microsoft word - prisma 2009 checklist.docdownload.lww.com/.../md/b/md_2016_11_03_kobeiss… ·...

Section/topic # Checklist item Reported on page #

TITLE Title 1 Identify the report as a systematic review, meta-analysis, or both. 1ABSTRACT Structured summary 2 Provide a structured summary including, as applicable: background; objectives; data sources; study eligibility criteria,

participants, and interventions; study appraisal and synthesis methods; results; limitations; conclusions and implications of key findings; systematic review registration number.

3

INTRODUCTION Rationale 3 Describe the rationale for the review in the context of what is already known. 4Objectives 4 Provide an explicit statement of questions being addressed with reference to participants, interventions, comparisons,

outcomes, and study design (PICOS). 4,5

METHODS Protocol and registration 5 Indicate if a review protocol exists, if and where it can be accessed (e.g., Web address), and, if available, provide

registration information including registration number. N/A

Eligibility criteria 6 Specify study characteristics (e.g., PICOS, length of follow-up) and report characteristics (e.g., years considered, language, publication status) used as criteria for eligibility, giving rationale.

6

Information sources 7 Describe all information sources (e.g., databases with dates of coverage, contact with study authors to identify additional studies) in the search and date last searched.

5,6

Search 8 Present full electronic search strategy for at least one database, including any limits used, such that it could be repeated.

6 + Supplementary Material 2

Study selection 9 State the process for selecting studies (i.e., screening, eligibility, included in systematic review, and, if applicable, included in the meta-analysis).

6

Data collection process 10 Describe method of data extraction from reports (e.g., piloted forms, independently, in duplicate) and any processes for obtaining and confirming data from investigators.

6,7

Data items 11 List and define all variables for which data were sought (e.g., PICOS, funding sources) and any assumptions and simplifications made.

7 + Supplementary Material 5

Risk of bias in individual studies

12 Describe methods used for assessing risk of bias of individual studies (including specification of whether this was done at the study or outcome level), and how this information is to be used in any data synthesis.

7,8 + Supplementary Material 6

Summary measures 13 State the principal summary measures (e.g., risk ratio, difference in means). N/ASynthesis of results 14 Describe the methods of handling data and combining results of studies, if done, including measures of consistency

(e.g., I2) for each meta-analysis. N/A

Page 1 of 2

Section/topic # Checklist item Reported on page #

Risk of bias across studies 15 Specify any assessment of risk of bias that may affect the cumulative evidence (e.g., publication bias, selective reporting within studies).

N/A

Additional analyses 16 Describe methods of additional analyses (e.g., sensitivity or subgroup analyses, meta-regression), if done, indicating which were pre-specified.

N/A

RESULTS Study selection 17 Give numbers of studies screened, assessed for eligibility, and included in the review, with reasons for exclusions at

each stage, ideally with a flow diagram. 7

Study characteristics 18 For each study, present characteristics for which data were extracted (e.g., study size, PICOS, follow-up period) and provide the citations.

Supplementary Material 3 & 4

Risk of bias within studies 19 Present data on risk of bias of each study and, if available, any outcome level assessment (see item 12). Supplementary Material 6

Results of individual studies 20 For all outcomes considered (benefits or harms), present, for each study: (a) simple summary data for each intervention group (b) effect estimates and confidence intervals, ideally with a forest plot.

N/A

Synthesis of results 21 Present results of each meta-analysis done, including confidence intervals and measures of consistency. N/ARisk of bias across studies 22 Present results of any assessment of risk of bias across studies (see Item 15). N/AAdditional analysis 23 Give results of additional analyses, if done (e.g., sensitivity or subgroup analyses, meta-regression [see Item 16]). N/ADISCUSSION Summary of evidence 24 Summarize the main findings including the strength of evidence for each main outcome; consider their relevance to

key groups (e.g., healthcare providers, users, and policy makers). 12, 13

Limitations 25 Discuss limitations at study and outcome level (e.g., risk of bias), and at review-level (e.g., incomplete retrieval of identified research, reporting bias).

