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Title: What tests and measures accurately diagnose persisting post-concussive symptoms in children, adolescents and adults following sport-related concussion? A systematic review.
Austin Authors: Yeates, Keith Owen;Räisänen, Anu M;Premji, Zahra;Debert, Chantel T;Frémont, Pierre;Hinds, Sidney;Smirl, Jonathan D;Barlow, Karen;Davis, Gavin A ;Echemendia, Ruben J;Feddermann-Demont, Nina;Fuller, Colm;Gagnon, Isabelle;Giza, Christopher C;Iverson, Grant L;Makdissi, Michael;Schneider, Kathryn J
Affiliation: Department of Psychology, University of Calgary, Calgary, Alberta, Canada
Department of Physical Therapy Education - Oregon, Western University of Health Sciences, College of Health Sciences - Northwest, Lebanon, Oregon, USA.
Libraries, University of Victoria, Victoria, British Columbia, Canada.
Department of Clinical Neuroscience, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada.
Department of Rehabilitation, Laval University, Quebec, Quebec, Canada.
Uniformed Services University, Bethesda, Maryland, USA.
Sport Injury Prevention Research Centre, Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada.
Child Health Research Centre, Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia.
Murdoch Children's Research Institute, Parkville, Victoria, Australia.
Department of Psychology, University of Missouri, Kansas City, Missouri, USA.
Department of Neurology, University Hospital Zurich, Zurich, Switzerland
College of Medicine and Health, University College Cork, Cork, Ireland
School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada.
Department of Neurosurgery, UCLA Steve Tisch BrainSPORT Program, Los Angeles, California, USA
Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
The Florey Institute of Neuroscience and Mental Health
Alberta Children's Hospital Research Institute, University of Calgary, Calgary, Alberta, Canada.
Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
Faculty of Kinesiology, University of Calgary, Calgary, Alberta, Canada
Cabrini Health, Malvern, Victoria, Australia
Psychological and Neurobehavioral Associates, Inc, State College, Pennsylvania, USA.
Sports Neuroscience, University of Zurich, Zurich, Switzerland.
Sports Medicine Department, Sports Surgery Clinic, Dublin, Ireland.
Trauma Center, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
Department of Pediatrics/Pediatric Neurology, Mattel Children's Hospital UCLA, Los Angeles, California, USA.
Sports Concussion Program, MassGeneral Hospital for Children, Boston, Massachusetts, USA.
Australian Football League, Melbourne, Victoria, Australia.
Issue Date: Jun-2023
Publication information: British Journal of Sports Medicine 2023
Abstract: To determine what tests and measures accurately diagnose persisting post-concussive symptoms (PPCS) in children, adolescents and adults following sport-related concussion (SRC). A systematic literature review. MEDLINE, Embase, PsycINFO, Cochrane Central Register of Controlled Trials, CINAHL and SPORTDiscus through March 2022. Original, empirical, peer-reviewed findings (cohort studies, case-control studies, cross-sectional studies and case series) published in English and focused on SRC. Studies needed to compare individuals with PPCS to a comparison group or their own baseline prior to concussion, on tests or measures potentially affected by concussion or associated with PPCS. Of 3298 records screened, 26 articles were included in the qualitative synthesis, including 1016 participants with concussion and 531 in comparison groups; 7 studies involved adults, 8 involved children and adolescents and 11 spanned both age groups. No studies focused on diagnostic accuracy. Studies were heterogeneous in participant characteristics, definitions of concussion and PPCS, timing of assessment and the tests and measures examined. Some studies found differences between individuals with PPCS and comparison groups or their own pre-injury assessments, but definitive conclusions were not possible because most studies had small convenience samples, cross-sectional designs and were rated high risk of bias. The diagnosis of PPCS continues to rely on symptom report, preferably using standardised symptom rating scales. The existing research does not indicate that any other specific tool or measure has satisfactory accuracy for clinical diagnosis. Future research drawing on prospective, longitudinal cohort studies could help inform clinical practice.
DOI: 10.1136/bjsports-2022-106657
ORCID: 0000-0001-7680-2892
Journal: British Journal of Sports Medicine
Start page: 780
End page: 788
PubMed URL: 37316186
ISSN: 1473-0480
Type: Journal Article
Subjects: Brain Concussion
Post-Concussion Syndrome/diagnosis
Brain Concussion/diagnosis
Appears in Collections:Journal articles

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