Compliance with brain trauma foundation (BTF) guidelines for management of traumatic brain injury (TBI) patients: systematic review and meta-analysis
Bibliographic record
Abstract
Background: TBI is a leading cause of death and disability. Management based on the BTF guidelines is widely accepted and thought to improve outcome. The objectives of this study were: 1) to review the rate of adherence to BTF guidelines; 2) to identify factors influencing adherence; and 3) to determine the effect of guideline-based management on outcome. Methods: We searched all electronic bibliographic databases. In duplicate and independently, two investigators screened titles, abstracts and articles to select appropriate studies reporting compliance rate, factors influencing compliance, and adjusted mortality or morbidity. Data extraction and assessment of bias risk were performed independently by both investigators. We excluded pediatric and military-related TBI studies. Results: A total of 30 articles met inclusion/exclusion criteria out of 1153 papers screened. Most are retrospective and cross-sectional observational studies; there were no randomized control trials. Preliminary analysis showed considerable variation in compliance rate with BTF guidelines ranging from 5.6-96%. Conclusions: Variation in the care of TBI patients persists across the world. Compliance with BTF guidelines was strongly influenced by implementing a guidelines-based protocol. Heterogeneity of the article prevents outcome assessment. Well-conducted study to support the existing literature of the beneficial effect of current guidelines is needed.
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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 | 0.037 | 0.107 |
| Meta-epidemiology (narrow) | 0.003 | 0.001 |
| Meta-epidemiology (broad) | 0.018 | 0.035 |
| Bibliometrics | 0.009 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.003 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".