15, 16

Conclusions 26 Provide a general interpretation of the results in the context of other evidence, and implications for future research. 14,15

FUNDING Funding 27 Describe sources of funding for the systematic review and other support (e.g., supply of data); role of funders for the

systematic review. 17

From: Moher D, Liberati A, Tetzlaff J, Altman DG, The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med 6(6): e1000097. doi:10.1371/journal.pmed1000097

For more information, visit: www.prisma - statement.org .

Page 2 of 2

Supplementary Material 2: OVID/Medline detailed search strategy.

Database: Ovid MEDLINE(R) In-Process & Other Non-Indexed Citations and Ovid MEDLINE(R) <1946 to Present> April 15th, 2016Search Strategy:--------------------------------------------------------------------------------

Concept 1: Traumatic Brain Injuries

1 exp Brain Injuries/ (54632) [Mesh]

2 TBI*.mp. (17869) [Key word]

3 ((brain* or encephalon* or cranium or cranio* or cranial or intracrani* or intra-crani* or skull* or cerebral or cerebell* or head or ventric* pontine or putamin* or dura* or subdura* or sub-dura* or ((supra or extra) adj2 dura*) or supradura* or epidura* or epi-dura* or arachnoid* or sub-arachnoid* or subarachnoid* or (intra adj2 arachnoid*)) adj3 (injur* or trauma* or concussion* or post-concussion* or h?emorrhag* or h?ematom* or bleed* or penetrat* or (non adj2 penetrat*) or edema* or oedema* or fracture* or anyeurysm* or pressur*)).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier] (226862) [Key words]

4 Neurosurgery/ or exp craniotomy/ or decompressive craniectomy/ or trephining/ (25630) [Mesh]

5 (neurosurg* or neuro-surg* or craniotom* or craniectom* or trepanation* or trepanning* or trephination* or trephining*).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier] (75645) [Key words]

6 brain injury, chronic/ or brain edema/ or exp brain concussion/ or contrecoup injury/ or post-concussion syndrome/ or exp brain hemorrhage, traumatic/ or brain stem hemorrhage, traumatic/ or cerebral hemorrhage, traumatic/ or pneumocephalus/ or exp intracranial hemorrhages/ or exp cerebral hemorrhage/ or putaminal hemorrhage/ or exp intracranial hemorrhage, hypertensive/ or exp intracranial hemorrhage, traumatic/ or exp

hematoma, epidural, cranial/ or exp hematoma, subdural/ or hematoma, subdural, acute/ or hematoma, subdural, chronic/ or hematoma, subdural, intracranial/ or subarachnoid hemorrhage, traumatic/ or exp pituitary apoplexy/ or exp subarachnoid hemorrhage/ or exp intracranial hypertension/ or exp trauma, nervous system/ or cerebrospinal fluid leak/ or cerebrospinal fluid otorrhea/ or cerebrospinal fluid rhinorrhea/ or coma, post-head injury/ or exp cranial nerve injuries/ or exp head injuries, closed/ or head injuries, penetrating/ or exp skull fractures/ or skull fracture, basilar/ or skull fracture, depressed/ or exp Cerebrovascular Trauma/ (234139) [Mesh]

7 (pneumocephal* or pneumo-cephal* or a?rocele* or pneumocyst* or pneumo-cyst* or ((CSF or cerebrospinal) adj3 (leak* or otorrhea* or rhinorrhea*)) or co?ntrecoup* or (co?ntre adj3 coup*)).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier] (21753) [Key words]

Concept 2: Lebanon

8 lebanon/ (3169) [Mesh]

9 (lebanon or lebanese or libanaise).mp. [mp=title, abstract, original title, name of substance word, subject heading word, keyword heading word, protocol supplementary concept word, rare disease supplementary concept word, unique identifier] (4533) [Key words]

Concept 2: Mesh Terms or Keywords 10 8 or 9 (4533)

Concept 1: Mesh Terms or Keywords 11 or/1-7 (392811)

Concept 1 AND Concept 212 10 and 11 (67)

***************************

Supplementary Material 3: Characteristics of Excluded studies in ascending chronological order.

