Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury among Children

Angela Lumba-Brown, Keith Owen Yeates, Kelly Sarmiento, Matthew J. Breiding, Tamara M. Haegerich, Gerard A. Gioia, Michael Turner, Edward C. Benzel, Stacy J. Suskauer, Christopher C. Giza, Madeline Joseph, Catherine Broomand, Barbara Weissman, Wayne Gordon, David W. Wright, Rosemarie Scolaro Moser, Karen McAvoy, Linda Ewing-Cobbs, Ann Christine Duhaime, Margot PutukianBarbara Holshouser, David Paulk, Shari L. Wade, Stanley A. Herring, Mark Halstead, Heather T. Keenan, Meeryo Choe, Cindy W. Christian, Kevin Guskiewicz, P. B. Raksin, Andrew Gregory, Anne Mucha, H. Gerry Taylor, James M. Callahan, John Dewitt, Michael W. Collins, Michael W. Kirkwood, John Ragheb, Richard G. Ellenbogen, Theodore J. Spinks, Theodore G. Ganiats, Linda J. Sabelhaus, Katrina Altenhofen, Rosanne Hoffman, Tom Getchius, Gary Gronseth, Zoe Donnell, Robert E. O'Connor, Shelly Timmons

Research output: Contribution to journalReview article

39 Citations (Scopus)

Abstract

Importance: Mild traumatic brain injury (mTBI), or concussion, in children is a rapidly growing public health concern because epidemiologic data indicate a marked increase in the number of emergency department visits for mTBI over the past decade. However, no evidence-based clinical guidelines have been developed to date for diagnosing and managing pediatric mTBI in the United States. Objective: To provide a guideline based on a previous systematic review of the literature to obtain and assess evidence toward developing clinical recommendations for health care professionals related to the diagnosis, prognosis, and management/treatment of pediatric mTBI. Evidence Review: The Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control Board of Scientific Counselors, a federal advisory committee, established the Pediatric Mild Traumatic Brain Injury Guideline Workgroup. The workgroup drafted recommendations based on the evidence that was obtained and assessed within the systematic review, as well as related evidence, scientific principles, and expert inference. This information includes selected studies published since the evidence review was conducted that were deemed by the workgroup to be relevant to the recommendations. The dates of the initial literature search were January 1, 1990, to November 30, 2012, and the dates of the updated literature search were December 1, 2012, to July 31, 2015. Findings: The CDC guideline includes 19 sets of recommendations on the diagnosis, prognosis, and management/treatment of pediatric mTBI that were assigned a level of obligation (ie, must, should, or may) based on confidence in the evidence. Recommendations address imaging, symptom scales, cognitive testing, and standardized assessment for diagnosis; history and risk factor assessment, monitoring, and counseling for prognosis; and patient/family education, rest, support, return to school, and symptom management for treatment. Conclusions and Relevance: This guideline identifies the best practices for mTBI based on the current evidence; updates should be made as the body of evidence grows. In addition to the development of the guideline, CDC has created user-friendly guideline implementation materials that are concise and actionable. Evaluation of the guideline and implementation materials is crucial in understanding the influence of the recommendations..

Original languageEnglish (US)
JournalJAMA Pediatrics
Volume172
Issue number11
DOIs
StatePublished - Nov 1 2018

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Brain Concussion
Centers for Disease Control and Prevention (U.S.)
Guidelines
Pediatrics
Neurobehavioral Manifestations
Advisory Committees
Patient Education
Practice Guidelines
Hospital Emergency Service
Counseling
Therapeutics
Public Health
History
Delivery of Health Care

