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Arch Iran Med. 2020;23(12): 813-820.
doi: 10.34172/aim.2020.108
  Abstract View: 399
  PDF Download: 261

Original Article

National Guidelines for Cognitive Assessment and Rehabilitation of Iranian Traumatic Brain Injury Patients

Heshmatollah Ghawami 1 ORCID logo, Seyed Behnam Jazayeri 2,3, Azad Sabeti Nowsud 1, Mahdi Sharif-Alhoseini 3, Armin Shirvani 4, Maryam Kheyri 5, Shayan Abdollah Zadegan 3, Nahid Noorian 6, Fatemeh Mohammadian 7, Kourosh Karimi Yarandi 8, Akram Azad 9, Fariborz Rezaeitalab 10, Majid Barekatain 11, Jalal Bakhtiyari 12, Alireza Moradi 13,14, Ahmad Reza Khatoonabadi 15, Hojjat Allah Haghgoo 16, Mohammad Reza Gheini 17, Masoud Khadivi 18, Morteza Faghih Jouibari 18, Hamid Reza Khayat Kashani 19, Zahra Mirzaasgari 20, Ali Meshkini 21, Hassan Haghshenas 22, Fariborz Samini 23, Parviz Mohit 24, Malahat Akbarfahimi 9, Yadollah Alimohammadi 25, Pooya Payandemehr 26, Jalal Abbaszadeh Ahranjani 27, Jalil Arabkheradmand 28, Zahra Vahabi 29, Mohammad Arbabi 30, Hossein Kermanpour 31, Kavian Ghandehari 10, Nour-Mohammad Bakhshani 32, Farhad Motlagh Pirooz 33, Gholamhossein Ghaedi 34, Behrooz Dolatshahi 35, Seyed Fakhredin Tavakoli 33,36, Iraj Vosough 37, Abbas Amirjamshidi 8, Javad Hatami 38*, Vafa Rahimi-Movaghar 3,18,39* ORCID logo

1 Neuropsychology Division, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
2 Students’ Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
3 Department of Neurotrauma, Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran
4 National Agency for Strategic Research in Medical Education (NASR), Tehran, Iran
5 Clinical Guideline Development and Standardization Group, Office of Health Technology Assessment, Standardization and Tariffs, Deputy for Curative Affairs, Iranian Ministry of Health and Medical Education (MOHME), Tehran, Iran
6 Department of Psychology, Shahid Rajaee University (SRTTU), Tehran, Iran
7 Department of Neurology, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
8 Department of Neurosurgery, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
9 Rehabilitation Research Center, Department of Occupational Therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
10 Department of Neurology, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
11 Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
12 Department of Speech Therapy, Neuromuscular Rehabilitation Research Center, School of Rehabilitation Sciences, Semnan University Medical Sciences, Semnan, Iran
13 Department of Clinical Psychology, Kharazmi University, Tehran, Iran
14 Department of Cognitive Psychology, Institute for Cognitive Sciences Studies, Tehran, Iran
15 Department of Speech Therapy, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran
16 Department of Occupational Therapy, School of Rehabilitation Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
17 Department of Neurology, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
18 Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran
19 Department of Neurosurgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran
20 Neurology Department, Firoozgar Hospital, Iran University of Medical Sciences, Tehran, Iran
21 Road Traffic Injury Research Center, Department of Neurosurgery, Tabriz University of Medical Sciences, Tabriz, Iran
22 Department of Psychiatry, Shiraz University of Medical Sciences, Shiraz, Iran
23 Department of Neurosurgery, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
24 Department of Neurosurgery, Mazandaran University of Medical Science, Sari, Iran
25 Neurosurgery Unit, Bahman Hospital, Tehran, Iran
26 Department of Emergency Medicine, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
27 Department of Neurosurgery, Urmia University of Medical Sciences, Urmia, Iran
28 Ahya Neuroscience Research Center, Tehran, Iran
29 Memory and Behavioral Neurology Division, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran
30 Department of Psychiatry, Psychosomatic Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran
31 Emergency Department, Sina Hospital, Tehran University of Medical Sciences, Tehran, Iran
32 Department of Psychology, Zahedan University of Medical Sciences, Zahedan, Iran
33 Department of Neurosurgery, Islamic Azad University, Medical Branch, Mashhad, Iran
34 Department of Psychiatry, Neurophysiology Research Center, Shahed University, Tehran, Iran
35 Department of Psychology, School of Behavioral Sciences, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
36 Farabi Hospital, Social Security Organization, Mashhad, Iran
37 Research and Education Department, Razavi Hospital, Mashhad, Iran
38 Department of Psychology, University of Tehran, Tehran, Iran
39 Research Centre for Neural Repair, University of Tehran, Tehran, Iran
*Corresponding Authors: Vafa Rahimi-Movaghar, MD; Sina Trauma and Surgery Research Center, Sina General Hospital, Tehran University of Medical Sciences, Hassan Abad Sq., Imam Khomeini St., Tehran, 11365/3876, Iran. Tel: +98-21-66757010; Email: ; Javad Hatami, PhD; Department of Psychology, University of Tehran, Tehran, Iran. Tel: +98-21-61117480; Email: hatamijm@ut.ac.ir v_rahimi@sina.tums.ac.ir

Abstract

Background: Individuals with moderate to severe traumatic brain injury (TBI) often have prolonged cognitive impairments, resulting in long-term problems with their real-life activities. Given the urgent need for evidence-based recommendations for neuropsychological management of Iranian TBI patients, the current work aimed to adapt eligible international guidelines for cognitive assessment and rehabilitation of the TBI patients in Iran.

Methods: The project was led by an executive committee, under the supervision of the Iranian Ministry of Health and Medical Education (MOHME). Following a systematic literature search and selection process, four guidelines were included for adaptation. Clinical recommendations of the source guidelines were tabulated as possible clinical scenarios for 90 PICO clinical questions covering all relevant phases of care. After summing up the scenarios, our initial list of recommendations was drafted according to the Iranian patients’ conditions. The final decision-making, with the contribution of a national interdisciplinary panel of 37 experts from across the country, was conducted in two rounds using online and offline survey forms (Round 1), and face-to-face and telephone meetings (Round 2).

Results: A total of 63 recommendations in six sections were included in the final list of recommendations, among which 24 were considered as key recommendations. In addition, some of the recommendations were identified as fundamental, meaning that proper implementation of the other recommendations is largely dependent on their implementation.

Conclusion: Iranian health policy makers and rehabilitation program managers are recommended to address some fundamental issues to provide the necessary infrastructure to set up an efficient cognitive rehabilitation service system.

Keywords: Cognitive rehabilitation, Guideline, Neuropsychology, Practice guideline, Traumatic brain injury
Cite this article as: Ghawami H, Jazayeri SB, Sabeti Nowsud A, Sharif-Alhoseini M, Shirvani A, Kheyri M, et al. National guidelines for cognitive assessment and rehabilitation of Iranian traumatic brain injury patients. Arch Iran Med. 2020;23(12):813–820. doi: 10.34172/aim.2020.108.
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Submitted: 23 Jun 2020
Revision: 30 Jul 2020
Accepted: 04 Aug 2020
ePublished: 01 Dec 2020
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