Lee Kong Chian School of Medicine, Singapore.
Duke-NUS Medical School, Singapore.
BMJ Open. 2020 Jun 16;10(6):e035513. doi: 10.1136/bmjopen-2019-035513.
Children who suffer from traumatic brain injury (TBI) are at risk of permanent brain damage and developmental deficits. Reports on neurodevelopmental outcomes in paediatric TBI suffer from small sample size and varying outcome definitions in the neurocognitive domains tested. This protocol describes a systematic review and meta-analysis of paediatric TBI in the following key neurocognitive domains: executive function, perceptual-motor function, language, learning and memory, social cognition and complex attention.
A comprehensive search comprising studies from Medline, Cochrane, Embase and PsycINFO published from 1988 to 2019 will be conducted. We will include studies on children ≤18 years old who suffer from mild, moderate and severe TBI as determined by the Glasgow Coma Scale that report neurocognitive outcomes in domains predetermined by the Diagnostic and Statistical Manual of Mental Disorders fifth edition criteria. Systematic reviews, meta-analyses, randomised controlled trials, case-control, cohort and cross-sectional studies will be included. References from systematic reviews and meta-analyses will be hand-searched for relevant articles. A meta-analysis will be performed and effect sizes will be calculated to summarise the magnitude of change in each neurocognitive domain compared at different timepoints and stratified by severity of TBI. Included studies will be pooled using pooled standardised mean differences with a random effects model to determine an overall effect. In the scenario that we are unable to pool the studies, we will perform a narrative analysis.
Ethics approval is not required for this study.The authors of this study will publish and present the findings in a peer-reviewed journal as well as national and international conferences. The results of this study will provide understanding into the association between different severities of paediatric TBI and long-term neurocognitive outcomes.
CRD42020152680.
患有创伤性脑损伤 (TBI) 的儿童有永久性脑损伤和发育缺陷的风险。关于儿科 TBI 的神经发育结果的报告存在样本量小和所测试的神经认知领域的结果定义不同的问题。本方案描述了对以下关键神经认知领域的儿科 TBI 的系统评价和荟萃分析：执行功能、知觉运动功能、语言、学习和记忆、社会认知和复杂注意力。
将对 1988 年至 2019 年期间在 Medline、Cochrane、Embase 和 PsycINFO 上发表的研究进行全面搜索。我们将包括格拉斯哥昏迷量表确定为轻度、中度和重度 TBI 的≤18 岁儿童的研究，这些研究报告了根据精神障碍诊断和统计手册第五版标准预先确定的神经认知领域的结果。将包括系统评价、荟萃分析、随机对照试验、病例对照、队列和横断面研究。将从系统评价和荟萃分析的参考文献中手动搜索相关文章。将进行荟萃分析，并计算效应大小，以总结每个神经认知领域在不同时间点和按 TBI 严重程度分层的变化幅度。将使用随机效应模型对具有 pooled 标准化均数差值的纳入研究进行汇总，以确定总体效应。在我们无法对研究进行汇总的情况下，我们将进行叙述性分析。
本研究不需要伦理批准。本研究的作者将在同行评议期刊以及国家和国际会议上发表和展示研究结果。本研究的结果将有助于了解不同严重程度的儿科 TBI 与长期神经认知结果之间的关系。
PROSPERO 注册号：CRD42020152680。
