The sensitivity and specificity of clinical measures of sport concussion: three tests are better than one.
BMJ Open Sport Exerc Med
; 2(1): e000012, 2016.
Article
en En
| MEDLINE
| ID: mdl-27900145
ABSTRACT
CONTEXT A battery of clinical measures of neurocognition, balance and symptoms has been recommended for the management of sport concussion (SC) but is based on variable evidence. OBJECTIVE:
To examine the sensitivity and specificity of a battery of tests to assess SC in college athletes.DESIGN:
Cross-sectional.SETTING:
Research laboratory. PATIENTS OR OTHERPARTICIPANTS:
Division 1 athletes diagnosed with a SC (n=40) who were 20.2±1.60â years of age and 180.5±11.12â cm tall and healthy athletes (n=40) who were 19.0±0.93â years of age and 179.1±11.39â cm tall were enrolled.INTERVENTIONS:
Participants were administered Immediate Postconcussion Assessment and Cognitive Test (ImPACT), the Sensory Organization Test (SOT) and the Revised Head Injury Scale (HIS-r) prior to and up to 24â h following injury between the 2004 and 2014 sport seasons. Sensitivity and specificity were calculated using predictive discriminant analyses (PDA) and clinical interpretation guidelines. MAIN OUTCOMEMEASURES:
Outcome measures included baseline and postinjury ImPACT, SOT and HIS-r composite scores.RESULTS:
Using PDA, each clinical measure's sensitivity ranged from 55.0% to 77.5% and specificity ranged from 52.5% to 100%. The test battery possessed a sensitivity and specificity of 80.0% and 100%, respectively. Using clinical interpretation guidelines, sensitivity ranged from 55% to 97.5% individually, and 100% when combined.CONCLUSIONS:
Our results support a multidimensional approach to assess SC in college athletes which correctly identified 80-100% of concussed participants as injured. When each test was evaluated separately, up to 47.5% of our sample was misclassified. Caution is warranted when using singular measures to manage SC.
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Tipo de estudio:
Diagnostic_studies
/
Guideline
/
Prognostic_studies
Idioma:
En
Revista:
BMJ Open Sport Exerc Med
Año:
2016
Tipo del documento:
Article
País de afiliación:
Ciudad del Vaticano