Low-value clinical practices in adult traumatic brain injury: an umbrella review protocol

Introduction Traumatic brain injury (TBI) leads to 50 000 deaths, 85 000 disabilities and costs $60 billion each year in the USA. Despite numerous interventions and treatment options, the outcomes of TBI have improved little over the last three decades. In a previous scoping review and expert consul...

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Main Authors: Belinda J Gabbe, Henry Thomas Stelfox, Patrick Archambault, François Lauzier, Fiona Lecky, Francois Lamontagne, Michaël Chasse, Pier-Alexandre Tardif, Lynne Moore, Imen Farhat, John Kortbeek, Paule Lessard-Bonaventure, Catherine Truchon, Alexis F Turgeon
Format: Article
Language:English
Published: BMJ Publishing Group 2019-10-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/9/10/e031747.full
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author Belinda J Gabbe
Henry Thomas Stelfox
Patrick Archambault
François Lauzier
Fiona Lecky
Francois Lamontagne
Michaël Chasse
Pier-Alexandre Tardif
Lynne Moore
Imen Farhat
John Kortbeek
Paule Lessard-Bonaventure
Catherine Truchon
Alexis F Turgeon
author_facet Belinda J Gabbe
Henry Thomas Stelfox
Patrick Archambault
François Lauzier
Fiona Lecky
Francois Lamontagne
Michaël Chasse
Pier-Alexandre Tardif
Lynne Moore
Imen Farhat
John Kortbeek
Paule Lessard-Bonaventure
Catherine Truchon
Alexis F Turgeon
author_sort Belinda J Gabbe
collection DOAJ
description Introduction Traumatic brain injury (TBI) leads to 50 000 deaths, 85 000 disabilities and costs $60 billion each year in the USA. Despite numerous interventions and treatment options, the outcomes of TBI have improved little over the last three decades. In a previous scoping review and expert consultation survey, we identified 13 potentially low-value clinical practices in acute TBI. The objective of this umbrella review is to synthesise the evidence on potentially low-value clinical practices in the care of acute TBI.Methods and analysis Using umbrella review methodology, we will search Cochrane Central Register of Controlled Trials, Embase, Epistemonikos, International Prospective Register of Systematic Reviews (PROSPERO) and PubMed to identify systematic reviews evaluating the effect of potential intrahospital low-value practices using tailored population, intervention, comparator, outcome and study design questions based on the results of a previous scoping review. We will present data on the methodological quality of these reviews (Assessing the Methodological Quality of Systematic Reviews-2), reported effect sizes and strength of evidence (Grading of Recommendations, Assessment, Development and Evaluation).Ethics and dissemination Ethics approval is not required as original data will not be collected. Knowledge users from five healthcare quality organisations and clinical associations are involved in the design and conduct of the study. Results will be disseminated in a peer-reviewed journal, at international scientific meetings and to clinical, healthcare quality and patient–partner associations. This work will support the development of metrics to measure the use of low-value practices, inform policy makers on potential targets for deimplementation and in the long term reduce the use of low-value clinical practices in acute TBI care.PROSPERO registration number CRD42019132428.
