Systematic Review and Final CDC Guideline on the Diagnosis and Management of Mild Traumatic Brain Injury Among Children, 45629-45630 [2018-19536]
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Federal Register / Vol. 83, No. 175 / Monday, September 10, 2018 / Notices
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Agenda
Tuesday October 2, 2018
Old Business:
• Acceptance of minutes of last
meeting
• Public Comment Period
New Business:
• Executive Director’s Report—
Executive Director Dayton
• 2019 Signature Event Proposals—
Executive Director Dan Dayton
• Financial Committee Report—
Commissioner Dunning
• Education Committee Report—
Commissioner O’Connell
• ACE Committee Report—
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17:54 Sep 07, 2018
Jkt 244001
Commissioner Monahan
• Memorial Report—Vice Chair
Fountain
• Fundraising Report—Commissioner
Sedgwick
• International Report—
Commissioner Seefried
Other Business:
• Chairman’s Report
Upcoming Meeting Dates
• January 22, 2019, via phone
• April 21–22, 2019, Washington, DC
• July 2019, Kansas City, MO
Motion to Adjourn
Dated: September 4, 2018.
Daniel S. Dayton,
Designated Federal Official, World War I
Centennial Commission.
[FR Doc. 2018–19491 Filed 9–7–18; 8:45 am]
BILLING CODE 6820–95–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[Docket No. CDC–2017–0089]
Systematic Review and Final CDC
Guideline on the Diagnosis and
Management of Mild Traumatic Brain
Injury Among Children
Centers for Disease Control and
Prevention (CDC), Department of Health
and Human Services (HHS).
ACTION: Notice; availability of final
guidance.
AGENCY:
The Centers for Disease
Control and Prevention (CDC), located
within the Department of Health and
Human Services (HHS), announces the
availability of the Systematic Review
and Final CDC Guideline on the
Diagnosis and Management of Mild
Traumatic Brain Injury Among
Children.
SUMMARY:
CDC published the final
Systematic Review and Final CDC
Guideline on the Diagnosis and
Management of Mild Traumatic Brain
Injury Among Children on September 4,
2018 in JAMA Pediatrics.
FOR FURTHER INFORMATION CONTACT:
Arlene I. Greenspan, National Center for
Injury Prevention and Control, Centers
for Disease Control and Prevention,
4770 Buford Highway NE, Mailstop
F–63, Atlanta, Georgia 30341.
Telephone: (770) 488–4694; email:
duipinquiries@cdc.gov.
SUPPLEMENTARY INFORMATION: On
September 29, 2017, CDC published a
notice in the Federal Register
DATES:
PO 00000
Frm 00036
Fmt 4703
Sfmt 4703
45629
announcing the opening of a docket to
obtain public comment on a Systematic
Review of the evidence on the
diagnosis, prognosis, and management
of pediatric mild traumatic brain injury
(mTBI), and an evidence-based
Guideline that offers clinical
recommendations for healthcare
providers (82 FR 45588). CDC also
provided an opportunity for public
comments during the National Center
for Injury Prevention and Control’s
Board of Scientific Counselors meeting
on September 7, 2016 (81 FR 49657).
The Systematic Review and Guideline
were developed through a rigorous
process guided by the American
Academy of Neurology methodology
and 2010 National Academy of Sciences
methodology for the development of
evidence-based guidelines. An extensive
review of the scientific literature,
spanning 25 years of research, formed
the basis of the Guideline.
The goal of the CDC Guideline is to
help healthcare providers take action to
improve the health of their pediatric
patients with mTBI. The Guideline
consists of 19 clinical recommendation
sets that cover diagnosis, prognosis, and
management and treatment. These
recommendations are applicable to
healthcare providers working in
inpatient, emergency, primary, and
outpatient care settings. CDC received
comments on the draft Systematic
Review and Guideline from two external
peer reviewers:
b Both provided references for
literature that was published following
the close of the literature review period
for the Guideline and Systematic
Review. Both reviewers requested
details about definitions of terms such
as mTBI and concussion and how they
are similar or different.
b Other comments focused on how
an existing consensus statement on
sports-related concussion aligns with
CDC recommendations; lack of
information available on children who
never seek medical attention to
highlight this current information gap;
and specificity of the recommendations
for clinicians in the acute care and
outpatient settings.
