Goldenberg Joshua Z, Batson Richard Davis, Pugh Mary Jo, Zwickey Heather, Beardsley Jennifer, Zeegers Maurice P, Freeman Michael
Helfgott Research Institute, National University of Natural Medicine, Portland, Oregon, USA.
Department of Epidemiology, Care and Public Health Research Institute, Maastricht University, Maastricht, the Netherlands.
Neurotrauma Rep. 2024 May 31;5(1):522-528. doi: 10.1089/neur.2023.0117. eCollection 2024.
A precise understanding of the latency to post-traumatic epilepsy (PTE) following a traumatic brain injury (TBI) is necessary for optimal patient care. This precision is currently lacking despite a surprising number of available data sources that could address this pressing need. Following guidance from the Cochrane Collaboration and Joanna Briggs Institute, we conduct a systematic review to address the research questions: What is the cumulative incidence of PTE following mild TBI (mTBI; concussion), and what is the distribution of the latency to onset? We designed a comprehensive search of medical databases and gray literature sources. Citations will be screened on both abstract and full-text levels, independently and in duplicate. Studies will be evaluated for risk of bias independently and in duplicate using published instruments specific to incidence/prevalence studies. Data will be abstracted independently and in duplicate using piloted extraction forms. Disagreements will be resolved by consensus or third-party adjudication. Evidence synthesis will involve pairwise and individual participant data meta-analysis with heterogeneity explored via a set of predetermined subgroups. The robustness of the findings will be subjected to sensitivity analyses based on the risk of bias, outlier studies, and mTBI definitional criteria. The overall certainty in the estimates will be reported using GRADE (Grading of Recommendations, Assessment, Development, and Evaluations). This protocol presents an innovative and impactful approach to build on the growing body of knowledge surrounding post-mTBI PTE. Through a precise understanding of the latency period, this study can contribute to early detection, tailored interventions, and improved outcomes, leading to a substantial impact on patient care and quality of life.
精确了解创伤性脑损伤（TBI）后创伤后癫痫（PTE）的潜伏期对于实现最佳患者护理至关重要。尽管有大量可用数据源可以满足这一迫切需求，但目前仍缺乏这种精确性。遵循Cochrane协作网和乔安娜·布里格斯研究所的指导意见，我们开展了一项系统综述，以解决以下研究问题：轻度TBI（mTBI；脑震荡）后PTE的累积发病率是多少，发病潜伏期的分布情况如何？我们设计了对医学数据库和灰色文献来源的全面检索。将对文献进行摘要和全文两级筛选，由两人独立进行且重复操作。将使用针对发病率/患病率研究的已发表工具，由两人独立且重复地评估研究的偏倚风险。将使用预先试用的提取表格，由两人独立且重复地提取数据。分歧将通过共识或第三方裁决解决。证据综合将包括成对和个体参与者数据的荟萃分析，并通过一组预先确定的亚组探讨异质性。将根据偏倚风险、异常值研究和mTBI定义标准对研究结果的稳健性进行敏感性分析。将使用GRADE（推荐分级、评估、制定与评价）报告估计值的总体确定性。本方案提出了一种创新且有影响力的方法，以在围绕mTBI后PTE的不断增长的知识体系基础上进一步发展。通过精确了解潜伏期，本研究有助于早期检测、量身定制干预措施并改善结果，从而对患者护理和生活质量产生重大影响。
