@article{438e66d6749f4ac19dab91c5eddefacf,
title = "Test-Retest Reliability and Efficacy of Individual Symptoms in Concussion Management",
abstract = "Objective: (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 5 5519) and cadets (n 5 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 5 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.",
keywords = "dizziness, headache, mild traumatic brain injury, pressure in the head, sport concussion assessment tool",
author = "{CARE Consortium Investigators} and Caccese, {Jaclyn B.} and Garcia, {Gian Gabriel P.} and Kontos, {Anthony P.} and Nicholas Port and Kate Valerio and Broglio, {Steven P.} and Michael McCrea and McAllister, {Thomas W.} and Pasquina, {Paul F.} and Buckley, {Thomas A.} and A. Hoy and Kelly, {L. A.} and J. DiFiori and Ortega, {J. D.} and M. Putukian and J. McDevitt and Giza, {C. C.} and Goldman, {J. T.} and Benjamin, {H. J.} and Kaminski, {T. W.} and Clugston, {J. R.} and O'Donnell, {P. G.} and Feigenbaum, {L. A.} and Eckner, {J. T.} and Mihalik, {J. P.} and {Dysart Miles}, J. and S. Anderson and Master, {C. L.} and M. Collins and Chrisman, {S. P.O.} and A. Brooks and Jackson, {J. C.} and C. Estevez and Svoboda, {S. J.} and Cameron, {K. L.} and Susmarski, {A. J.} and S. Duma and S. Rowson and Miles, {C. M.} and L. Lintner",
note = "Funding Information: 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. W81XWH1420151. Opinions, interpretations, conclusions, and recommendations are those of the author and are not necessarily endorsed by the Department of Defense. Data collection and sharing for this project was conducted with support from the National Collegiate Athletic Association (NCAA) and the Department of Defense (DOD). The US Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. Funding Information: Data collection and sharing for this project was conducted with support from the National Collegiate Athletic Association (NCAA) and the Department of Defense (DOD). The US Army Medical Research Acquisition Activity, 820 Chandler Street, Fort Detrick MD 21702-5014 is the awarding and administering acquisition office. Funding Information: 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. W81XWH1420151. Opinions, interpretations, conclusions, and recommendations are those of the author and are not necessarily endorsed by the Department of Defense. Publisher Copyright: {\textcopyright} 2022 Wolters Kluwer Health, Inc. All rights reserved.",
year = "2023",
month = jan,
day = "1",
doi = "10.1097/JSM.0000000000001084",
language = "English",
volume = "33",
pages = "52--60",
journal = "Clinical Journal of Sport Medicine",
issn = "1050-642X",
number = "1",
}