Quantifying the Value of Multidimensional Assessment Models for Acute Concussion: An Analysis of Data from the NCAA-DoD Care Consortium

Sports Medicine
Gian-Gabriel P GarciaCARE Consortium Investigators

Abstract

Many concussion assessment methods exist, but few studies quantify the performance of these methods to determine which can best assess acute concussion alone or in combination. The objectives of this study were to evaluate: (1) selected concussion assessments for acute concussion assessment; (2) the utility of change scores for acute concussion assessment; and (3) concussion assessment capabilities when constrained to limited clinical data or objective clinical measures. The 'acute concussion' group contained assessments from < 6 h post-injury (n = 560) and 24-48 h post-injury (n = 733). The 'normal performance' group contained assessments from baseline testing (n = 842) and unrestricted return to play (n = 707) timepoints. Univariate and multivariate logistic regression models were created separately for < 6- and 24- to 48-h timepoints. Models were evaluated on sensitivity, specificity, and area under the receiver operating characteristic curve. Within the univariate analysis, Sport Concussion Assessment Tool symptom assessments had the highest combination of sensitivity, specificity, and area under the receiver operating characteristic curve, with values up to 0.93, 0.97, and 0.98, respectively. Full models had a sensitivity,...Continue Reading

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