Specialist healthcare services for concussion/mild traumatic brain injury in England: a consensus statement using modified Delphi methodology

Objective To establish a consensus on the structure and process of healthcare services for patients with concussion in England to facilitate better healthcare quality and patient outcome.Design This consensus study followed the modified Delphi methodology with five phases: participant identification...

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Main Authors: Antonio Belli, Vanessa Raymont, Damian Holliman, Catherine McMahon, Peter Whitfield, Mark Wilson, Angelos G Kolias, Ben Jones, Richard Sylvester, Mario Ganau, Michael Parker, Shrouk Messahel, Peter John Hutchinson, Clint Gomes, Michael Grey, Michael Griffiths, Adel Helmy, Kanchan Sharma, Rupert Noad, Peter Jenkins, Emma Woodberry, Elika Karvandi, Timothy Griffiths, Philippa Griffiths, Tim Lawrence, Terence McLoughlin, Joanne Newton, Daniel Tadmor
Format: Article
Language:English
Published: BMJ Publishing Group 2023-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/13/12/e077022.full
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author Antonio Belli
Vanessa Raymont
Damian Holliman
Catherine McMahon
Peter Whitfield
Mark Wilson
Angelos G Kolias
Ben Jones
Richard Sylvester
Mario Ganau
Michael Parker
Shrouk Messahel
Peter John Hutchinson
Clint Gomes
Michael Grey
Michael Griffiths
Adel Helmy
Kanchan Sharma
Rupert Noad
Peter Jenkins
Emma Woodberry
Elika Karvandi
Timothy Griffiths
Philippa Griffiths
Tim Lawrence
Terence McLoughlin
Joanne Newton
Daniel Tadmor
author_facet Antonio Belli
Vanessa Raymont
Damian Holliman
Catherine McMahon
Peter Whitfield
Mark Wilson
Angelos G Kolias
Ben Jones
Richard Sylvester
Mario Ganau
Michael Parker
Shrouk Messahel
Peter John Hutchinson
Clint Gomes
Michael Grey
Michael Griffiths
Adel Helmy
Kanchan Sharma
Rupert Noad
Peter Jenkins
Emma Woodberry
Elika Karvandi
Timothy Griffiths
Philippa Griffiths
Tim Lawrence
Terence McLoughlin
Joanne Newton
Daniel Tadmor
author_sort Antonio Belli
collection DOAJ
description Objective To establish a consensus on the structure and process of healthcare services for patients with concussion in England to facilitate better healthcare quality and patient outcome.Design This consensus study followed the modified Delphi methodology with five phases: participant identification, item development, two rounds of voting and a meeting to finalise the consensus statements. The predefined threshold for agreement was set at ≥70%.Setting Specialist outpatient services.Participants Members of the UK Head Injury Network were invited to participate. The network consists of clinical specialists in head injury practising in emergency medicine, neurology, neuropsychology, neurosurgery, paediatric medicine, rehabilitation medicine and sports and exercise medicine in England.Primary outcome measure A consensus statement on the structure and process of specialist outpatient care for patients with concussion in England.Results 55 items were voted on in the first round. 29 items were removed following the first voting round and 3 items were removed following the second voting round. Items were modified where appropriate. A final 18 statements reached consensus covering 3 main topics in specialist healthcare services for concussion; care pathway to structured follow-up, prognosis and measures of recovery, and provision of outpatient clinics.Conclusions This work presents statements on how the healthcare services for patients with concussion in England could be redesigned to meet their health needs. Future work will seek to implement these into the clinical pathway.
