Evaluation of traumatic brain injury guidelines using AGREE instrument.

BACKGROUND This study aims to assess the quality of four selected traumatic brain injuries management guidelines used mainly in the US and in Europe. METHODS The instrument Appraisal of Guidelines Research & Evaluation was selected to provide a framework for guidelines appraisal. Four guidelines addressing a specific topic related to the treatment of traumatic brain injury were selected for evaluation: three developed in the United States of America and one from the United Kingdom. A trauma surgeon, one anaesthesiologist, one emergency physician and a public health specialist evaluated the guidelines. RESULTS In the overall assessment of all guidelines, the United Kingdom guidelines attracted the best score, achieving the highest score of all four guidelines in five of six domains. The scientific quality of collected evidence was excellent and well documented in all four guidelines. Overall, the domains of Stakeholder involvement and Applicability were the lowest scoring for all the guidelines. CONCLUSION A Broad spectrum of stakeholders should be represented in the brain trauma management guidelines development. The potential organizational and financial barriers for the application of guidelines need to be considered during their development. The paper provides suggestions for those who develop new guidelines for the management of patients with head injuries (Tab. 8, Ref. 29). Full Text (Free, PDF) www.bmj.sk.