Disorders of Consciousness Task Force
Disorders of Consciousness Task Force
John Whyte, MD, PhD, FACRM
Director, Moss Rehabilitation Research Institute
Risa Nakase-Richardson, PhD, FACRM
Clinical Neuropsychologist, James A. Haley VA Hospital
FOCUS / MISSION
To advance scientific knowledge, develop standards of practice, and advocate for the appropriate care of persons with disordered consciousness. Projects developed fall under the umbrellas of clinical, research, advocacy, and education about this patient group.
NIDILRR & VA TBI Model System DOC Special Interest Group members collaborate on task force projects and monthly telephone calls.
2018 Call for Proposals
- Organize 2018 Galveston Brain Injury Conference (May)
- Federal Interagency Conference on TBI DOC Track Presentations (June)
- Publish 1 Guideline and 3 Position Statements
- Complete BI-ISIG Funded Survey of Educational Materials for Caregivers and Professionals
- Fact Sheet Published: Severe Traumatic Brain Injury: What to Expect in the Trauma Center, Hospital, and Beyond on Model System Knowledge Translation Website
- Organized 2017 Galveston Brain Injury Conference Addressing Ethics, Cost Models for DOC Rehabilitation, and Delphi Voting and Refinement of the Post Traumatic Confusional State Definition
- Dissemination of 21 DOC Minimal Competency Recommendations at IBIA and AAPM&R
- Work in Progress to completing 1 AAN, ACRM, TBIMS Guideline (DOC Diagnosis, Prognosis, Treatment and Natural History) and 3 position statements relevant to DOC (DOC Rehabilitation Recommendations, DOC Outcome, Case Definition of Post Traumatic Confusional State)
Members of the DOC Task Force have been very busy presenting at various conferences and completing a number of projects. Co-chairs, Risa Nakase Richardson and John Whyte, are leading a team of most prolific collaborators. Here are some of the upcoming highlights of their work.
AAN, ACRM, TBIMS Guideline
The joint guideline developed with AAN, ACRM, and TBIMS on DOC diagnosis, prognosis, natural history, and treatment is expected by Spring of 2018. A customary updated literature review and tweak of the guidelines voted on by Delphi was recently completed; Dr. Joe Giacino occasionally comes up for air.
Other Position Statements and Reviews in Progress
- Case Definition for Acute Confusional State is led by Mark Sherer, Yelena Bodien and Doug Katz. The team has completed the initial round of Delphi, and voted for the definition.
- A DOC Outcome Paper initiative is organized by Ron Seel. The inclusion criteria are different than the AAN guideline effort. Several teleconferences have been held and the review is in progress.
- A Minimal Competency Set of Recommendations for DOC Rehabilitation is currently underway. Dr. Joe Giacino and his collaborators are writing 5 major subsections.
MSKTC Fact Sheet
A MSKTC Fact Sheet was developed by ACRM and TBIMS joint DOC members (led by Amy Rosenbaum) and is now available online (Severe Traumatic Brain Injury: What to Expect in the Trauma Center, Hospital, and Beyond). Members are finding it may be locate (labeled “severe tbi” on the website) so they are in the process of improving publicity and information about it.
Recent & Upcoming Presentations of DOC Task Force Members
- American Academy of Physical Medicine and Rehabilitation - Three members of the DOC task force will be presenting in early October 2017 on the recommendations from the position statement in progress about DOC rehabilitation & minimal competency standards (Sunil Kothari, Risa Nakase Richardson, Alan Weintraub).
- Galveston Brain Injury Conference - Members of the DOC Task Force will organize a follow-up Galveston Brain Injury Conference in 2018.One of the sub-committees from the 2017 conference (Bioethics) has secured a special issue in the American Journal of Bioethics with 5 papers. Commentary will be invited. A legal sub-committee is writing a paper on the current state of withdrawing and limiting treatment in disorders of consciousness.
- Federal InterAgency Conference on TBI – 11 - 12 June 2018 Washington, DC - Several members have been discussing the content and goal of having non-stop DOC content at the meeting. Specific Submissions discussed included:
- AAN, ACRM, TBIMS Guidelines
- The TBIMS DOC Study Series – submitted (Risa Nakase-Richardson, Flora Hammond, Robert Kowalski)
- Smart Home for DOC
- Acute Confusion Case Definition (Mark Sherer, Yelena Bodien, Doug Katz)
- DOC Outcome Literature Review on Prognosis (led by Ron Seel and several members)