Research priorities for diagnosis, prognosis, and rehabilitation following concussion: results from a national survey of Australian health professionals.

ABSTRACT

PURPOSE: Recently, the Concussion James Lind Alliance Priority Setting Partnership (JLAPSP) (Canada) identified serious research gaps regarding diagnosis, management, and access to effective rehabilitation for concussion/mild traumatic brain injury (mTBI). Our aim was to determine if the same research priorities are important to Australian health professionals working in the concussion/mTBI field. MATERIALS AND METHODS: A survey was distributed via professional networks, social media, professional group listservs, a research project noticeboard, and at conferences. It comprised of 25 of the highest ranked concussion research questions from the JLAPSP. We examined how professionals ranked the research questions and analyzed variation in ranking by clinical role and concussion/mTBI work experience. RESULTS: Our sample of 187 participants included medical and allied health professionals. Most participants were occupational therapists (22%), physiotherapists (18%), neuropsychologists (17%), and worked in Victoria (47%), New South Whales (18%), or Queensland (15%) in metropolitan areas. Health professionals ranked three research questions highest identifying methods to predict prolonged recovery; effectiveness of early referral and treatment by a specialized concussion/mTBI team; and implementation studies on upskilling healthcare workers. CONCLUSIONS: The research priorities identified can guide research efforts to improve the assessment, management, and rehabilitation of individuals with concussion/mTBI in Australia.

Health professionals with experience in the assessment and rehabilitation of adults with concussions overwhelmingly agree that there is a need for further research to understand the prognosis and the effectiveness of specialized rehabilitation clinics.The role of healthcare providers in supporting recovery and the long-term health implications of suffering a concussion was identified as a priority.Both pre-clinical and clinical research are identified priorities to determine the effectiveness of biomarkers for concussion and return to activity.Health professionals also call for clinical trials testing management protocols, and implementation trials to support translation of clinical guidelines into practice to understand the role of healthcare providers in rehabilitation.