No. Author, Date Reason for Exclusion Reference1. Jamra et al., 1974 Case report about letter bombing with

no injuries reported to head or brain2. Haddad, 1978 Conference lecture3. Abderakhman S, 1983 Russian Article4. Groswasser et al. 1985 Non-Lebanese5. Rosenberg et al. 1986 Only abstract6. Zaytoun et al. 1986 Head and Neck injuries, but mainly

to facial bones. None were reported for brain injury or skull fractures

7. Fuad Haddad, 1986 Non-TBI8. Rahme et al., 2009 Ventriculostomy with no reference to

TBI9. Frykberg et al. 1989 Non-Lebanese participants10. J. J. M. Askenasy, 1989 Non-Lebanese – epilepsy post TBI11. Fuad Haddad, 1989 Conference lecture12. Hammoud et al. , 1995 Study about Spinal cord injuries, only

reported one case of head injury with no mentioning of TBI

13. Levi et al. 1990 Non-Lebanese participants14. Levi et al. 1990 Non-Lebanese participants15. Levi L. 1992 Non-Lebanese participants16. Cutting & Agha, 1992 Non-Lebanese participants17. Khoury et al. 1994 Non-nervous traumatic arteriovenous

fistulae in Lebanese patients 18. Aboutanos et al. 1997 Review about trauma, but no head

injuries were mentioned.

19. Sviri et al. 1999 Non-Lebanese study, where they mentioned Lebanese patients, but were not identified.

20. Simpson et al. 2000 Case report: Australian Study – TBI in Lebanese and non-Lebanese, but with no clear indication if TBI occurred in Lebanon or not. 6 TBI individuals were identified.

21. Haddad FS, 2002 Biography22. Moussa et al. 2006 Intracranial hemorrhag but due to

causes other than TBI23. Ferenc Kuhn, 2011 Editorial, Ocular trauma with no

reference to TBI24. Haddad FS, 2002 Review article about TBI in Lebanon,

All references checked; all previously retrieved.

1. Jamra FA, Halasa A, Salman S. Letter bomb injuries: a report of three cases. J Trauma. 1974;14(4):275-9.2. Haddad FS. Wilder Penfield Lecture: nature and management of penetrating head injuries during the Civil War in Lebanon. Can J Surg. 1978;21(3):233-7, 40.3. Abderakhman S. [Gastrointestinal hemorrhage after acute cranio-cerebral injury during the war in Lebanon]. Vrach Delo. 1983(6):90-1.4. Groswasser Z, Cohen M. Rehabilitation outcome of combat head injuries: comparison of October 1973 War and Lebanon War, 1982. Isr J Med Sci. 1985;21(12):957-61.5. Rosenberger A, Fuchs W, Adler OB, Braun J, Kleinhaus U, Goldsher D, et al. Radiology in war. Acta Radiol Suppl. 1986;367:1-82.6. Zaytoun GM, Shikhani AH, Salman SD. Head and neck war injuries: 10-year experience at the American University of Beirut Medical Center. The Laryngoscope. 1986;96(8):899-903.7. Haddad FS. Genetically transmitted diseases in neurology and neurosurgery with special reference to Lebanon. J Med Liban. 1986;36(2):92-5.8. Rahme R, Rahme RJ, Hourani R, Moussa R, Nohra G, Okais N, et al. Endoscopic third ventriculostomy: the Lebanese experience. Pediatr Neurosurg. 2009;45(5):361-7.

