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Ghawami H, Jazayeri SB, Sabeti Nowsud A, Sharif-Alhoseini M, Shirvani A, Kheyri M, Abdollah Zadegan S, Noorian N, Mohammadian F, Karimi Yarandi K, Azad A, Rezaeitalab F, Barekatain M, Bakhtiyari J, Moradi A, Khatoonabadi AR, Haghgoo HA, Gheini MR, Khadivi M, Faghih Jouibari M, Khayat Kashani HR, Mirzaasgari Z, Meshkini A, Haghshenas H, Samini F, Mohit P, Akbarfahimi M, Alimohammadi Y, Payandemehr P, Abbaszadeh Ahranjani J, Arabkheradmand J, Vahabi Z, Arbabi M, Kermanpour H, Ghandehari K, Bakhshani NM, Motlagh Pirooz F, Ghaedi G, Dolatshahi B, Tavakoli SF, Vosough I, Amirjamshidi A, Hatami J, Rahimi-Movaghar V. National Guidelines for Cognitive Assessment and Rehabilitation of Iranian Traumatic Brain Injury Patients. Arch Iran Med 2020; 23:813-820. [PMID: 33356338 DOI: 10.34172/aim.2020.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 08/04/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Individuals with moderate to severe traumatic brain injury (TBI) often have prolonged cognitive impairments, resulting in long-term problems with their real-life activities. Given the urgent need for evidence-based recommendations for neuropsychological management of Iranian TBI patients, the current work aimed to adapt eligible international guidelines for cognitive assessment and rehabilitation of the TBI patients in Iran. METHODS The project was led by an executive committee, under the supervision of the Iranian Ministry of Health and Medical Education (MOHME). Following a systematic literature search and selection process, four guidelines were included for adaptation. Clinical recommendations of the source guidelines were tabulated as possible clinical scenarios for 90 PICO clinical questions covering all relevant phases of care. After summing up the scenarios, our initial list of recommendations was drafted according to the Iranian patients' conditions. The final decision-making, with the contribution of a national interdisciplinary panel of 37 experts from across the country, was conducted in two rounds using online and offline survey forms (Round 1), and face-to-face and telephone meetings (Round 2). RESULTS A total of 63 recommendations in six sections were included in the final list of recommendations, among which 24 were considered as key recommendations. In addition, some of the recommendations were identified as fundamental, meaning that proper implementation of the other recommendations is largely dependent on their implementation. CONCLUSION Iranian health policy makers and rehabilitation program managers are recommended to address some fundamental issues to provide the necessary infrastructure to set up an efficient cognitive rehabilitation service system.
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Affiliation(s)
- Heshmatollah Ghawami
- Neuropsychology Division, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Behnam Jazayeri
- Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Neurotrauma, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Azad Sabeti Nowsud
- Neuropsychology Division, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahdi Sharif-Alhoseini
- Department of Neurotrauma, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Armin Shirvani
- National Agency for Strategic Research in Medical Education (NASR), Tehran, Iran
| | - Maryam Kheyri
- Clinical Guideline Development and Standardization Group, Office of Health Technology Assessment, Standardization and Tariffs, Deputy for Curative Affairs, Iranian Ministry of Health and Medical Education (MOHME), Tehran, Iran
| | - Shayan Abdollah Zadegan
- Department of Neurotrauma, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Nahid Noorian
- Department of Psychology, Shahid Rajaee University (SRTTU), Tehran, Iran
| | - Fatemeh Mohammadian
- Department of Neurology, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kourosh Karimi Yarandi
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Akram Azad
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Fariborz Rezaeitalab
- Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Majid Barekatain
- Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Jalal Bakhtiyari
- Department of Speech Therapy, Neuromuscular Rehabilitation Research Center, School of Rehabilitation Sciences, Semnan University Medical Sciences, Semnan, Iran
| | - Alireza Moradi
- Department of Clinical Psychology, Kharazmi University, Tehran, Iran.,Department of Cognitive Psychology, Institute for Cognitive Sciences Studies, Tehran, Iran
| | - Ahmad Reza Khatoonabadi
- Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
