National guidelines for cognitive assessment and rehabilitation of Iranian traumatic brain injury patients

Ghawami, H. and Jazayeri, S.B. and Nowsud, A.S. and Sharif-Alhoseini, M. and Shirvani, A. and Kheyri, M. and Zadegan, S.A. and Noorian, N. and Mohammadian, F. and Yarandi, K.K. and Azad, A. and Rezaeitalab, F. and Barekatain, M. and Bakhtiyari, J. and Moradi, A. and Khatoonabadi, A.R. and Haghgoo, H.A. and Gheini, M.R. and Khadivi, M. and Jouibari, M.F. and Khayat Kashani, H.R. and Mirzaasgari, Z. and Meshkini, A. and Haghshenas, H. and Samini, F. and Mohit, P. and Akbarfahimi, M. and Alimohammadi, Y. and Payandemehr, P. and Ahranjani, J.A. and Arabkheradmand, J. and Vahabi, Z. and Arbabi, M. and Kermanpour, H. and Ghandehari, K. and Bakhshani, N.-M. and Pirooz, F.M. and Ghaedi, G. and Dolatshahi, B. and Tavakoli, S.F. and Vosough, I. and Amirjamshidi, A. and Hatami, J. and Rahimi-Movaghar, V. (2020) National guidelines for cognitive assessment and rehabilitation of Iranian traumatic brain injury patients. Archives of Iranian Medicine, 23 (12). pp. 813-820.

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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. © 2020 Academy of Medical Sciences of I.R. Iran. All rights reserved.

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