Agreement Between Athlete-Recalled and Clinically Documented Concussion Histories in Former Collegiate Athletes
Agreement Between Athlete-Recalled and Clinically Documented Concussion Histories in Former Collegiate Athletes
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DOI：
10.1177/0363546514562180
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发表时间：
2015-03-01
影响因子：
4.8
通讯作者：
Marshall, Stephen W.
中科院分区：
文献类型：
--
作者：
Kerr, Zachary Y.;Mihalik, Jason P.;Marshall, Stephen W.
背景：运动员回忆和临床记录的脑震荡病史已被用于对前运动员的研究，但两者都有局限性。比较这两种类型的脑震荡历史是必要的，以提高准确性的估计脑震荡的历史，为未来的研究和临床护理。目的：估计之间的协议运动员回忆和临床记录的脑震荡历史在大学期间，并探讨差异的原因。研究：队列研究证据等级：3.方法：运动员回忆的脑震荡史是由130名前大学运动员使用在线问卷提供的，他们分别与之前收集的临床数据相关联，这些数据追踪了1996年至2012年在主办机构进行的医学诊断的脑震荡。组内相关系数（ICC 2，1）用于评估运动员回忆和临床记录的脑震荡病史之间的一致性。进行描述性分析以评估不一致的原因。结果：运动员回忆的脑震荡病史与临床记录的脑震荡病史之间的一致性较低（ICC 2，1 = 0.21; 95%置信区间，0.05-0.37），但女性更高（ICC 2，1 = 0.65; 95%置信区间，0.44-0.79）和最近参加比赛的运动员（2005-2012; ICC 2，1 = 0.39; 95%置信区间，0.01-0.67）。在53名自我报告与大学运动有关的脑震荡的运动员中，40%的人认为他们持续的撞击应该被诊断为脑震荡，但没有被发现，21%的人承认没有透露疑似脑震荡。不公开的常见原因包括：认为伤势不够严重（91%），不知道是脑震荡（73%），不想离开比赛/练习（73%）。鉴于运动员回忆和临床记录的脑震荡病史之间的一致性很低，需要进行方法学研究，以提高用于评估前运动员脑震荡史的工具的质量。
Background: Athlete-recalled and clinically documented concussion histories have been used in research on former athletes, but both have limitations. Comparisons of these 2 types of concussion histories are needed to improve the accuracy of estimates of concussion history for future research and clinical care.Purpose: To estimate the agreement between athlete-recalled and clinically documented concussion histories during college and to explore reasons for differences.Study: Cohort study (diagnosis); Level of evidence, 3.Methods: Athlete-recalled concussion histories were provided by a convenience sample of 130 former collegiate athletes using an online questionnaire, and they were individually linked to previously collected clinical data that tracked medically diagnosed concussions at the host institution from 1996 to 2012. The intraclass correlation coefficient (ICC2,1) was used to assess agreement between athlete-recalled and clinically documented concussion histories. Descriptive analyses were performed to assess reasons for disagreement.Results: Agreement between athlete-recalled and clinically documented concussion histories was low (ICC2,1 = 0.21; 95% confidence interval, 0.05-0.37), but it was higher for women (ICC2,1 = 0.65; 95% confidence interval, 0.44-0.79) and for athletes playing more recently (2005-2012; ICC2,1 = 0.39; 95% confidence interval, 0.01-0.67). Of the 53 athletes who self-reported college sports-related concussions, 40% believed that they sustained impacts that should have been diagnosed as concussions but were undetected, and 21% admitted nondisclosure of suspected concussions. Common reasons for nondisclosure included the following: did not think injury was serious enough (91%), did not know it was a concussion (73%), and did not want to leave the game/practice (73%).Conclusion: Given the low agreement between athlete-recalled and clinically documented concussion histories, methodologic research is needed to improve the quality of tools used to assess concussion histories in former athletes.