9. Frykberg ER, Tepas JJ, 3rd, Alexander RH. The 1983 Beirut Airport terrorist bombing. Injury patterns and implications for disaster management. Am Surg. 1989;55(3):134-41.10. Askenasy JJ. Association of intracerebral bone fragments and epilepsy in missile head injuries. Acta Neurol Scand. 1989;79(1):47-52.11. Haddad FS. Neurosurgery in the Middle East: life under fire. Neurosurgery. 1989;25(2):303-11.12. Hammoud M, Haddad F, Moufarrij N. Spinal cord missile injuries during the Lebanese civil war. Surg Neurol. 1995;43(5):432-42.13. Levi L, Borovich B, Guilburd JN, Grushkiewicz I, Lemberger A, Linn S, et al. Wartime neurosurgical experience in Lebanon, 1982-85. I: Penetrating craniocerebral injuries. Isr J Med Sci. 1990;26(10):548-54.14. Levi L, Borovich B, Guilburd JN, Grushkiewicz I, Lemberger A, Linn S, et al. Wartime neurosurgical experience in Lebanon, 1982-85. II: Closed craniocerebral injuries. Isr J Med Sci. 1990;26(10):555-8.15. Levi L. Intracranial infection after missile injuries to the brain: report of 30 cases from the Lebanese Conflict. Neurosurgery. 1992;31(1):162.16. Cutting PA, Agha R. Surgery in a Palestinian refugee camp. Injury. 1992;23(6):405-9.17. Khoury G, Sfeir R, Nabbout G, Jabbour-Khoury S, Fahl M. Traumatic arteriovenous fistulae: "the Lebanese war experience". European journal of vascular surgery. 1994;8(2):171-3.18. Aboutanos MB, Baker SP. Wartime civilian injuries: epidemiology and intervention strategies. J Trauma. 1997;43(4):719-26.19. Sviri GE, Guilburd JN, Soustiel JF, Zaaroor M, Feinsod M. Penetrating head injuries caused by a new weapon, the side dome. Mil Med. 1999;164(10):746-50.20. Simpson G, Mohr R, Redman A. Cultural variations in the understanding of traumatic brain injury and brain injury rehabilitation. Brain Inj. 2000;14(2):125-40.21. Haddad FS. Anesthesia over the past 55 years. Reminicences of a neurosurgeon. Middle East journal of anaesthesiology. 2002;16(5):469-76.22. Moussa R, Harb A, Menassa L, Risk T, Nohra G, Samaha E, et al. [Etiologic spectrum of intracerebral hemorrhage in young patients]. Neurochirurgie. 2006;52(2-3 Pt 1):105-9.23. Kuhn F. Ocular trauma: from epidemiology to war-related injuries. Graefe's Archive for Clinical and Experimental Ophthalmology. 2011;249(12):1753-4.24. Haddad FS. Penetrating Missile Head Injuries: Personal Experiences During the Lebanese Conflict. Neurosurgery Quarterly. 2002;12(4):299-306.

Supplementary Material 4: Characteristics of the included studies in ascending chronological order.Author, Year, Ref.Study Design

Participants, Setting and Time

Head Injuries

Causes of InjuryAge DistributionandGender Distribution

Brain Injuries&Severity

Assessment Methods

Associated injuries

Complications

Achram et al.1980 Retrospective

Cohort Study

N= 219

American University of Beirut Medical Center

Lebanese War (1983)

Traumatic intracranial aneurysms: 7

War injury Shrapnel: 6 Bullet: 1

Intracerebral bleeding: 5/7

Arteriograms None Reported

None Reported

Scott et al. 1986 Retrospective

Cohort Study

N = 346

234 immediate deaths and 112 survivors

USS Iwo JIMA and local Beirut hospitals

October 23,

Among the 112 survivors: Head injuries: 20 scalp lacerations, 13 skull fractures,6 facial bone fractures, 2 CSF fistulas,

Terrorist bombing

37 (28%) concussions,, 4 cerebral contusions, 5 Dural lacerations,2 intracerebral hematomas

None Reported 2 spine injuries

9 peripheral nerve injuries

1 facial nerve palsy

Post-concussion syndrome in 7/28

Deaths among immediate survivors: 7 (6.3%)