All Science Journal Classification (ASJC) codes

  • Pediatrics, Perinatology, and Child Health

Cite this

Lumba-Brown, A., Yeates, K. O., Sarmiento, K., Breiding, M. J., Haegerich, T. M., Gioia, G. A., ... Timmons, S. (2018). Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury among Children. JAMA Pediatrics, 172(11). https://doi.org/10.1001/jamapediatrics.2018.2853
Lumba-Brown, Angela ; Yeates, Keith Owen ; Sarmiento, Kelly ; Breiding, Matthew J. ; Haegerich, Tamara M. ; Gioia, Gerard A. ; Turner, Michael ; Benzel, Edward C. ; Suskauer, Stacy J. ; Giza, Christopher C. ; Joseph, Madeline ; Broomand, Catherine ; Weissman, Barbara ; Gordon, Wayne ; Wright, David W. ; Moser, Rosemarie Scolaro ; McAvoy, Karen ; Ewing-Cobbs, Linda ; Duhaime, Ann Christine ; Putukian, Margot ; Holshouser, Barbara ; Paulk, David ; Wade, Shari L. ; Herring, Stanley A. ; Halstead, Mark ; Keenan, Heather T. ; Choe, Meeryo ; Christian, Cindy W. ; Guskiewicz, Kevin ; Raksin, P. B. ; Gregory, Andrew ; Mucha, Anne ; Taylor, H. Gerry ; Callahan, James M. ; Dewitt, John ; Collins, Michael W. ; Kirkwood, Michael W. ; Ragheb, John ; Ellenbogen, Richard G. ; Spinks, Theodore J. ; Ganiats, Theodore G. ; Sabelhaus, Linda J. ; Altenhofen, Katrina ; Hoffman, Rosanne ; Getchius, Tom ; Gronseth, Gary ; Donnell, Zoe ; O'Connor, Robert E. ; Timmons, Shelly. / Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury among Children. In: JAMA Pediatrics. 2018 ; Vol. 172, No. 11.
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title = "Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury among Children",
abstract = "Importance: Mild traumatic brain injury (mTBI), or concussion, in children is a rapidly growing public health concern because epidemiologic data indicate a marked increase in the number of emergency department visits for mTBI over the past decade. However, no evidence-based clinical guidelines have been developed to date for diagnosing and managing pediatric mTBI in the United States. Objective: To provide a guideline based on a previous systematic review of the literature to obtain and assess evidence toward developing clinical recommendations for health care professionals related to the diagnosis, prognosis, and management/treatment of pediatric mTBI. Evidence Review: The Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control Board of Scientific Counselors, a federal advisory committee, established the Pediatric Mild Traumatic Brain Injury Guideline Workgroup. The workgroup drafted recommendations based on the evidence that was obtained and assessed within the systematic review, as well as related evidence, scientific principles, and expert inference. This information includes selected studies published since the evidence review was conducted that were deemed by the workgroup to be relevant to the recommendations. The dates of the initial literature search were January 1, 1990, to November 30, 2012, and the dates of the updated literature search were December 1, 2012, to July 31, 2015. Findings: The CDC guideline includes 19 sets of recommendations on the diagnosis, prognosis, and management/treatment of pediatric mTBI that were assigned a level of obligation (ie, must, should, or may) based on confidence in the evidence. Recommendations address imaging, symptom scales, cognitive testing, and standardized assessment for diagnosis; history and risk factor assessment, monitoring, and counseling for prognosis; and patient/family education, rest, support, return to school, and symptom management for treatment. Conclusions and Relevance: This guideline identifies the best practices for mTBI based on the current evidence; updates should be made as the body of evidence grows. In addition to the development of the guideline, CDC has created user-friendly guideline implementation materials that are concise and actionable. Evaluation of the guideline and implementation materials is crucial in understanding the influence of the recommendations..",
author = "Angela Lumba-Brown and Yeates, {Keith Owen} and Kelly Sarmiento and Breiding, {Matthew J.} and Haegerich, {Tamara M.} and Gioia, {Gerard A.} and Michael Turner and Benzel, {Edward C.} and Suskauer, {Stacy J.} and Giza, {Christopher C.} and Madeline Joseph and Catherine Broomand and Barbara Weissman and Wayne Gordon and Wright, {David W.} and Moser, {Rosemarie Scolaro} and Karen McAvoy and Linda Ewing-Cobbs and Duhaime, {Ann Christine} and Margot Putukian and Barbara Holshouser and David Paulk and Wade, {Shari L.} and Herring, {Stanley A.} and Mark Halstead and Keenan, {Heather T.} and Meeryo Choe and Christian, {Cindy W.} and Kevin Guskiewicz and Raksin, {P. B.} and Andrew Gregory and Anne Mucha and Taylor, {H. Gerry} and Callahan, {James M.} and John Dewitt and Collins, {Michael W.} and Kirkwood, {Michael W.} and John Ragheb and Ellenbogen, {Richard G.} and Spinks, {Theodore J.} and Ganiats, {Theodore G.} and Sabelhaus, {Linda J.} and Katrina Altenhofen and Rosanne Hoffman and Tom Getchius and Gary Gronseth and Zoe Donnell and O'Connor, {Robert E.} and Shelly Timmons",
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Lumba-Brown, A, Yeates, KO, Sarmiento, K, Breiding, MJ, Haegerich, TM, Gioia, GA, Turner, M, Benzel, EC, Suskauer, SJ, Giza, CC, Joseph, M, Broomand, C, Weissman, B, Gordon, W, Wright, DW, Moser, RS, McAvoy, K, Ewing-Cobbs, L, Duhaime, AC, Putukian, M, Holshouser, B, Paulk, D, Wade, SL, Herring, SA, Halstead, M, Keenan, HT, Choe, M, Christian, CW, Guskiewicz, K, Raksin, PB, Gregory, A, Mucha, A, Taylor, HG, Callahan, JM, Dewitt, J, Collins, MW, Kirkwood, MW, Ragheb, J, Ellenbogen, RG, Spinks, TJ, Ganiats, TG, Sabelhaus, LJ, Altenhofen, K, Hoffman, R, Getchius, T, Gronseth, G, Donnell, Z, O'Connor, RE & Timmons, S 2018, 'Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury among Children', JAMA Pediatrics, vol. 172, no. 11. https://doi.org/10.1001/jamapediatrics.2018.2853

Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury among Children. / Lumba-Brown, Angela; Yeates, Keith Owen; Sarmiento, Kelly; Breiding, Matthew J.; Haegerich, Tamara M.; Gioia, Gerard A.; Turner, Michael; Benzel, Edward C.; Suskauer, Stacy J.; Giza, Christopher C.; Joseph, Madeline; Broomand, Catherine; Weissman, Barbara; Gordon, Wayne; Wright, David W.; Moser, Rosemarie Scolaro; McAvoy, Karen; Ewing-Cobbs, Linda; Duhaime, Ann Christine; Putukian, Margot; Holshouser, Barbara; Paulk, David; Wade, Shari L.; Herring, Stanley A.; Halstead, Mark; Keenan, Heather T.; Choe, Meeryo; Christian, Cindy W.; Guskiewicz, Kevin; Raksin, P. B.; Gregory, Andrew; Mucha, Anne; Taylor, H. Gerry; Callahan, James M.; Dewitt, John; Collins, Michael W.; Kirkwood, Michael W.; Ragheb, John; Ellenbogen, Richard G.; Spinks, Theodore J.; Ganiats, Theodore G.; Sabelhaus, Linda J.; Altenhofen, Katrina; Hoffman, Rosanne; Getchius, Tom; Gronseth, Gary; Donnell, Zoe; O'Connor, Robert E.; Timmons, Shelly.

In: JAMA Pediatrics, Vol. 172, No. 11, 01.11.2018.

Research output: Contribution to journalReview article

TY - JOUR

T1 - Centers for Disease Control and Prevention Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury among Children

AU - Lumba-Brown, Angela

AU - Yeates, Keith Owen

AU - Sarmiento, Kelly

AU - Breiding, Matthew J.

AU - Haegerich, Tamara M.

AU - Gioia, Gerard A.

AU - Turner, Michael

AU - Benzel, Edward C.

AU - Suskauer, Stacy J.

AU - Giza, Christopher C.

AU - Joseph, Madeline

AU - Broomand, Catherine

AU - Weissman, Barbara

AU - Gordon, Wayne

AU - Wright, David W.

AU - Moser, Rosemarie Scolaro

AU - McAvoy, Karen

AU - Ewing-Cobbs, Linda

AU - Duhaime, Ann Christine

AU - Putukian, Margot

AU - Holshouser, Barbara

AU - Paulk, David

AU - Wade, Shari L.

AU - Herring, Stanley A.

AU - Halstead, Mark

AU - Keenan, Heather T.

AU - Choe, Meeryo

AU - Christian, Cindy W.

AU - Guskiewicz, Kevin

AU - Raksin, P. B.

AU - Gregory, Andrew

AU - Mucha, Anne

AU - Taylor, H. Gerry

AU - Callahan, James M.

