Specialist healthcare services for concussion/mild traumatic brain injury in England: a consensus statement using modified Delphi methodology

Author:

Karvandi ElikaORCID,Helmy Adel,Kolias Angelos GORCID,Belli Antonio,Ganau Mario,Gomes Clint,Grey Michael,Griffiths Michael,Griffiths Timothy,Griffiths Philippa,Holliman Damian,Jenkins Peter,Jones BenORCID,Lawrence Tim,McLoughlin Terence,McMahon Catherine,Messahel ShroukORCID,Newton Joanne,Noad Rupert,Raymont VanessaORCID,Sharma Kanchan,Sylvester Richard,Tadmor Daniel,Whitfield Peter,Wilson Mark,Woodberry Emma,Parker Michael,Hutchinson Peter JohnORCID

Abstract

ObjectiveTo establish a consensus on the structure and process of healthcare services for patients with concussion in England to facilitate better healthcare quality and patient outcome.DesignThis consensus study followed the modified Delphi methodology with five phases: participant identification, item development, two rounds of voting and a meeting to finalise the consensus statements. The predefined threshold for agreement was set at ≥70%.SettingSpecialist outpatient services.ParticipantsMembers of the UK Head Injury Network were invited to participate. The network consists of clinical specialists in head injury practising in emergency medicine, neurology, neuropsychology, neurosurgery, paediatric medicine, rehabilitation medicine and sports and exercise medicine in England.Primary outcome measureA consensus statement on the structure and process of specialist outpatient care for patients with concussion in England.Results55 items were voted on in the first round. 29 items were removed following the first voting round and 3 items were removed following the second voting round. Items were modified where appropriate. A final 18 statements reached consensus covering 3 main topics in specialist healthcare services for concussion; care pathway to structured follow-up, prognosis and measures of recovery, and provision of outpatient clinics.ConclusionsThis work presents statements on how the healthcare services for patients with concussion in England could be redesigned to meet their health needs. Future work will seek to implement these into the clinical pathway.

Publisher

BMJ

Subject

General Medicine

Reference77 articles.

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4. Letter: A Scoping review of registered clinical studies on mild traumatic brain injury and concussion (2000-2019);Ganau;Neurosurgery,2021

5. Diagnosis, prognosis, and clinical management of mild traumatic brain injury;Levin;Lancet Neurol,2015

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