TY - GEN
T1 - Simulation-Optimization to Distinguish Optimal Symptom Free Waiting Period for Return-to-Play Decisions in Sport-Related Concussion
AU - Garcia, Gian Gabriel P.
AU - Czerniak, Lauren L.
AU - Lavieri, Mariel S.
AU - Liebel, Spencer W.
AU - McCrea, Michael A.
AU - McAllister, Thomas W.
AU - Pasquina, Paul F.
AU - Broglio, Steven P.
N1 - Funding Information:
This publication was made possible in part by the National Collegiate Athletic Association (NCAA) and the Department of Defense (DOD). The U.S. Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. This work was supported by the Office of the Assistant Secretary of Defense for Health Affairs, through the Combat Casualty Care Research Program, endorsed by the Department of Defense, through the Joint Program Committee 6/ Combat Casualty Care Research Program – Psychological Health and Traumatic Brain Injury Program under Award No. W81XWH1820047. Opinions, interpretations, conclusions, and recommendations are those of the author and are not necessarily endorsed by the Department of Defense. Lauren Czerniak was supported by the National Science Foundation Research Fellowship Program [Grant DGE 1841052]. Lauren Czerniak and Mariel Lavieri received support from the NSF CAREER Award [CMMI-1552545].
Publisher Copyright:
© 2022 IEEE.
PY - 2022
Y1 - 2022
N2 - Approximately 1.6-3.8 million sport and recreation concussions occur annually. Yet, there is currently no universal agreement on when an athlete should be permitted to unrestricted play after being diagnosed with a concussion. Simulation-optimization provides a tractable method to optimize the length of the symptom-free waiting period (SFWP), i.e., the number of consecutive days after starting the return-to-play protocol that an athlete must be symptom-free before they are permitted to unrestricted play. We develop a two-part treatment initiation/cessation simulation model consisting of a (1) Controlled Hidden Markov Model [pre-return-to-play] and (2) Uncontrolled Markov Chain [post-return-to-play] and apply four simulation-optimization methods (Crude Monte Carlo, 2-Stage Decomposition, NSGS, KN) to optimize the SFWP. For collegiate men's football and women's soccer, we find an optimal SFWP of approximately 2 and 3.5 weeks, respectively. This research provides clinical decision-support for return-to-play decisions.
AB - Approximately 1.6-3.8 million sport and recreation concussions occur annually. Yet, there is currently no universal agreement on when an athlete should be permitted to unrestricted play after being diagnosed with a concussion. Simulation-optimization provides a tractable method to optimize the length of the symptom-free waiting period (SFWP), i.e., the number of consecutive days after starting the return-to-play protocol that an athlete must be symptom-free before they are permitted to unrestricted play. We develop a two-part treatment initiation/cessation simulation model consisting of a (1) Controlled Hidden Markov Model [pre-return-to-play] and (2) Uncontrolled Markov Chain [post-return-to-play] and apply four simulation-optimization methods (Crude Monte Carlo, 2-Stage Decomposition, NSGS, KN) to optimize the SFWP. For collegiate men's football and women's soccer, we find an optimal SFWP of approximately 2 and 3.5 weeks, respectively. This research provides clinical decision-support for return-to-play decisions.
UR - http://www.scopus.com/inward/record.url?scp=85147448350&partnerID=8YFLogxK
U2 - 10.1109/WSC57314.2022.10015285
DO - 10.1109/WSC57314.2022.10015285
M3 - Conference contribution
AN - SCOPUS:85147448350
T3 - Proceedings - Winter Simulation Conference
SP - 1021
EP - 1032
BT - Proceedings of the 2022 Winter Simulation Conference, WSC 2022
A2 - Feng, B.
A2 - Pedrielli, G.
A2 - Peng, Y.
A2 - Shashaani, S.
A2 - Song, E.
A2 - Corlu, C.G.
A2 - Lee, L.H.
A2 - Chew, E.P.
A2 - Roeder, T.
A2 - Lendermann, P.
PB - Institute of Electrical and Electronics Engineers Inc.
Y2 - 11 December 2022 through 14 December 2022
ER -