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These Searches Were Reviewed Independently By Two Members Of The Research Team, Who Applied Predefined, Broad Eligibility Criteria

Abstracts of each article retrieved by these searches were reviewed independently by two members of the research team, who applied predefined, broad eligibility criteria. When the two reviewers disagreed, a third reviewer read the abstract and cast the deciding vote on whether it should be included. In the event a reference did not have an abstract, and the title for the reference was not sufficient for determination of status, the article was retrieved and reviewed to determine its eligibility. The two reviewers examined each abstract and indicated whether it met the inclusion criteria and, if not, the reason for exclusion. If the abstract was eligible, or if it did not contain sufficient information to determine eligibility, the full text of the article was retrieved for review in the next phase of the selection process.

Eighty-seven articles pertaining to questions 1 and 2, 114 articles for question 3, 93 articles for question 4, and 69 articles for question 5 passed the eligibility screen. Sixty-seven additional articles were recommended for inclusion by experts or by review of reference lists of review articles. In all, 363 articles were retrieved for review and abstraction.

Additional criteria for inclusion were defined separately for each of the five questions. The criteria varied because the necessary types of studies varied from question to question. Articles that applied to more than one question were maintained as duplicates (or triplicates, etc.) in each question-specific file, so they could be considered for inclusion based on their relevance to each question.

Data Abstraction
An instrument was designed to record data abstracted from each eligible article. The instrument includes items for patient characteristics, interventions, cointerventions, outcomes, study methods, relevance to the specific research questions, and results of the study. The instrument has two components: the first four pages of the instrument apply to all articles specified for inclusion in the study; the remaining pages are individual instruments that apply to one of the five questions. To abstract an article, a reader used the initial abstraction instrument plus one or more of the five question instruments.

The first few questions of the initial abstraction instrument allowed the reviewer to determine if the article actually met the eligibility criteria for inclusion in the report. If an article was determined to be ineligible, it was passed to a second reader for confirmation. The remaining articles were subjected to the full abstraction protocol.

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	Did You Know?
	Brain damage has many causes. Brain damage may be caused by external physical force, insufficient blood supply, toxic substances, malignancy, disease-producing organisms, congenital disorders, birth trauma or degenerative processes.