In 2004, the Brain Trauma Foundation (BTF) called a meeting of all the Traumatic Brain Injury (TBI) Guidelines contributing authors for the purpose of formalizing a collaborative process of Guidelines updates, publication, and implementation shared by those with a stake in acute TBI care. A partnership of interested professional associations was formed to review, endorse and implement editions of the Guidelines. The mission of this TBI Partnership is to improve the outcome of TBI through collaboration and the promotion of evidence-based medicine.
For these and future Guidelines projects, contributing authors agreed to establish a Center for Guidelines Management (Center), which would be responsible for generating new guidelines as well as updating those that exist. The participants endorsed the BTF proposal to establish the Center to be located at Oregon Health & Sciences University (OHSU). A collaboration was established between the Center and the Oregon Evidence-based Practice Center (EPC). The Oregon EPC conducts systematic reviews of various healthcare topics for federal and state agencies and private foundations. These reviews report the evidence from clinical research studies, and the quality of that evidence, for use by policy makers in decisions about guidelines and coverage issues. The collaboration made the expertise and personnel of the EPC available to the Center.
The TBI partnership further agreed to adopt and explicitly adhere to a systematic process and set of criteria for reviewing, assessing, and synthesizing the scientific literature. The process and criteria are derived from work by the U.S. Preventive Services Task Force, the National Health Service Centre for Reviews and Dissemination (U.K.), and the Cochrane Collaboration. The goal was to establish a process for Guidelines development that was scientifically rigorous, consistent across all topics, and independent of the interests and biases of contributing authors.
Authors drafted manuscripts for each topic. The entire team gathered for a 2-day work session to discuss the literature base and to achieve consensus on classification of evidence and level of recommendations. Manuscripts were revised. Virtual meetings were held with a subset of the co-authors to complete the editing and consensus processes. The final draft manuscript was circulated to the peer review panel.
Criteria were applied when feasible to estimate the reliability of the findings from each study included for this topic; however, levels of recommendation were not applied.