment for persons with TBI. 

(50 minutes)

We present and integrate findings from treatments related to cognitive, neurobehavioral,  and QOL outcomes and examine the evidence presented in papers in order to evaluate the quality of the methods used and determine any limitations.

1.       Cognitive and neurobehavioral symptoms: Sonya Kim

2.       Emotional status and quality of life: Marianne Mortera

 

Discussion /Question-Answer, Patricia Heyn (10 minutes)

Supply Learning Objectives: A minimum of three (3) learning objectives are required.

  1. Describe the methods used to identify relevant systematic reviews and meta-analyses included in the Cog-TBI workgroup of the Task Force.
  2. Describe and critique the published pharmacological literature (systematic reviews/meta-analysis) on cognitive function and related behavioral outcomes, and adverse events related to TBI. 
  3. Describe the gaps in the cognitive outcomes literature related to pharmacological treatments for TBI.
  4. Discuss pharmacological treatment standards for the TBI population.
  5. Identify limitations in the pharmacological treatment studies that warrant further consideration.
Place, publisher, year, edition, pages
Chicago, USA, 2016.
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:umu:diva-133952OAI: oai:DiVA.org:umu-133952DiVA: diva2:1090144
Conference
ACRM 93rd ANNUAL CONFERENCE
Available from: 2017-04-22 Created: 2017-04-22 Last updated: 2017-04-22

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Citation style
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