234 immediate deaths

1983

Among the 234 immediate deaths:Head injuries: 167 (93 scalp lacerations, 85 skull fractures, 24 facial bone fractures and 22 spine injuries) and 9 peripheral nerve injuries (1 facial nerve palsy)

Taha et al.1991 ProspectiveCohort Study

N = 600


None Reported

Missile injuries:- Bullet: 17 (57%)- Shrapnel fragment: 13 (43%)

Mean age: 23,

One lobe 6Two lobes 20Severe injury 23

GCS score:- 4-5: 7- 6-8: 11- 9-12: 4- 13-15: 8

None Reported

30 intracranial infections:

- Brain abscess: 16- Cerebritis: 9- Infected intracerebral hematoma: 2- Meningitis: 5

1981-1988 Range: 3-51 years

Males: 28 Females: 4

Recurrent intracranial infections: 2/30

Seizures: 50%

Mortality rate: 285 (43%|)

Taha et al.1991 ProspectiveCohort Study

N = 600


1981-1988

32 Missile injuries:- Bullet: 5- Shrapnel fragment: 27

Males: 62.8% Females: 37.2%

32 CT Glasgow Coma

Scaleo Range

10-15o Mean:

14

None Reported

CSF leakage and abscess: 1/32

Seizures: 2/32

Nohra et al. 2002 Retrospective

Cohort Study

N = 500

Hotel-Dieu de France

1975 - 1990

272 cranio-cerebral Trauma’s

Missile Head Injuries

Closed TBI: 69Penetrating TBI: 201Unknown: 2

Intracerebral Material: 78

Bone fragment: 8

Bullet: 103 Shrapnel: 162

CT Glasgow Coma

Scale

58 but not specified

Infections : 31 Abscess: 7 Meningitis: 20 Abscess +

Meningitis: 4 Fistulae: 29 Sinus: 31 Death due to non-

infectious causes: 33(13.7%)

Unknown: 7 Death due to infections: 7 (26.6%)

Haddad et al. 2008 Retrospective

Cohort Study

N = 150


February 14, 2005

4 head injuries:- 2 Brain- 2 Facial bone injuries

Bomb attack

Age range: 21-59 years, Mean age: 32.2 years

Males: 23Females: 5

2 brain injuries

Severe brain injuries: 2

Radiographs and non-enhanced CT scans

None Reported

None Reported

Mansour et al. 2009 Retrospective

Cohort Study

N = 841


1980-1996

Pediatric (0–16): 147 + 179 = 326

Adult: 392 + 115 = 507

War injuries:M: 84.7%F: 15.3%

Domestic injuries:M: 75.1%F: 24.9%

War injuries: 544

- Rocket shrapnel: 417 (77.2%)- Gun: 92 (17.0%)- Mine: 27 (5.0%)- Hand grenade: 4 (0.7%)

Domestic injuries: 297

Brain injuries: 16 of 841

None Reported Right eye: 210 + 135 = 345

Left eye: 229 + 149 = 378

Both eyes: 105 + 13 = 118

Face injuries: 86 + 23 = 109

None Reported

Maha Habre, 2012 Retrospective

Cross-sectional Study

N = 175


February 1, 2010 to July 31, 2010

- Causes Fall: 42.1% MVC: 20.7% Strikes

against/bumping into something: 16.5%

Assaults: 10.7 % Sports-related

3.3 % No mechanism

of injury: 6.6%

Age distribution 18-40 years:

48.8%, \ 41-59 years:

19.8%, >60 years:

31.4%

Mild TBI: 98 (96.1%)

Moderate TBI: 3 (2.9%)

Unknown: 1 (1%)

CT, GCS, reflexes, motor power, and sensory assessment

None Reported

None Reported

Fares & Fares. 2013 ProspectiveCohort Study

N = 407Males: 382Females: 25Age range: 10 -67

NeurosurgeryDivision at

29

10-18 years: 818-67 years: 21

Below 18:

Cluster bombs None Reported Fares’ Scale:- Grade I: 175- Grade II: 203- Grade III: 8- Grade IV: 21

