Kerr Zachary Y, Mihalik Jason P, Guskiewicz Kevin M, Rosamond Wayne D, Evenson Kelly R, Marshall Stephen W
Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Center for the Study of Retired Athletes, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Matthew A. Gfeller Sport-Related Traumatic Brain Injury Research Center, Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Am J Sports Med. 2015 Mar;43(3):606-13. doi: 10.1177/0363546514562180. Epub 2015 Jan 5.
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.
To estimate the agreement between athlete-recalled and clinically documented concussion histories during college and to explore reasons for differences.
Cohort study (diagnosis); Level of evidence, 3.
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.
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%).
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.
运动员回忆的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。需要对这两种类型的脑震荡病史进行比较，以提高未来研究和临床护理中脑震荡病史估计的准确性。
评估大学期间运动员回忆的和临床记录的脑震荡病史之间的一致性，并探讨差异的原因。
队列研究（诊断）；证据等级，3级。
通过在线问卷，对130名前大学运动员的便利样本提供运动员回忆的脑震荡病史，并将其分别与1996年至2012年在主办机构收集的跟踪医学诊断脑震荡的先前临床数据相关联。组内相关系数（ICC2,1）用于评估运动员回忆的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。
运动员回忆的和临床记录的脑震荡病史之间的一致性较低（ICC2,1 = 0.21；95%置信区间，0.05 - 0.37），但女性（ICC2,1 = 0.65；95%置信区间，0.44 - 0.79）和近期（2005 - 2012年）参赛的运动员（ICC2,1 = 0.39；95%置信区间，0.01 - 0.67）的一致性较高。在53名自我报告有大学体育相关脑震荡的运动员中，40%认为他们受到了本应被诊断为脑震荡但未被检测到的撞击，21%承认未披露疑似脑震荡情况。未披露的常见原因包括：认为伤势不够严重（91%）、不知道这是脑震荡（73%）以及不想离开比赛/训练（73%）。
鉴于运动员回忆的和临床记录的脑震荡病史之间的一致性较低，需要进行方法学研究以提高用于评估前运动员脑震荡病史的工具的质量。