| | - Hojjat Allah Haghgoo
- Department of Occupational Therapy, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Reza Gheini
- Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Khadivi
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Morteza Faghih Jouibari
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Zahra Mirzaasgari
- Neurology Department, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Ali Meshkini
- Road Traffic Injury Research Center, Department of Neurosurgery, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Hassan Haghshenas
- Department of Psychiatry, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fariborz Samini
- Department of Neurosurgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Parviz Mohit
- Department of Neurosurgery, Mazandaran University of Medical Science, Sari, Iran
| | - Malahat Akbarfahimi
- Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | | | - Pooya Payandemehr
- Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Zahra Vahabi
- Memory and Behavioral Neurology Division, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Arbabi
- Department of Psychiatry, Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Hossein Kermanpour
- Emergency Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kavian Ghandehari
- Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | | | - Gholamhossein Ghaedi
- Department of Psychiatry, Neurophysiology Research Center, Shahed University, Tehran, Iran
| | - Behrooz Dolatshahi
- Department of Psychology, School of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Seyed Fakhredin Tavakoli
- Department of Neurosurgery, Islamic Azad University, Medical Branch, Mashhad, Iran.,Farabi Hospital, Social Security Organization, Mashhad, Iran
| | - Iraj Vosough
- Research and Education Department, Razavi Hospital, Mashhad, Iran
| | - Abbas Amirjamshidi
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Javad Hatami
- Department of Psychology, University of Tehran, Tehran, Iran
| | - Vafa Rahimi-Movaghar
- Department of Neurotrauma, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran.,Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.,Research Centre for Neural Repair, University of Tehran, Tehran, Iran
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Abdollah Zadegan S, Ghodsi SM, Arabkheradmand J, Amirjamshidi A, Sheikhrezaei A, Khadivi M, Faghih Jouibari M, Tabatabaeifar SM, Sharifi G, Abbaszadeh Ahranjani J, Motlagh Pirooz F, Tavakoli SF, Mohit P, Alimohammadi Y, Rahimi-Movaghar V. Adaptation of Traumatic Brain Injury Guidelines in Iran. Trauma Mon 2016; 21:e28012. [PMID: 27626012 PMCID: PMC5003467 DOI: 10.5812/traumamon.28012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Accepted: 05/09/2015] [Indexed: 11/16/2022] Open
Abstract
CONTEXT The 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 ACQUISITION The 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. RESULTS The 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. CONCLUSIONS The 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.
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Affiliation(s)
- Shayan Abdollah Zadegan
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
- Research Centre for Neural Repair, Tehran University, Tehran, IR Iran
| | - Seyed Mohammad Ghodsi
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | | | - Abbas Amirjamshidi
- Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Abdolreza Sheikhrezaei
- Department of Neurosurgery, Imam Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Masoud Khadivi
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Morteza Faghih Jouibari
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
| | - Seyed Mahmood Tabatabaeifar
- Functional Neurosurgery Research Center, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | - Guive Sharifi
- Department of Neurosurgery, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
| | | | - Farhad Motlagh Pirooz
- Department of Neurosurgery, Islamic Azad University, Medical Branch, Mashhad, IR Iran
| | | | - Parviz Mohit
- Tehran University of Medical Sciences, Tehran, IR Iran
| | | | - Vafa Rahimi-Movaghar
- Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, IR Iran
- Research Centre for Neural Repair, Tehran University, Tehran, IR Iran
- Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran
- Corresponding author: Vafa Rahimi-Movaghar, Sina Trauma and Surgery Research Center, Hassan-Abad Square, Imam Khomeini Ave, P. O. Box: 113653876, Tehran, IR Iran. Tel: +98-9153422682; +98-2166718311, Fax: +98-2166705140, E-mail:
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