Reported several, but exact injuries associated with TBI are not specified

- Functional disability: 301 of 407- Partial recovery: 55 of 407- Psycho-social effect: 312 of 407- 51(non-specific to TBI)

the Lebanese University and its affiliated medical centers

September 2006 to August 2012

M:7F: 1Above 18: M:15F: 6

Fares et al.2013 ProspectiveCohort Study

N= 407Below 18 = 122(30%)

NeurosurgeryDivision at the Lebanese University and its affiliated medical centers

14 August 2006 to 31 December 2011

Average age: 14 years

- Children: 34.4%- Adolescents: 65.6%7

M: 116 (95%)F: 6 (5%)

Cluster munitions

4(3.6)

Penetrating TBI: 3(2.7)

Closed TBI: 1

None Reported None Reported

Death: 10 (8.2%), all males

Fares et al. 2013 ProspectiveCohort Study

N = 417

NeurosurgeryDivision at the Lebanese University and its affiliated medical centers

14 August 2006 to 15 February 2013

29 (7%)Below 18: 7 males and 1 female

Above 18: 15 males and 6 females

Age Range: 10-54 years

Median Age: 27 years

M: 22(76%)F: 7(24%)

Cluster munitions’ blasts

Traumatic Brain Injuries (TBIs): 18

- Penetrating TBI: 7 (24%)- closed TBI: 11 (38%)

CT Fares Scale:

- Grade I: 175- Grade II: 203- Grade III: 8- Grade IV: 21

Facial Nerve injury: 7 (24%)

Eyes injuries: 7 (24%)

Otology: 17 (59%)

Oral injuries: 2 (7%)

Skin, scalp and soft-tissue lesions: 29 (100%)

Psychological disorders:- Post-traumatic stress disorder (PTSD): 29 (100%)- Major depressive disorder (MDD): 21 (72%)- Acute stress disorder (ASD): 4 (14%)- Generalized anxiety disorder (GAD): 23 (79%)

1. Achram, M., G. Rizk, and F. Haddad, Angiographic aspects of traumatic intracranial aneurysms following war injuries. The British Journal of Radiology, 1980. 53(636): p. 1144-1149.

2. Scott, B.A., et al., The Beirut terrorist bombing. Neurosurgery, 1986. 18(1): p. 107-10.3. Taha, J., F. Haddad, and J. Brown, Intracranial infection after missile injuries to the brain: report of 30 cases from the Lebanese conflict.

Neurosurgery, 1991a. 29(6): p. 864-868.

4. Taha, J., M. Saba, and J. Brown, Missile injuries to the brain treated by simple wound closure: results of a protocol during the Lebanese conflict. Neurosurgery, 1991b. 29(3): p. 380-384.

5. Nohra, G., et al., [Infections after missile head injury. Experience during the Lebanese civilian war]. Neurochirurgie, 2002. 48(4): p. 339-44.6. Haddad, M.C., N.J. Khoury, and M.H. Hourani, Radiology of terror injuries: the American University of Beirut Medical Center experience. Clin Imaging,

2008. 32(2): p. 83-7.7. Mansour, A.M., et al., Comparison of domestic and war ocular injuries during the Lebanese Civil War. Ophthalmologica, 2009. 223(1): p. 36-40.8. HABRE, M., EVALUATION OF MILD TRAUMATIC BRAIN INJURY MANAGEMENT IN THE EMERGENCY DEPARTMENT AT AUBMC. 2012, American

University of Beirut.9. Fares, Y. and J. Fares, Anatomical and neuropsychological effects of cluster munitions. Neurological Sciences, 2013. 34(12): p. 2095-2100.10. Fares, Y., et al., Pain and neurological sequelae of cluster munitions on children and adolescents in South Lebanon. Neurological Sciences, 2013a.

34(11): p. 1971-1976.11. Fares, Y., J. Fares, and S. Gebeily, Head and facial injuries due to cluster munitions. Neurological Sciences, 2014. 35(6): p. 905-910.