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spelling doaj-art-56f8fe2a326e4acd8b02ef330f6dc6872025-08-20T02:38:18ZengBMJ Publishing GroupBMJ Open2044-60552019-10-0191010.1136/bmjopen-2019-031747Low-value clinical practices in adult traumatic brain injury: an umbrella review protocolBelinda J Gabbe0Henry Thomas Stelfox1Patrick Archambault2François Lauzier3Fiona Lecky4Francois Lamontagne5Michaël Chasse6Pier-Alexandre Tardif7Lynne Moore8Imen Farhat9John Kortbeek10Paule Lessard-Bonaventure11Catherine Truchon12Alexis F Turgeon13Population Data Science, Swansea University, Swansea, Swansea, UK3 Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada5 Département de médecine de famille et de médecine d`urgence, Université Laval, Québec, Québec, CanadaPopulation Health and Optimal Health Practives Research Unit (Trauma - Emergency - Critical Care Medicine), Centre de Recherche du CHU de Québec - Université Laval, Quebec, Quebec, CanadaCentre for Urgent and Emergency Care Research, School of Medicine and Population Health, University of Sheffield, Sheffield, UKassistant professorDepartment of Medicine, Université de Montréal, Montreal, Québec, CanadaPopulation Health and Optimal Health Practices Research Unit, Trauma – Emergency – Critical Care Medicine, Centre de Recherche du CHU de Québec (Hôpital de l’Enfant-Jésus), Université Laval, Québec City, Québec, Canada1 Axe Santé des populations et Pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Québec, CanadaPopulation Health and Optimal Health Practices Research Unit, Trauma – Emergency – Critical Care Medicine, Centre de Recherche du CHU de Québec (Hôpital de l’Enfant-Jésus), Laval University, Quebec City, Quebec, Canada11 Department of Surgery, University of Calgary, Calgary, Alberta, Canada1 Population Health and Optimal Health Practices Unit, Trauma—Emergency—Critical Care Medicine, Centre de Recherche du CHU de Québec—Université Laval (Hôpital de l’Enfant-Jésus), Université Laval, Montreal, Quebec, Canada13 Institut national d’excellence en santé et en services sociaux du Québec, Quebec City, Quebec, CanadaDepartment of Anesthesiology and Critical Care Medicine, Université Laval, Québec, Québec, CanadaIntroduction Traumatic brain injury (TBI) leads to 50 000 deaths, 85 000 disabilities and costs $60 billion each year in the USA. Despite numerous interventions and treatment options, the outcomes of TBI have improved little over the last three decades. In a previous scoping review and expert consultation survey, we identified 13 potentially low-value clinical practices in acute TBI. The objective of this umbrella review is to synthesise the evidence on potentially low-value clinical practices in the care of acute TBI.Methods and analysis Using umbrella review methodology, we will search Cochrane Central Register of Controlled Trials, Embase, Epistemonikos, International Prospective Register of Systematic Reviews (PROSPERO) and PubMed to identify systematic reviews evaluating the effect of potential intrahospital low-value practices using tailored population, intervention, comparator, outcome and study design questions based on the results of a previous scoping review. We will present data on the methodological quality of these reviews (Assessing the Methodological Quality of Systematic Reviews-2), reported effect sizes and strength of evidence (Grading of Recommendations, Assessment, Development and Evaluation).Ethics and dissemination Ethics approval is not required as original data will not be collected. Knowledge users from five healthcare quality organisations and clinical associations are involved in the design and conduct of the study. Results will be disseminated in a peer-reviewed journal, at international scientific meetings and to clinical, healthcare quality and patient–partner associations. This work will support the development of metrics to measure the use of low-value practices, inform policy makers on potential targets for deimplementation and in the long term reduce the use of low-value clinical practices in acute TBI care.PROSPERO registration number CRD42019132428.https://bmjopen.bmj.com/content/9/10/e031747.full
spellingShingle Belinda J Gabbe
Henry Thomas Stelfox
Patrick Archambault
François Lauzier
Fiona Lecky
Francois Lamontagne
Michaël Chasse
Pier-Alexandre Tardif
Lynne Moore
Imen Farhat
John Kortbeek
Paule Lessard-Bonaventure
Catherine Truchon
Alexis F Turgeon
Low-value clinical practices in adult traumatic brain injury: an umbrella review protocol
BMJ Open
title Low-value clinical practices in adult traumatic brain injury: an umbrella review protocol
title_full Low-value clinical practices in adult traumatic brain injury: an umbrella review protocol
title_fullStr Low-value clinical practices in adult traumatic brain injury: an umbrella review protocol
title_full_unstemmed Low-value clinical practices in adult traumatic brain injury: an umbrella review protocol
title_short Low-value clinical practices in adult traumatic brain injury: an umbrella review protocol
title_sort low value clinical practices in adult traumatic brain injury an umbrella review protocol
url https://bmjopen.bmj.com/content/9/10/e031747.full
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