Cognitive Rehabilitation Therapy for Traumatic Brain Injury Evaluating the Evidence (2011) / Chapter Skim
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6 Methods
6 Methods
Pages 115-124
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• re cognitive rehabilitation interventions delivered through tele A health technology safe and efficacious? LITERATURE REVIEW The committee reviewed published systematic reviews (Cicerone et al.
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This practice is common when conducting a literature review. To complete the secondary search, the committee extensively examined the bibliographies of previously published systematic reviews on cognitive rehabilitation therapy for TBI, reading all full-text articles contained in those reference lists that had not been identified in the primary search.
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could be either objective or subjective measures; AND 3.2 Studies where the only outcome measures are performance of tasks that were directly practiced in the treatment protocol are excluded. 4.0 Study Design 4.1 Uncontrolled case reports or case series are excluded.
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The committee designed forms for extracting and summarizing data from each study, including information about study design and methods, patient characteristics, treatment interventions and outcomes (i.e., World Health Organization International Classification of Functioning, Disability and Health [WHO-ICF] framework)
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These distinctions are useful because achievements on objective measures of benefit may not translate into improvement in realworld functioning. It is important to note that standards for other aspects of medical practice and research, such as pharmacologic agents, do not require patient-centered outcomes, such as return to work or improved quality of life, to show any treatment benefit or to receive regulatory ap TABLE 6-2 Study Design by Treatment Domain or Strategy Study Design by Treatment Language Multimodal/ Domain or Executive and Social Comprehensive Strategy Attention Function Communication Memory CRT RCTs 6 10 4 13 6 Nonrandomized, 0 4 1 2 8 Parallel Group Pre-Post Single 2 4 0 6 7 Group Single Subject 1 8 0 6 0 Multiple Baseline TOTAL 9 26 5 27 21
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To determine effectiveness, the committee evaluated studies comparing CRT treatment to another form of CRT. Comparative effectiveness studies may be premature without preceding efficacy trials of the interventions applied in each arm.
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. Conclusions were not based solely on findings from uncontrolled studies; however, the committee included pre-post single group designs and single subject, multiple baseline experiments in the review because uncontrolled studies may include useful information about nascent interventions or lend support to a controlled design with similar results.
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Some trial reports provided consort figures or detailed descriptions of follow-up including number of participants randomized to groups, completeness of follow-up, and amount of missing data by group; most trials did not report all of this information. Few trial reports detailed analytic methods that were used to handle missing data or specified numbers of people included in analyses of each outcome measure that was reported.
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These five chapters include evidence tables with key information about included studies. Chapter 12 summarizes studies that applied telehealth technology, and Chapter 13 describes possible adverse events or harm from CRT.
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2007. Treatment efficacy of social communication skills training after traumatic brain injury: A randomized treatment and deferred treatment controlled trial.
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