Supplementary Material 5: Data item definitions.1. Author

2. Year of publication

3. Study design

4. Sample size

5. Study setting

6. Study time period – year

7. Study time period – occasion

a. Civil was

b. Lebanese-Israeli conflict

c. Blast

8. Inclusion Criteria – Lebanese with TBI in Lebanon

9. Exclusion Criteria-

a. Lebanese with TBI outside Lebanon

b. Non-Lebanese TBI in Lebanon

c. Case reports, biographies, abstracts

10. Head injuries

a. Rates

b. Causes

c. Age distribution

d. Age Range

e. Mean Age

f. Sex distribution

11. Brain injuries

a. Rates

b. Causes

c. Age distribution

d. Age Range

e. Mean Age

f. Sex distribution

g. Severity – Mild/ Moderate/ Severe

h. Severity – Blunt/ Penetrating

12. Assessment methods

a. Glasgow-coma scale

b. Computed Tomography

c. Arteriograms

d. Special scales

13. Associated injuries

a. Neck

b. Abdomen

c. Pelvic

d. Spine

e. Extremities

14. Outcomes

a. Recovery

b. Mortality Rates

c. Infections

i. Intracranial

ii. Extra cranial

iii. Seizures

iv. Psychological outcomes

1. PTSD

2. Generalized Anxiety Disorders

3. Depression

15. Rehabilitation

16. Cost of health

a. Direct due to trauma hospitalization

b. Indirect costs – medications, employment

c. Rehabilitation

Supplementary Material 4: Down and Black Checklist for measuring Quality.Study 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 QIAchram et al. 1980

1 1 0 1 0 1 0 0 0 0 1 1 1 0 0 0 1 0 0 1 0 0 0 0 0 0 0 9

Scott et al. 1986

1 1 0 1 0 1 0 0 0 0 1 1 1 0 0 0 1 0 0 1 1 1 0 0 0 0 0 11

Taha et al. 1991

1 1 0 1 1 1 0 1 1 0 1 1 1 0 0 0 0 1 0 1 1 1 1 0 1 1 0 17

Taha et al. 1991

1 1 1 1 1 1 0 1 0 0 1 1 1 0 0 0 0 0 0 1 1 1 0 0 1 0 0 14

Nohra et al. 2002

1 1 1 1 0 1 0 1 0 1 1 1 0 0 0 0 0 1 1 1 0 1 0 0 1 0 0 14

Haddad et al. 2008

1 1 0 1 0 1 0 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 0 0 0 8

Mansour et al. 2009

1 1 1 1 1 1 0 1 1 1 0 0 0 0 0 1 1 1 0 1 1 1 0 0 1 1 0 17

Maya Habre, 2012

1 1 1 1 1 1 0 0 0 1 1 1 1 0 0 0 1 1 1 1 1 1 0 0 0 0 0 16

Fares et al. 2013

1 1 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 1 0 0 0 0 0 10

Fares & Fares. 2013

1 1 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 1 0 0 0 0 0 10

Fares et 1 1 1 1 0 1 0 0 0 0 0 0 1 0 0 1 0 0 0 1 1 1 0 0 0 0 0 10

al.2013

PRISMA 2009 Checklist

Full Description of Down and Black Criteria.1. Is the hypothesis/aim/objective of the study clearly described?

(Yes = 1; No = 0)

2. Are the main outcomes to be measured clearly described in the Introduction or Methods section?

(Yes = 1; No = 0)

3. Are the characteristics of the patients included in the study clearly described?

(Yes = 1; No = 0)

4. Are the interventions of interest clearly described?

(Yes = 1; No = 0)

5. Are the distributions of principal confounders in each group of subjects to be compared clearly described?

(Yes = 2; Partially =1; No = 0)

6. Are the main findings of the study clearly described?

(Yes = 1; No = 0)

7. Does the study provide estimates of the random variability in the data for the main outcomes?

(Yes = 1; No = 0)

8. Have all important adverse events that may be a consequence of the intervention been reported?

(Yes = 1; No = 0)

9. Have the characteristics of patients lost to follow-up been described?

(Yes = 1; No = 0)

10. Have actual probability values been reported (e.g. 0.035 rather than <0.05) for the main outcomes except where the probability value is less than 0.001?


