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International Survey on Diagnostic and Prognostic Procedures in Pediatric Disorders of Consciousness

Research output: Contribution to journalArticlepeer-review

Erika Molteni, Beth S. Slomine, Enrico Castelli, Nathan Zasler, Caroline Schnakers, Anna Estraneo

Original languageEnglish
Pages (from-to)517-528
Number of pages12
JournalBrain Injury
Issue number4
Early online date19 Jan 2019
Accepted/In press2 Jan 2019
E-pub ahead of print19 Jan 2019
Published21 Mar 2019


King's Authors


Aims: 1. to investigate diagnostic and prognostic procedures routinely used by international profes- sionals to assess children with disorders of consciousness (DoC); 2. to explore use and availability of internal and national guidelines for pediatric DoC; 3. to identify international differences in diagnostic/ prognostic protocols.
Methods: The International Brain Injury Association DoC Special Interest Group emailed a survey link to 43,469 professionals. The survey included questions on diagnostic/prognostic procedures and guidelines for children with DoC.
Results: Data on 82 respondents [(50% physicians) primarily from Europe (43.9%)and North America (37.8%)] were analyzed. Common diagnostic tools included the Glasgow Coma Scale for clinical assessment (94%), the Coma Recovery Scale-Revised for outcome measurement (57%), and cerebral MRI (94%). Clinical features used most frequently to inform prognosis varied with patient age. Few respondents used national (28%) admission protocols for children with DoC, and most were unaware of published national guidelines for diagnostic (72%) and prognostic (85%) procedures. Compared to North American respondents, more European respondents were physicians and used neurophysio- logical data for prognosis.
Conclusions: This international survey provides useful information about diagnostic and prognostic procedures currently used for children with DoC and highlights the need for guidelines to promote best practices for diagnosis/prognosis in pediatric DoC.

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