Two studies were reanalyses of a prior publication; these were not classified as new studies but were evaluated

and the findings are discussed. We fully reviewed and evaluated 112 studies. For these 112 studies, the level of evidence was determined based on criteria used in our prior reviews.1 and 2 Well-designed, prospective, RCTs were considered class I evidence; studies using buy Roscovitine a prospective design with quasi-randomized assignment to treatment conditions were designated as class Ia studies. Given the inherent difficulty in blinding rehabilitation interventions, we did not consider this as criterion for class I or Ia studies, LDK378 manufacturer consistent with our prior reviews. Class II studies consisted of prospective, nonrandomized cohort studies; retrospective,

nonrandomized case-control studies; or multiple-baseline studies that permitted a direct comparison of treatment conditions. Clinical series without concurrent controls, or single-subject designs with adequate quantification and analysis were considered class III evidence. Studies that were designed as comparative effectiveness studies but did not include a direct statistical comparison of treatment conditions were considered class III; this occurred for 4 articles. Disagreements between the 2 primary reviewers (as occurred for 3 articles) were first addressed by discussion between reviewers to correct minor sources of disagreement,

and then by obtaining a third review. Of the 112 studies, 14 were rated as class I, 5 as class Ia, 11 as class II, and 82 as class III. The overall evidence within each predefined to area of intervention was synthesized and recommendations were derived from the relative strengths of the evidence. The level of evidence required to determine Practice Standards, Practice Guidelines, or Practice Options was based on the decision rules applied in our initial review ( table 1). All recommendations were reviewed for consensus by the entire task force through face-to-face discussion. We reviewed 2 class I studies9 and 10 and 6 class III studies11, 12, 13, 14, 15 and 16 addressing remediation of attention. A class I study9 investigated the effectiveness of cognitive remediation and cognitive-behavioral psychotherapy for participants with persisting complaints after mild or moderate TBI. The cognitive remediation consisted of direct attention training along with training in use of a memory notebook and problem-solving strategies. Cognitive-behavioral therapy was used to increase coping behaviors and reduce stress.