Fuller Gordon Ward, Miles John, Tucker Ross, Douglas Marc, Raftery Martin, Falvey Eanna, Mathema Prabhat
Centre for Urgent and Emergency Care Research, School of Health and Related Research, University of Sheffield, Regent Court, 30 Regent Street, Sheffield, S1 4DA, UK.
Wales Rugby Union, Principality Stadium, Westgate Street, Cardiff, CF10 1NS, UK.
Sports Med Open. 2021 Feb 15;7(1):14. doi: 10.1186/s40798-021-00303-z.
The Sports Concussion Assessment Tool (SCAT) is recommended to screen for concussion following head impact events in elite sport. The most recent 5th edition (SCAT5) included a 'rapid neurological screen' which introduced new subtests examining comprehension, passive neck movement, and diplopia. This study evaluated the additional diagnostic value of these new subtests.
A prospective cohort study was performed in the Pro14 elite Rugby Union competition between September 2018 and January 2020. The SCAT5 was administered by the team doctor to players undergoing off-field screening for concussion during a medical room assessment. Sensitivity, specificity, false negatives, and positives were examined for SCAT5 comprehension, passive neck movement, and diplopia subtests. The reference standard was a final diagnosis of concussion, established by serial standardised clinical assessments over 48 h.
Ninety-three players undergoing off-field screening for concussion were included. Sensitivity and specificity of the comprehension, passive neck movement, and diplopia subtests were 0, 8, 5% and 0, 91, 97%, respectively (concussion prevalence 63%). No players had any abnormality in comprehension. No players had abnormal passive neck movement or diplopia in the absence of abnormalities in other SCAT5 sub-components.
The new SCAT5 neurological screen subtests are normal in the majority of players undergoing off-field concussion screening and appear to lack diagnostic utility over and above other SCAT5 subtests.
运动性脑震荡评估工具（SCAT）被推荐用于精英运动中头部撞击事件后脑震荡的筛查。最新的第5版（SCAT5）包含一个“快速神经学筛查”，其中引入了新的子测试来检查理解力、被动颈部运动和复视。本研究评估了这些新子测试的额外诊断价值。
在2018年9月至2020年1月期间的Pro14精英橄榄球联盟比赛中进行了一项前瞻性队列研究。团队医生在医务室评估期间，对在场外接受脑震荡筛查的球员进行SCAT5测试。对SCAT5的理解力、被动颈部运动和复视子测试的敏感性、特异性、假阴性和假阳性进行了检查。参考标准是通过48小时内的系列标准化临床评估确定的脑震荡最终诊断。
纳入了93名在场外接受脑震荡筛查的球员。理解力、被动颈部运动和复视子测试的敏感性和特异性分别为0%、8%、5%和0%、91%、97%（脑震荡患病率63%）。没有球员在理解力方面有任何异常。在其他SCAT5子组件无异常的情况下，没有球员出现被动颈部运动或复视异常。
在大多数在场外接受脑震荡筛查的球员中，新的SCAT5神经学筛查子测试结果正常，并且似乎在诊断效用上并不优于其他SCAT5子测试。
