The Recovery of Consciousness via Evidence-Based Medicine and Research (RECOVER) Program: A Paradigm for Advancing Neuroprognostication.

IF 2.3 Q3 CLINICAL NEUROLOGY Neurology. Clinical practice Pub Date : 2024-12-01 Epub Date: 2024-08-16 DOI:10.1212/CPJ.0000000000200351

David Fischer, Benjamin S Abella, Geoffrey D Bass, Jeremy Charles, Stephen Hampton, Catherine V Kulick-Soper, Matthew T Mendlik, Oscar J Mitchell, Aliza M Narva, William Pino, Morgan L Sikandar, Saurabh R Sinha, Genna J Waldman, Jeffrey B Ware, Joshua M Levine

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Abstract

Background: Neuroprognostication for disorders of consciousness (DoC) after severe acute brain injury is a major challenge, and the conventional clinical approach struggles to keep pace with a rapidly evolving literature. Lacking specialization, and fragmented between providers, conventional neuroprognostication is variable, frequently incongruent with guidelines, and prone to error, contributing to avoidable mortality and morbidity.

Recent findings: We review the limitations of the conventional approach to neuroprognostication and DoC care, and propose a paradigm entitled the Recovery of Consciousness Via Evidence-Based Medicine and Research (RECOVER) program to address them. The aim of the RECOVER program is to provide specialized, comprehensive, and longitudinal care that synthesizes interdisciplinary perspectives, provides continuity to patients and families, and improves the future of DoC care through research and education.

Implications for practice: This model, if broadly adopted, may help establish neuroprognostication as a new subspecialty that improves the care of this vulnerable patient population.

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通过循证医学和研究恢复意识计划（RECOVER）：推进神经诊断的范例。

背景：严重急性脑损伤后意识障碍（DoC）的神经诊断是一项重大挑战，传统的临床方法难以跟上快速发展的文献。传统的神经诊断方法缺乏专业性，而且各医疗机构之间各自为政，因此诊断结果多变，经常与指南不一致，而且容易出错，导致本可避免的死亡和发病：我们回顾了神经诊断和昏迷患者护理的传统方法的局限性，并提出了一个名为 "通过循证医学和研究恢复意识"（RECOVER）计划的范例来解决这些问题。RECOVER 计划的目标是提供专业、全面和纵向的护理，综合跨学科的观点，为患者和家属提供连续性，并通过研究和教育改善意识障碍护理的未来：这种模式如果被广泛采用，将有助于将神经诊断确立为一个新的亚专科，从而改善对这一弱势患者群体的护理。

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来源期刊

Neurology. Clinical practice CLINICAL NEUROLOGY-

CiteScore

4.00

自引率

0.00%

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期刊介绍： Neurology® Genetics is an online open access journal publishing peer-reviewed reports in the field of neurogenetics. The journal publishes original articles in all areas of neurogenetics including rare and common genetic variations, genotype-phenotype correlations, outlier phenotypes as a result of mutations in known disease genes, and genetic variations with a putative link to diseases. Articles include studies reporting on genetic disease risk, pharmacogenomics, and results of gene-based clinical trials (viral, ASO, etc.). Genetically engineered model systems are not a primary focus of Neurology® Genetics, but studies using model systems for treatment trials, including well-powered studies reporting negative results, are welcome.