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Rehabilitation of Persons With Traumatic Brain Injury

OBJECTIVE To provide biomedical researchers and clinicians with information regarding and recommendations for effective rehabilitation measures for persons who have experienced a traumatic brain injury (TBI). PARTICIPANTS A nonfederal, nonadvocate, 16-member panel representing the fields of neuropsy...

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Bibliographic Details
Published in:JAMA : the journal of the American Medical Association 1999-09, Vol.282 (10), p.974-983
Main Author: NIH Consensus Development Panel on Rehabilitation of Persons With Traumatic Brain Injury
Format: Article
Language:English
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Summary:OBJECTIVE To provide biomedical researchers and clinicians with information regarding and recommendations for effective rehabilitation measures for persons who have experienced a traumatic brain injury (TBI). PARTICIPANTS A nonfederal, nonadvocate, 16-member panel representing the fields of neuropsychology, neurology, psychiatry, behavioral medicine, family medicine, pediatrics, physical medicine and rehabilitation, speech and hearing, occupational therapy, nursing, epidemiology, biostatistics, and the public. In addition, 31 experts from these same fields presented data to the panel and a conference audience of 883 members of the public. The conference consisted of (1) presentations by investigators working in areas relevant to the consensus questions during a 2-day public session; (2) questions and statements from conference attendees during open discussions that were part of the public session; and (3) closed deliberations by the panel during the remainder of the second day and part of the third. Primary sponsors of the conference were the National Institute of Child Health and Human Development and the National Institutes of Health Office of Medical Applications of Research. EVIDENCE The literature was searched through MEDLINE for articles from January 1988 through August 1998 and an extensive bibliography of 2563 references was provided to the panel and the conference audience. Experts prepared abstracts for their conference presentations with relevant citations from the literature. The panel prepared a compendium of evidence, including a patient contribution and reports from federal agencies. Scientific evidence was given precedence over clinical anecdotal experience. CONSENSUS PROCESS The panel, answering predefined questions, developed their conclusions based on the scientific evidence presented during the open forum (October 26-28, 1998) and in the scientific literature. The panel composed a draft statement that was read in its entirety and circulated to the experts and the audience for comment. Thereafter, the panel resolved conflicting recommendations and released a revised statement at the end of the conference. The panel finalized the revisions within a few weeks after the conference. The draft statement was made available on the Internet immediately following its release at the conference and was updated with the panel's final revisions. CONCLUSIONS Traumatic brain injury results principally from vehicular incidents, falls, acts of violence,
ISSN:0098-7484
1538-3598
DOI:10.1001/jama.282.10.974