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spelling doaj-art-a092f856382c4604b7af6d1a5794eac22025-08-20T03:52:28ZengBMJ Publishing GroupBMJ Open2044-60552023-12-01131210.1136/bmjopen-2023-077022Specialist healthcare services for concussion/mild traumatic brain injury in England: a consensus statement using modified Delphi methodologyAntonio Belli0Vanessa Raymont1Damian Holliman2Catherine McMahon3Peter Whitfield4Mark Wilson5Angelos G Kolias6Ben Jones7Richard Sylvester8Mario Ganau9Michael Parker10Shrouk Messahel11Peter John Hutchinson12Clint Gomes13Michael Grey14Michael Griffiths15Adel Helmy16Kanchan Sharma17Rupert Noad18Peter Jenkins19Emma Woodberry20Elika Karvandi21Timothy Griffiths22Philippa Griffiths23Tim Lawrence24Terence McLoughlin25Joanne Newton26Daniel Tadmor27Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK2 Department of Psychiatry, University of Oxford, Oxford, UKDepartment of Neurosurgery, Royal Victoria Infirmary, Newcastle upon Tyne, UKFaculty of Medicine Health and Human Sciences, Macquarie University, Sydney, New South Wales, AustraliaUniversity Hospitals Plymouth NHS Trust, Plymouth, UKGraduate Medicine, Faculty of Science Medicine and Health, University of Wollongong, Wollongong, New South Wales, AustraliaDepartment of Clinical Neurosciences, University of Cambridge, Cambridge, UKCarnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UKNational Hospital for Neurology and Neurosurgery, London, London, UK3Nuffield Department of Clinical Neurosciences, Oxford University Hospitals, Oxford, UKEthox Centre, University of Oxford, Oxford, UK3 Alder Hey Children`s NHS Foundation Trust, Liverpool, Merseyside, UKDepartment of Clinical Neurosciences, University of Cambridge, Cambridge, UKRoyal Liverpool University Hospital, Liverpool, UKSchool of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UKDepartment of Clinical Infection, Microbiology and Immunology, Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UKDepartment of Neurosurgery, University of Cambridge, Cambridge, UKDepartment of Neurology, North Bristol NHS Trust, Westbury on Trym, UKUniversity Hospitals Plymouth NHS Trust, Plymouth, UKWessex Neuroscience Centre, Southampton General Hospital, Southampton, UKDepartment of Neuropsychology, University of Cambridge, Cambridge, UKDepartment of Neurosurgery, University of Cambridge, Cambridge, UKDepartment of Cognitive Neurology, Newcastle University, Newcastle Upon Tyne, UKSunderland & South Tyneside Community Acquired Brain Injury Service, Northumberland Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UKNuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK1 Liverpool University Hospitals NHS Foundation Trust, Liverpool, UKNewcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK1Carnegie Applied Rugby Research (CARR) centre, Carnegie School of Sport, Leeds Beckett University, Leeds, UKObjective To establish a consensus on the structure and process of healthcare services for patients with concussion in England to facilitate better healthcare quality and patient outcome.Design This consensus study followed the modified Delphi methodology with five phases: participant identification, item development, two rounds of voting and a meeting to finalise the consensus statements. The predefined threshold for agreement was set at ≥70%.Setting Specialist outpatient services.Participants Members of the UK Head Injury Network were invited to participate. The network consists of clinical specialists in head injury practising in emergency medicine, neurology, neuropsychology, neurosurgery, paediatric medicine, rehabilitation medicine and sports and exercise medicine in England.Primary outcome measure A consensus statement on the structure and process of specialist outpatient care for patients with concussion in England.Results 55 items were voted on in the first round. 29 items were removed following the first voting round and 3 items were removed following the second voting round. Items were modified where appropriate. A final 18 statements reached consensus covering 3 main topics in specialist healthcare services for concussion; care pathway to structured follow-up, prognosis and measures of recovery, and provision of outpatient clinics.Conclusions This work presents statements on how the healthcare services for patients with concussion in England could be redesigned to meet their health needs. Future work will seek to implement these into the clinical pathway.https://bmjopen.bmj.com/content/13/12/e077022.full
spellingShingle Antonio Belli
Vanessa Raymont
Damian Holliman
Catherine McMahon
Peter Whitfield
Mark Wilson
Angelos G Kolias
Ben Jones
Richard Sylvester
Mario Ganau
Michael Parker
Shrouk Messahel
Peter John Hutchinson
Clint Gomes
Michael Grey
Michael Griffiths
Adel Helmy
Kanchan Sharma
Rupert Noad
Peter Jenkins
Emma Woodberry
Elika Karvandi
Timothy Griffiths
Philippa Griffiths
Tim Lawrence
Terence McLoughlin
Joanne Newton
Daniel Tadmor
Specialist healthcare services for concussion/mild traumatic brain injury in England: a consensus statement using modified Delphi methodology
BMJ Open
title Specialist healthcare services for concussion/mild traumatic brain injury in England: a consensus statement using modified Delphi methodology
title_full Specialist healthcare services for concussion/mild traumatic brain injury in England: a consensus statement using modified Delphi methodology
title_fullStr Specialist healthcare services for concussion/mild traumatic brain injury in England: a consensus statement using modified Delphi methodology
title_full_unstemmed Specialist healthcare services for concussion/mild traumatic brain injury in England: a consensus statement using modified Delphi methodology
title_short Specialist healthcare services for concussion/mild traumatic brain injury in England: a consensus statement using modified Delphi methodology
title_sort specialist healthcare services for concussion mild traumatic brain injury in england a consensus statement using modified delphi methodology
url https://bmjopen.bmj.com/content/13/12/e077022.full
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