(Yes = 1; No = 0; Unable to determine = 0)

11. Were the subjects asked to participate in the study representative of the entire population from which they were recruited?


12. Were those subjects who were prepared to participate representative of the entire population from which they were recruited?


13. Were the staff, places, and facilities where the patients were treated, representative of the treatment the majority of patients receive?


14. Was an attempt made to blind study subjects to the intervention they have received?


15. Was an attempt made to blind those measuring the main outcomes of the intervention?


16. If any of the results of the study were based on “data dredging”, was this made clear?


17. In trials and cohort studies, do the analyses adjust for different lengths of follow-up of patients, or in case control studies, is the time period between the intervention and outcome the same for cases and controls?


18. Were the statistical tests used to assess the main outcomes appropriate?


19. Was compliance with the intervention/s reliable?



20. Were the main outcome measures used accurate (valid and reliable)?


21. Were the patients in different intervention groups (trials and cohort studies) or were the cases and controls (case-control studies) recruited from the same population?


22. Were study subjects in different intervention groups (trials and cohort studies) or were the cases and controls (case-control studies) recruited over the same time?


23. Were study subjects randomised to intervention groups?


24. Was the randomised intervention assignment concealed from both patients and health care staff until recruitment was complete and irrevocable?


25. Was there adequate adjustment for confounding in the analyses from which the main findings were drawn?


26. Were losses of patients to follow-up taken into account?


27. Did the study have sufficient power to detect a clinically important effect where the probability value for a difference being due to chance <5%.

SN. Sample Size QI pointA. 1<n1 0B. n1-n2 1C. n3-n4 2D. n5-n6 3E. n7-n8 4F. n8 5


1. Achram M, Rizk G, Haddad F. Angiographic aspects of traumatic intracranial aneurysms following war injuries. The British Journal of Radiology. 1980;53(636):1144-9.2. Scott BA, Fletcher JR, Pulliam MW, Harris RD. The Beirut terrorist bombing. Neurosurgery. 1986;18(1):107-10.3. Taha J, Haddad F, Brown J. Intracranial infection after missile injuries to the brain: report of 30 cases from the Lebanese conflict. Neurosurgery. 1991a;29(6):864-8.4. Taha J, Saba M, Brown J. Missile injuries to the brain treated by simple wound closure: results of a protocol during the Lebanese conflict. Neurosurgery. 1991b;29(3):380-4.5. Nohra G, Maarrawi J, Samaha E, Rizk T, Okais N. [Infections after missile head injury. Experience during the Lebanese civilian war]. Neuro-Chirurgie. 2002;48(4):339-44.6. Haddad MC, Khoury NJ, Hourani MH. Radiology of terror injuries: the American University of Beirut Medical Center experience. Clinical imaging. 2008;32(2):83-7.7. Mansour AM, Zein WM, Sibai TA, Mehio-Sibai A, Ismail H, Orm SB. Comparison of domestic and war ocular injuries during the Lebanese Civil War. Ophthalmologica. 2009;223(1):36-40.8. HABRE M. EVALUATION OF MILD TRAUMATIC BRAIN INJURY MANAGEMENT IN THE EMERGENCY DEPARTMENT AT AUBMC: American University of Beirut; 2012.9. Fares Y, Fares J, Gebeily S. Head and facial injuries due to cluster munitions. Neurol Sci. 2014;35(6):905-10.10. Fares Y, Fares J. Anatomical and neuropsychological effects of cluster munitions. Neurological Sciences. 2013;34(12):2095-100.11. Fares Y, Ayoub F, Fares J, Khazim R, Khazim M, Gebeily S. Pain and neurological sequelae of cluster munitions on children and adolescents in South Lebanon. Neurological Sciences. 2013a;34(11):1971-6.

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