CDC also received 10 public
comments from professional
organizations, academia, and the public:
b Five were from medical and
clinical professional organizations.
These groups shared their perspective
on diagnosis and treatment of mTBI and
how specialty groups are affected
differently.
b Two were from community
members and parents sharing their
support of the work.
E:\FR\FM\10SEN1.SGM
10SEN1
45630
Federal Register / Vol. 83, No. 175 / Monday, September 10, 2018 / Notices
b One was from a commenter who
did not provide an affiliation. The
commenter shared concerns regarding
how the level of evidence was graded.
b One was from a healthcare
provider who shared citations for
consideration.
b One was from an advocacy group
that provided a comment outside the
scope of the docket.
A summary of the revisions made to
the final Systematic Review and
Guideline based on external peer
reviewer comments are posted in the
Supporting Documents section of the
docket (document titled ‘‘Ped mTBI
Guideline Response to Peer Reviewer
Comments’’).
CDC also revised the document based
on public comments. For example, a few
commenters expressed concern
regarding recommendations not being
applicable in the emergency care
setting. As the clinical
recommendations in the guideline were
created for both the acute care and
primary care setting, CDC added
language to emphasize that the
recommendations were drafted to be
relevant for both settings. As another
example, multiple comments were
received regarding the content in the
systematic review on the use of CT
imaging. Commenters explained that
current evidence that provides the basis
for CT imaging focus on ruling out
clinically-important traumatic brain
injury among pediatric patients
presenting with a TBI. In response, CDC
revised the conclusion to specify that
the recommendations are for children
presenting with mTBI versus TBI of all
severity levels in the acute care setting.
All public and peer reviewer comments
were carefully reviewed and considered
to strengthen and improve the quality of
the Systematic Review and Guideline.
The final Systematic Review and
Guideline on the Diagnosis and
Management of Mild Traumatic Brain
Injury Among Children can be found at
https://jamanetwork.com/journals/
jamapediatrics/fullarticle/2698456?
guestAccessKey=80a9ecdc-ea57-447da1b3-b4a87cadd40d (Guideline) and
https://jamanetwork.com/journals/
jamapediatrics/fullarticle/2698455?
guestAccessKey=24b78e3d-571f-49fb9daf-499d2b3e2cc1 (Systematic
Review).
Dated: September 5, 2018.
Lauren Hoffmann,
Acting Executive Secretary, Centers for
Disease Control and Prevention.
[FR Doc. 2018–19536 Filed 9–7–18; 8:45 am]
BILLING CODE 4163–18–P
DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Administration for Children and
Families
Proposed Information Collection
Activity; Comment Request
Title: Tribal Maternal, Infant, and
Early Childhood Home Visiting Program
Quarterly Performance Reporting Form.
OMB No.: New Collection.
Description: The Administration for
Children and Families (ACF), Office of
Child Care, in collaboration with the
Health Resources and Services
Administration (HRSA), Maternal and
Child Health Bureau, administers the
Maternal, Infant, and Early Childhood
Home Visiting (MIECHV) Program, as
authorized by Title V, Section 511 of the
Social Security Act. The Administration
for Children and Families administers
the Tribal MIECHV Program while
HRSA administers the State/Territory
MIECHV Program. Tribal MIECHV
discretionary grants support cooperative
agreements to conduct community
needs assessments; plan for and
implement high-quality, culturallyrelevant, evidence-based home visiting
programs in at-risk tribal communities;
establish, measure, and report on
progress toward meeting performance
measures in six legislatively-mandated
benchmark areas; and conduct rigorous
evaluation activities to build the
knowledge base on home visiting among
Native populations.
