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  • Ovid Technologies (Wolters Kluwer Health)  (3)
  • Caccese, Jaclyn B.  (3)
  • 1
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    Online Resource
    Preinjury Measures Do Not Predict Future Concussion Among Collegiate Student-Athletes : Findings From the CARE Consortium
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  American Journal of Physical Medicine & Rehabilitation Vol. 102, No. 9 ( 2023-9), p. 823-828
    Details
    In: American Journal of Physical Medicine & Rehabilitation, Ovid Technologies (Wolters Kluwer Health), Vol. 102, No. 9 ( 2023-9), p. 823-828
    Abstract: This prospective cohort study aimed to determine whether preinjury characteristics and performance on baseline concussion assessments predicted future concussions among collegiate student-athletes. Participant cases (concussed = 2529; control = 30,905) completed preinjury: demographic forms (sport, concussion history, sex), Immediate Post-Concussion Assessment and Cognitive Test, Balance Error Scoring System, Sport Concussion Assessment Tool symptom checklist, Standardized Assessment of Concussion, Brief Symptom Inventory–18 item, Wechsler Test of Adult Reading, and Brief Sensation Seeking Scale. We used machine-learning logistic regressions with area under the curve, sensitivity, and positive predictive values statistics for univariable and multivariable analyses. Primary sport was determined to be the strongest univariable predictor (area under the curve = 64.3% ± 1.4, sensitivity = 1.1% ± 1.4, positive predictive value = 4.9% ± 6.5). The all-predictor multivariable model was the strongest (area under the curve = 68.3% ± 1.6, sensitivity = 20.7% ± 2.7, positive predictive value = 16.5% ± 2.0). Despite a robust sample size and novel analytical approaches, accurate concussion prediction was not achieved regardless of modeling complexity. The strongest positive predictive value (16.5%) indicated only 17 of every 100 individuals flagged would experience a concussion. These findings suggest preinjury characteristics or baseline assessments have negligible utility for predicting subsequent concussion. Researchers, healthcare providers, and sporting organizations therefore should not use preinjury characteristics or baseline assessments for future concussion risk identification at this time.
    Type of Medium: Online Resource
    ISSN: 1537-7385 , 0894-9115
    URL: Article
    DOI: 10.1097/PHM.0000000000002302
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2272463-1
    detail.hit.zdb_id: 2049617-5
    SSG: 31
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  • 2
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    Online Resource
    Test–Retest Reliability and Efficacy of Individual Symptoms in Concussion Management
    Ovid Technologies (Wolters Kluwer Health) ; 2023
    In:  Clinical Journal of Sport Medicine Vol. 33, No. 1 ( 2023-01), p. 52-60
    Details
    In: Clinical Journal of Sport Medicine, Ovid Technologies (Wolters Kluwer Health), Vol. 33, No. 1 ( 2023-01), p. 52-60
    Abstract: (1) To determine test–retest reliability of individual Sport Concussion Assessment Tool—Third Edition (SCAT-3) symptom scores and symptom severity scores, (2) to examine the specificity/sensitivity of individual SCAT-3 symptom severity scores acutely (24-48 hours) postconcussion, and (3) to develop a model of symptoms best able to differentiate concussed from nonconcussed student athletes and cadets. Design: Prospective, longitudinal, and cross-sectional. Setting: Twenty-six civilian schools and 3 US service academies. Participants: Collegiate student athletes (n = 5519) and cadets (n = 5359) from the National Collegiate Athletic Association–Department of Defense Grand Alliance: Concussion Assessment, Research and Education Consortium, including 290 student athletes and 205 cadets, assessed 24 to 48 hours postconcussion. Independent Variables: Concussed and nonconcussed student athlete and cadet groups. Main Outcome Measures: Sport Concussion Assessment Tool—Third Edition individual symptom severity scores, total symptom scores, and symptom severity scores. Results: Results indicated poor test–retest reliability across all symptom scores (intraclass correlation coefficient = 0.029-0.331), but several individual symptoms had excellent predictive capability in discriminating concussed from nonconcussed participants (eg, headache, pressure in the head, and don't feel right had area under the curve 〉 0.8, sensitivity 〉 70%, and specificity 〉 85%) regardless of baseline testing. These symptoms were consistent with Chi-square Automatic Interaction Detector classification trees with the highest mean probability. Conclusions: Findings support the excellent diagnostic accuracy of honest symptom reporting, notwithstanding the known limitations in symptom underreporting, and suggest that there may be added value in examining individual symptoms rather than total symptom scores and symptom severity scores alone. Finally, findings suggest that baseline testing is not necessary for interpreting postconcussion symptom scores.
    Type of Medium: Online Resource
    ISSN: 1050-642X
    URL: Article
    DOI: 10.1097/JSM.0000000000001084
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2023
    detail.hit.zdb_id: 2045233-0
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  • 3
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    Online Resource
    Estimated age of first exposure to American football and outcome from concussion
    Ovid Technologies (Wolters Kluwer Health) ; 2020
    In:  Neurology Vol. 95, No. 21 ( 2020-11-24), p. e2935-e2944
    Details
    In: Neurology, Ovid Technologies (Wolters Kluwer Health), Vol. 95, No. 21 ( 2020-11-24), p. e2935-e2944
    Abstract: To examine the association between estimated age at first exposure (eAFE) to American football and clinical measures throughout recovery following concussion. Methods Participants were recruited across 30 colleges and universities as part of the National Collegiate Athletic Association (NCAA)–Department of Defense Concussion Assessment, Research and Education Consortium. There were 294 NCAA American football players (age 19 ± 1 years) evaluated 24–48 hours following concussion with valid baseline data and 327 (age 19 ± 1 years) evaluated at the time they were asymptomatic with valid baseline data. Participants sustained a medically diagnosed concussion between baseline testing and postconcussion assessments. Outcome measures included the number of days until asymptomatic, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) composite scores, Balance Error Scoring System (BESS) total score, and Brief Symptom Inventory 18 (BSI-18) subscores. The eAFE was defined as participant's age at the time of assessment minus self-reported number of years playing football. Results In unadjusted regression models, younger eAFE was associated with lower (worse) ImPACT Visual Motor Speed ( R 2 = 0.031, p = 0.012) at 24–48 hours following injury and lower (better) BSI-18 Somatization subscores ( R 2 = 0.014, p = 0.038) when the athletes were asymptomatic. The effect sizes were very small. The eAFE was not associated with the number of days until asymptomatic, other ImPACT composite scores, BESS total score, or other BSI-18 subscores. Conclusion Earlier eAFE to American football was not associated with longer symptom recovery, worse balance, worse cognitive performance, or greater psychological distress following concussion. In these NCAA football players, longer duration of exposure to football during childhood and adolescence appears to be unrelated to clinical recovery following concussion.
    Type of Medium: Online Resource
    ISSN: 0028-3878 , 1526-632X
    URL: Article
    DOI: 10.1212/WNL.0000000000010672
    RVK:
    XA 10000
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2020
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