AU - Dewitt, John

AU - Collins, Michael W.

AU - Kirkwood, Michael W.

AU - Ragheb, John

AU - Ellenbogen, Richard G.

AU - Spinks, Theodore J.

AU - Ganiats, Theodore G.

AU - Sabelhaus, Linda J.

AU - Altenhofen, Katrina

AU - Hoffman, Rosanne

AU - Getchius, Tom

AU - Gronseth, Gary

AU - Donnell, Zoe

AU - O'Connor, Robert E.

AU - Timmons, Shelly

PY - 2018/11/1

Y1 - 2018/11/1

N2 - Importance: Mild traumatic brain injury (mTBI), or concussion, in children is a rapidly growing public health concern because epidemiologic data indicate a marked increase in the number of emergency department visits for mTBI over the past decade. However, no evidence-based clinical guidelines have been developed to date for diagnosing and managing pediatric mTBI in the United States. Objective: To provide a guideline based on a previous systematic review of the literature to obtain and assess evidence toward developing clinical recommendations for health care professionals related to the diagnosis, prognosis, and management/treatment of pediatric mTBI. Evidence Review: The Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control Board of Scientific Counselors, a federal advisory committee, established the Pediatric Mild Traumatic Brain Injury Guideline Workgroup. The workgroup drafted recommendations based on the evidence that was obtained and assessed within the systematic review, as well as related evidence, scientific principles, and expert inference. This information includes selected studies published since the evidence review was conducted that were deemed by the workgroup to be relevant to the recommendations. The dates of the initial literature search were January 1, 1990, to November 30, 2012, and the dates of the updated literature search were December 1, 2012, to July 31, 2015. Findings: The CDC guideline includes 19 sets of recommendations on the diagnosis, prognosis, and management/treatment of pediatric mTBI that were assigned a level of obligation (ie, must, should, or may) based on confidence in the evidence. Recommendations address imaging, symptom scales, cognitive testing, and standardized assessment for diagnosis; history and risk factor assessment, monitoring, and counseling for prognosis; and patient/family education, rest, support, return to school, and symptom management for treatment. Conclusions and Relevance: This guideline identifies the best practices for mTBI based on the current evidence; updates should be made as the body of evidence grows. In addition to the development of the guideline, CDC has created user-friendly guideline implementation materials that are concise and actionable. Evaluation of the guideline and implementation materials is crucial in understanding the influence of the recommendations..

AB - Importance: Mild traumatic brain injury (mTBI), or concussion, in children is a rapidly growing public health concern because epidemiologic data indicate a marked increase in the number of emergency department visits for mTBI over the past decade. However, no evidence-based clinical guidelines have been developed to date for diagnosing and managing pediatric mTBI in the United States. Objective: To provide a guideline based on a previous systematic review of the literature to obtain and assess evidence toward developing clinical recommendations for health care professionals related to the diagnosis, prognosis, and management/treatment of pediatric mTBI. Evidence Review: The Centers for Disease Control and Prevention (CDC) National Center for Injury Prevention and Control Board of Scientific Counselors, a federal advisory committee, established the Pediatric Mild Traumatic Brain Injury Guideline Workgroup. The workgroup drafted recommendations based on the evidence that was obtained and assessed within the systematic review, as well as related evidence, scientific principles, and expert inference. This information includes selected studies published since the evidence review was conducted that were deemed by the workgroup to be relevant to the recommendations. The dates of the initial literature search were January 1, 1990, to November 30, 2012, and the dates of the updated literature search were December 1, 2012, to July 31, 2015. Findings: The CDC guideline includes 19 sets of recommendations on the diagnosis, prognosis, and management/treatment of pediatric mTBI that were assigned a level of obligation (ie, must, should, or may) based on confidence in the evidence. Recommendations address imaging, symptom scales, cognitive testing, and standardized assessment for diagnosis; history and risk factor assessment, monitoring, and counseling for prognosis; and patient/family education, rest, support, return to school, and symptom management for treatment. Conclusions and Relevance: This guideline identifies the best practices for mTBI based on the current evidence; updates should be made as the body of evidence grows. In addition to the development of the guideline, CDC has created user-friendly guideline implementation materials that are concise and actionable. Evaluation of the guideline and implementation materials is crucial in understanding the influence of the recommendations..

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