Adaptation of Traumatic Brain Injury Guidelines in Iran.
BACKGROUND
The National institute for health and care excellence (NICE) and scottish intercollegiate guidelines network (SIGN) are two well-known sources of clinical guideline development. In the past years, they have developed clinical guidelines for the management of head injury. In this report, we will highlight our modifications to these guidelines according to the domestic situation in a developing country.


METHODS
The guidelines were appraised using the appraisal of guidelines for research and evaluation (AGREE) instrument. All key recommendations were reviewed by 14 prominent Iranian neurosurgeons; levels of evidence were evaluated and items with limited evidence were determined. Available evidence for selected items were reviewed and discussed.


RESULTS
The following items were the most challenging when accounting for the domestic situation in Iran: age as a risk factor for referral, computed tomography scan, the impact of medical comorbidities, pregnancy, consultation, referral to a neurosurgical unit, and teleconsulting and observation before discharge.


CONCLUSIONS
The evidence in the discussed topics was limited and controversial. This report is important because it exposes the current knowledge gap in head trauma studies in Iran.
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, IR Iran; Research Centre for Neural Repair, Tehran University, Tehran, IR Iran.
Shayan
S
Abdollah Zadegan
Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Seyed Mohammad
SM
Ghodsi
Ahya Neuroscience Research Center, Tehran, IR Iran.
Jalil
J
Arabkheradmand
Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Abbas
A
Amirjamshidi
Department of Neurosurgery, Imam Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Abdolreza
A
Sheikhrezaei
Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Masoud
M
Khadivi
Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Morteza
M
Faghih Jouibari
Functional Neurosurgery Research Center, Shohadaye Tajrish Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Seyed Mahmood
SM
Tabatabaeifar
Department of Neurosurgery, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran.
Guive
G
Sharifi
Department of Neurosurgery, Urmia University of Medical Sciences, Urmia, IR Iran.
Jalal
J
Abbaszadeh Ahranjani
Department of Neurosurgery, Islamic Azad University, Medical Branch, Mashhad, IR Iran.
Farhad
F
Motlagh Pirooz
Department of Neurosurgery, Islamic Azad University, Medical Branch, Mashhad, IR Iran.
Seyed Fakhredin
SF
Tavakoli
Tehran University of Medical Sciences, Tehran, IR Iran.
Parviz
P
Mohit
Tehran University of Medical Sciences, Tehran, IR Iran.
Yadollah
Y
Alimohammadi
Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, IR Iran; Research Centre for Neural Repair, Tehran University, Tehran, IR Iran; Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
Vafa
V
Rahimi-Movaghar
Age Factors; Brain Injuries; Comorbidity; Patient Discharge; Practice Guideline; Referral and Consultation; Telemedicine; Trauma