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Clinical practice guidelines for the care of patients with severe traumatic brain injury: A systematic evaluation of their quality

T brain injury (TBI) is a relevant global public health and socioeconomic problem in today’s society. An estimated 57 million people have been hospitalized worldwide with TBI at some point, and at least 10 million cases of TBI are severe enough to result in death or hospitalization every year. Clinical practice guidelines (CPGs) are a set of recommendations that, unlike classical protocols, are systematically developed to assist both health professionals and patients in the process of making decisions in the most appropriate health interventions for addressing a specific clinical condition. Despite the validation and dissemination inherent to CPGs, concerns remain about their quality, applicability, and the lack of evidence of their recommendations. These shortcomings may account for the limited effect of CPGs on health outcomes. Previous studies on CPG evaluation have reported a quality ranking that ranges between moderate and low. Four studies have evaluated the quality of CPGs on TBI, three of which are focused on mild TBI and one on severe TBI. The last one made a partial evaluation of the four studies. The aim of this study was to evaluate the quality of CPGs on treating adults with severe TBI that are available in the scientific literature and/or on specialized Web sites in this area.