The proposed data collection form is
as follows: In order to continuously
monitor, provide grant oversight, quality
improvement guidance, and technical
assistance to Tribal MIECHV grantees,
ACF is seeking to collect services
utilization data on a quarterly basis. The
Tribal MIECHV Quarterly Data
Performance Reporting Form, is made
up of five categories of data—program
capacity, place-based services, family
engagement, staff recruitment and
retention and staff vacancies. This form
will be used by Tribal MIECHV grantees
that receive grants under the Tribal
MIECHV Program to collect data in
order to determine the caseload capacity
grantees are achieving, where services
are being delivered, the retention and
attrition of enrolled families, and the
retention and attrition of program staff
on a quarterly basis.
Respondents: Tribal Maternal, Infant,
and Early Childhood Home Visiting
Program Managers. The information
collection does not include direct
interaction with individuals or families
that receive the services.
daltland on DSKBBV9HB2PROD with NOTICES
ANNUAL BURDEN ESTIMATES
Number of
respondents
Number of
responses per
respondent
Average
burden per
response
(in hours)
Total
burden hours
Type of respondent
Form name
Tribal MIECHV Grantees ..................
Tribal MIECHV Quarterly Reporting
Form.
25
4
24
2,400
Total ...........................................
...........................................................
........................
........................
........................
2,400
Estimated Total Annual Burden
Hours: 2,400.
In compliance with the requirements
of the Paperwork Reduction Act of 1995
(Pub. L. 104–13, 44 U.S.C. Chap 35), the
Administration for Children and
Families is soliciting public comment
on the specific aspects of the
information collection described above.
Copies of the proposed collection of
VerDate Sep<11>2014
17:54 Sep 07, 2018
Jkt 244001
information can be obtained and
comments may be forwarded by writing
to the Administration for Children and
Families, Office of Planning, Research
and Evaluation, 330 C Street SW,
Washington DC 20201. Attn: ACF
Reports Clearance Officer. Email
address: infocollection@acf.hhs.gov. All
requests should be identified by the title
of the information collection.
PO 00000
Frm 00037
Fmt 4703
Sfmt 4703
The Department specifically requests
comments on: (a) Whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information shall have
practical utility; (b) the accuracy of the
agency’s estimate of the burden of the
proposed collection of information; (c)
the quality, utility, and clarity of the
E:\FR\FM\10SEN1.SGM
10SEN1
]]>Agencies
[Federal Register Volume 83, Number 175 (Monday, September 10, 2018)]
[Notices]
[Pages 45629-45630]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2018-19536]
=======================================================================
-----------------------------------------------------------------------
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Centers for Disease Control and Prevention
[Docket No. CDC-2017-0089]
Systematic Review and Final CDC Guideline on the Diagnosis and
Management of Mild Traumatic Brain Injury Among Children
AGENCY: Centers for Disease Control and Prevention (CDC), Department of
Health and Human Services (HHS).
ACTION: Notice; availability of final guidance.
-----------------------------------------------------------------------
SUMMARY: The Centers for Disease Control and Prevention (CDC), located
within the Department of Health and Human Services (HHS), announces the
availability of the Systematic Review and Final CDC Guideline on the
Diagnosis and Management of Mild Traumatic Brain Injury Among Children.
DATES: CDC published the final Systematic Review and Final CDC
Guideline on the Diagnosis and Management of Mild Traumatic Brain
Injury Among Children on September 4, 2018 in JAMA Pediatrics.
