Translating Research to Care: Canadian Pediatric Concussion Guidelines

Kids playing soccer in the park on a fall day.

A Canada-wide collaboration between researchers and health-care providers has produced the first “living” guideline for pediatric concussion diagnosis and treatment, connecting clinical caregivers with the latest evidence on concussion research. Funded by the Ontario Neurotrauma Foundation, the Living Guideline for Diagnosing and Managing Pediatric Concussion (“the Guideline”), integrates existing evidence-based approaches and allows for more efficiency in updating or revising the Guideline in the future.  

Concussion affects children differently than adults. Children may be more vulnerable to a concussive injury, and symptoms of brain injury can affect a child’s day-to-day life, impacting their learning and social development. It can also take children longer to recover. According to the National Ambulatory Care Reporting System, there were approximately 46,000 concussions diagnosed in children between 5 and 19 years of age in 2016. According to the Public Health Agency of Canada, only 15 percent of Canadians are able to correctly identify the best ways to treat concussion.

Development of the Guideline was led by Drs Roger Zemek and Nick Reed, and co-authored with the support of concussion experts from across Canada, including Dr. Cheryl Wellington, who recently demonstrated the potential for a blood biomarker in pediatric traumatic brain injury (Lancet Child and Adolescent Health, June 2019), and Dr. Shelina Babul, who developed the Concussion Awareness Training Tool at BC Children’s Hospital.

For Dr. Wellington, this means the potential to translate discoveries made in her lab toward clinical decision-making in a more efficient manner than with traditional guidelines. For Dr. Babul, the Guideline further supports healthcare professionals with the latest knowledge and resources for effective concussion diagnosis, treatment and management approaches for patients. The Guideline is available online as a reference tool for clinicians; the previous (analog) version of the Guideline was published in 2014.

“It’s really exciting that together we’ve integrated the entire Canadian landscape of concussion research and care into a single living document,” said Dr. Babul. “This is a very dynamic way to communicate tools and resources with clinicians that will ultimately improve care for kids with concussions.”

Having the Guideline online means that evidence-based, clinically useful concussion information is accessible to any member of an individual’s care team who might need it, from clinicians to coaches to parents. It also offers current information for people outside urban settings who may have limited access to specialized care.

“We are proud to be involved in this project,” said Dr. Wellington. “It shows that the research we all do is important to the people making clinical decisions, and it means we have the ability to communicate the most up-to-date information we have with medical doctors and healthcare professionals.”

The Guideline provides 22 clinician-focused tools, from factors influencing the sleep/wake cycle to a broad range of resources across 14 key domains, from acute care to longer-term recovery.

“The benefit of this new platform for concussion information and care is that we can see our research informing changes to practice, and that it’s giving mobility to how we understand and treat concussion,” said Dr. Wellington.