Adherence to Brain Trauma Foundation guidelines for management of traumatic brain injury patients: study protocol for a systematic review and meta-analysis
Bibliographic record
Abstract
BACKGROUND: Traumatic brain injury (TBI) is a leading cause of death and disability around the world. Management based on Brain Trauma Foundation (BTF) guidelines is widely accepted and thought to improve outcome. The objectives of this systematic review are to give an overview of adherence to the BTF guidelines, describe factors influencing adherence, and study the effect of guideline-based management on outcome. METHODS/DESIGN: We will search electronic bibliographic databases: PROSPERO, Medline, EMBASE, SCOPUS, NHS, CINAHL, Cochrane Database, and ProQuest Dissertations and Theses Global. Two investigators will independently screen all titles, abstracts, and articles and select Randomized Controlled Trial (RCT), cohort studies, case-control studies, and case series reporting the adherence rate, factors influencing adherence, and mortality or morbidity. These investigators will also independently extract data using a pre-designed and pilot-tested standardized electronic data extraction form and assess the risk of bias. We will exclude pediatric and military-related TBI studies, studies that included fewer than ten patients or addressed adherence to pre-hospital guidelines. Narrative synthesis and if appropriate, quantitative meta-analysis clustered by type of recommendation will be reported. DISCUSSION: This study is expected to demonstrate the current level of professionals' adherence to BTF guidelines in patients with severe traumatic brain injury, it will describe the factors influencing adherence, which may provide valuable input for development of strategies to successfully increase adherence. In addition, if the studies are sufficiently homogenous, it will describe the effect of these guidelines on patient outcome. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42015017794.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.057 | 0.082 |
| Meta-epidemiology (narrow) | 0.006 | 0.005 |
| Meta-epidemiology (broad) | 0.023 | 0.028 |
| Bibliometrics | 0.010 | 0.010 |
| Science and technology studies | 0.002 | 0.003 |
| Scholarly communication | 0.007 | 0.007 |
| Open science | 0.004 | 0.004 |
| Research integrity | 0.005 | 0.006 |
| Insufficient payload (model declined to judge) | 0.043 | 0.004 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".