FOR FURTHER INFORMATION CONTACT: Arlene I. Greenspan, National Center
for Injury Prevention and Control, Centers for Disease Control and
Prevention, 4770 Buford Highway NE, Mailstop F-63, Atlanta, Georgia
30341. Telephone: (770) 488-4694; email: [email protected].
SUPPLEMENTARY INFORMATION: On September 29, 2017, CDC published a
notice in the Federal Register announcing the opening of a docket to
obtain public comment on a Systematic Review of the evidence on the
diagnosis, prognosis, and management of pediatric mild traumatic brain
injury (mTBI), and an evidence-based Guideline that offers clinical
recommendations for healthcare providers (82 FR 45588). CDC also
provided an opportunity for public comments during the National Center
for Injury Prevention and Control's Board of Scientific Counselors
meeting on September 7, 2016 (81 FR 49657).
The Systematic Review and Guideline were developed through a
rigorous process guided by the American Academy of Neurology
methodology and 2010 National Academy of Sciences methodology for the
development of evidence-based guidelines. An extensive review of the
scientific literature, spanning 25 years of research, formed the basis
of the Guideline.
The goal of the CDC Guideline is to help healthcare providers take
action to improve the health of their pediatric patients with mTBI. The
Guideline consists of 19 clinical recommendation sets that cover
diagnosis, prognosis, and management and treatment. These
recommendations are applicable to healthcare providers working in
inpatient, emergency, primary, and outpatient care settings. CDC
received comments on the draft Systematic Review and Guideline from two
external peer reviewers:
[ballot] Both provided references for literature that was published
following the close of the literature review period for the Guideline
and Systematic Review. Both reviewers requested details about
definitions of terms such as mTBI and concussion and how they are
similar or different.
[ballot] Other comments focused on how an existing consensus
statement on sports-related concussion aligns with CDC recommendations;
lack of information available on children who never seek medical
attention to highlight this current information gap; and specificity of
the recommendations for clinicians in the acute care and outpatient
settings.
CDC also received 10 public comments from professional
organizations, academia, and the public:
[ballot] Five were from medical and clinical professional
organizations. These groups shared their perspective on diagnosis and
treatment of mTBI and how specialty groups are affected differently.
[ballot] Two were from community members and parents sharing their
support of the work.
[[Page 45630]]
[ballot] One was from a commenter who did not provide an
affiliation. The commenter shared concerns regarding how the level of
evidence was graded.
[ballot] One was from a healthcare provider who shared citations
for consideration.
[ballot] One was from an advocacy group that provided a comment
outside the scope of the docket.
A summary of the revisions made to the final Systematic Review and
Guideline based on external peer reviewer comments are posted in the
Supporting Documents section of the docket (document titled ``Ped mTBI
Guideline Response to Peer Reviewer Comments'').
CDC also revised the document based on public comments. For
example, a few commenters expressed concern regarding recommendations
not being applicable in the emergency care setting. As the clinical
recommendations in the guideline were created for both the acute care
and primary care setting, CDC added language to emphasize that the
recommendations were drafted to be relevant for both settings. As
another example, multiple comments were received regarding the content
in the systematic review on the use of CT imaging. Commenters explained
that current evidence that provides the basis for CT imaging focus on
ruling out clinically-important traumatic brain injury among pediatric
patients presenting with a TBI. In response, CDC revised the conclusion
to specify that the recommendations are for children presenting with
mTBI versus TBI of all severity levels in the acute care setting. All
public and peer reviewer comments were carefully reviewed and
considered to strengthen and improve the quality of the Systematic
Review and Guideline. The final Systematic Review and Guideline on the
Diagnosis and Management of Mild Traumatic Brain Injury Among Children
can be found at https://jamanetwork.com/journals/jamapediatrics/fullarticle/2698456?guestAccessKey=80a9ecdc-ea57-447d-a1b3-b4a87cadd40d
(Guideline) and https://jamanetwork.com/journals/jamapediatrics/fullarticle/2698455?guestAccessKey=24b78e3d-571f-49fb-9daf-499d2b3e2cc1
(Systematic Review).
Dated: September 5, 2018.
Lauren Hoffmann,
Acting Executive Secretary, Centers for Disease Control and Prevention.
[FR Doc. 2018-19536 Filed 9-7-18; 8:45 am]
BILLING CODE 4163-18-P
