232543 Improving outcomes of rehabilitation treatments for traumatic brain injury: The development of an online database

Monday, November 8, 2010

Jillian Davis, BS , Department of Health Sciences, Boston University, Boston, MA
Eileen O'Keefe, MD, MPH , Department of Health Sciences, Boston University, Boston, MA
Eileen Elias, MEd , JBS International Inc., North Bethesda, MD
Olubunmi Orekoya, MPH , Department of Health Sciences, Boston University, Boston, MA
Todd Sponholtz , Department of Health Sciences, Boston University, Boston, MA
Heywan Tesfaye, BS , Department of Health Sciences, Boston University, Boston, MA
Objectives: Traumatic brain injury (TBI) is the signature injury of the Iraq and Afghanistan conflicts and a major public health issue that affects soldiers and civilians alike. This study seeks to identify gaps in research, determine areas for improvement in study design, and identify standards of care for TBI rehabilitation. Methods: TBI rehabilitation treatments were divided into four categories: behavioral, cognitive, functional, and physical. Published studies within the four categories were identified through PubMed and PsycINFO literature searches. The studies were reviewed and analyzed using a standardized algorithm which was developed into an online Oracle database. Studies were classified and assigned a level of evidence based on the American Academy of Neurology (AAN) classification guidelines. Results: Published studies are generally small and lack blinding and randomization. Due to these limitations, few studies meet AAN Class I guidelines, and thus standards of care within TBI rehabilitation cannot be satisfactorily determined. Conclusions: Steps to improve the quality of future TBI studies include increasing study size, utilizing randomization and double-blinding, and increasing funding of large multi-center studies. This will inform the development of effective standards of care for TBI rehabilitation across the life spectrum.

Learning Areas:
Public health or related research

Learning Objectives:
1. Articulate the procedure for the review and the determination of the level of evidence of a TBI study 2. List the components crucial to a strong TBI study 3. Identify studies that indicate the effectiveness of treatment with a high level of evidence

Keywords: Evidence Based Practice, Traumatic Brain Injury

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a student of health sciences and epidemiology with training in epidemiological research.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.