Rehabilitation of traumatic injuries: use of the delphi method to identify topics for evidence-based review

During recent years, there has been an increase in the number of research publications on rehabilitation. Some investigators consider that the quality of recent rehabilitation research is improving through a greater emphasis on functional outcomes and use of appropriate study designs. Despite these trends, it remains difficult to apply results of intervention research to many areas of clinical care. Clinicians may be unaware of all relevant literature on a specific topic, and it can be difficult to draw conclusions when many studies suffer from methodologic limitations.

One of the keys to meeting this challenge is use of evidence-based reviews of intervention research. A comprehensive evidence-based review defines the complete body of research on a topic, rates the quality of the evidence, and determines if there is evidence for an effect, evidence for no effect, or inadequate evidence by which to make a judgment. If there is a lack of high-quality data, evidence-based reviews can serve as indicators to researchers and funding agencies that specific research questions require further investigation.

Evidence-based reviews are being conducted with increasing frequency in many areas of medicine. Evidence-based reviews have been conducted on a number of rehabilitation topics, including cardiac rehabilitation, cognitive rehabilitation after stroke, and the rehabilitation of children with traumatic brain injuries. Some evidence-based reviews in rehabilitation have been used for the development of clinical practice guidelines, such as those published by the Consortium for Spinal Cord Medicine.

This study was undertaken to outline research questions that are appropriate for evidence-based review. Due to the breadth of topics in the field of rehabilitation, the study focused on a specific group of disorders: those resulting from traumatic injuries. We chose this focus because traumatic injuries are a common cause of disability, a large number of studies assess their treatment, and special funding opportunities exist for research on these conditions. We used the Delphi method to arrive at a consensus among rehabilitation investigators and practitioners on the most important research questions for evidence-based review.

Rehabilitation Topics for Systematic Review (Am J Phys Med Rehabil. 2003 May;82(5):410-4.)