自我报告的脑震荡病史：提供脑震荡定义的影响
Self-reported concussion history: impact of providing a definition of concussion.
作者信息
Robbins Clifford A, Daneshvar Daniel H, Picano John D, Gavett Brandon E, Baugh Christine M, Riley David O, Nowinski Christopher J, McKee Ann C, Cantu Robert C, Stern Robert A
机构信息
Center for the Study of Traumatic Encephalopathy, Boston University School of Medicine, Boston, MA, USA.
Center for the Study of Traumatic Encephalopathy, Boston University School of Medicine, Boston, MA, USA ; Department of Neurology, Boston University School of Medicine, Boston, MA, USA.
出版信息
Open Access J Sports Med. 2014 May 7;5:99-103. doi: 10.2147/OAJSM.S58005. eCollection 2014.
BACKGROUND
In recent years, the understanding of concussion has evolved in the research and medical communities to include more subtle and transient symptoms. The accepted definition of concussion in these communities has reflected this change. However, it is unclear whether this shift is also reflected in the understanding of the athletic community.
WHAT IS KNOWN ABOUT THE SUBJECT
Self-reported concussion history is an inaccurate assessment of someone's lifetime exposure to concussive brain trauma. However, unfortunately, in many cases it is the only available tool.
HYPOTHESIS/PURPOSE: We hypothesize that athletes' self-reported concussion histories will be significantly greater after reading them the current definition of concussion, relative to the reporting when no definition was provided. An increase from baseline to post-definition response will suggest that athletes are unaware of the currently accepted medical definition.
STUDY DESIGN
Cross-sectional study of 472 current and former athletes.
METHODS
Investigators conducted structured telephone interviews with current and former athletes between January 2010 and January 2013, asking participants to report how many concussions they had received in their lives. Interviewers then read participants a current definition of concussion, and asked them to re-estimate based on that definition.
RESULTS
THE TWO ESTIMATES WERE SIGNIFICANTLY DIFFERENT (WILCOXON SIGNED RANK TEST: z=15.636, P<0.001). Comparison of the baseline and post-definition medians (7 and 15, respectively) indicated that the post-definition estimate was approximately twice the baseline. Follow-up analyses indicated that this effect was consistent across all levels of competition examined and across type of sport (contact versus non-contact).
CONCLUSION
Our results indicate that athletes' current understandings of concussions are not consistent with a currently accepted medical definition. We strongly recommend that clinicians and researchers preface requests for self-reported concussion history with a definition. In addition, it is extremely important that researchers report the definition they used in published manuscripts of their work.
WHAT THIS STUDY ADDS TO EXISTING KNOWLEDGE
Our study shows that unprompted reporting of concussion history produces results that are significantly different from those provided after a definition has been given, suggesting one possible mechanism to improve the reliability of self-reported concussion history across multiple individuals.
背景
近年来，研究和医学界对脑震荡的认识不断发展，将更多细微和短暂的症状纳入其中。这些领域中公认的脑震荡定义也反映了这一变化。然而，尚不清楚这种转变是否也体现在体育界的认知中。
关于该主题已知的信息
自我报告的脑震荡病史并不能准确评估某人一生中遭受脑震荡性脑损伤的情况。然而，不幸的是，在许多情况下它是唯一可用的工具。
假设/目的：我们假设，相对于未提供定义时的报告，向运动员宣读当前脑震荡定义后，他们自我报告的脑震荡病史会显著增加。从基线反应到定义后反应的增加将表明运动员不了解当前公认的医学定义。
研究设计
对472名现役和退役运动员进行横断面研究。
方法
研究人员在2010年1月至2013年1月期间对现役和退役运动员进行了结构化电话访谈，询问参与者他们一生中遭受过多少次脑震荡。访谈者随后向参与者宣读了当前的脑震荡定义，并要求他们根据该定义重新估计。
结果
两次估计有显著差异（威尔科克森符号秩检验：z = 15.636，P < 0.001）。基线和定义后中位数（分别为7和15）的比较表明，定义后估计约为基线的两倍。后续分析表明，在所有检查的比赛级别和运动类型（接触性与非接触性）中，这种效应都是一致的。
结论
我们的结果表明，运动员目前对脑震荡的理解与当前公认的医学定义不一致。我们强烈建议临床医生和研究人员在要求自我报告脑震荡病史时先给出定义。此外，研究人员在其工作的已发表手稿中报告他们使用的定义极其重要。
本研究对现有知识的补充
我们的研究表明，在未提示的情况下报告脑震荡病史所产生的结果与给出定义后提供的结果有显著差异，这表明了一种可能提高多个个体自我报告脑震荡病史可靠性的机制。
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