Methodological issues and research recommendations for mild traumatic brain injury: the who collaborating centre task force on mild traumatic brain injury

TLDR

Mild traumatic brain injury research is of variable quality, with frequent methodological flaws. The Task Force recommends avoiding common methodological shortcomings, identifies urgent research priorities, calls for large, well‑designed studies to inform emergency‑room triage of children and prognosis in the elderly, and advocates standard criteria with a proposed definition for mild traumatic brain injury. The WHO Task Force conducted a comprehensive literature review of 743 studies (313 accepted) from 1980–2002 to synthesize best evidence on epidemiology, diagnosis, prognosis, and treatment of mild traumatic brain injury. They recommend avoiding methodological shortcomings and highlight urgent research topics.

Abstract

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.