Erdman Nicholas K, Kelshaw Patricia M, Hacherl Samantha L, Caswell Shane V
Sports Medicine Assessment Research & Testing (SMART) Laboratory, Athletic Training Education Program, School of Kinesiology, George Mason University, 10890 George Mason Circle, Katherine Johnson Hall 221, MSN 4E5, Manassas, VA, 20110, USA.
Virginia Concussion Initiative, George Mason University, Manassas, VA, USA.
Sports Med Open. 2022 Aug 13;8(1):104. doi: 10.1186/s40798-022-00499-8.
The Child Sport Concussion Assessment Tool 5th Edition (Child SCAT5) was developed to evaluate children between 5 and 12 years of age for a suspected concussion. However, limited empirical evidence exists demonstrating the value of the Child SCAT5 for acute concussion assessment. Therefore, the purpose of our study was to examine differences and assess the diagnostic properties of Child SCAT5 scores among concussed and non-concussed middle school children on the same day as a suspected concussion.
Our participants included 34 concussed (21 boys, 13 girls; age = 12.8 ± 0.86 years) and 44 non-concussed (31 boys, 13 girls; age = 12.4 ± 0.76 years) middle school children who were administered the Child SCAT5 upon suspicion of a concussion. Child SCAT5 scores were calculated from the symptom evaluation (total symptoms, total severity), child version of the Standardized Assessment of Concussion (SAC-C), and modified Balance Error Scoring System (mBESS). The Child SCAT5 scores were compared between the concussed and non-concussed groups. Non-parametric effect sizes ([Formula: see text]) were calculated to assess the magnitude of difference for each comparison. The diagnostic properties (sensitivity, specificity, diagnostic accuracy, predictive values, likelihood ratios, and diagnostic odds ratio) of each Child SCAT5 score were also calculated.
Concussed children endorsed more symptoms (p < 0.001, [Formula: see text]=0.45), higher symptom severity (p < 0.001, [Formula: see text]=0.44), and had higher double leg (p = 0.046, [Formula: see text]=0.23), single leg (p = 0.035, [Formula: see text]=0.24), and total scores (p = 0.022, [Formula: see text]=0.26) for the mBESS than the non-concussed children. No significant differences were observed for the SAC-C scores (p's ≥ 0.542). The quantity and severity of endorsed symptoms had the best diagnostic accuracy (AUC = 0.76-0.77), negative predictive values (NPV = 0.84-0.88), and negative likelihood ratios (-LR = 0.22-0.31) of the Child SCAT5 scores.
Clinicians should prioritize interpretation of the symptom evaluation form of the Child SCAT5 as it was the most effective component for differentiating between concussed and non-concussed middle school children on the same day as a suspected concussion.
儿童运动性脑震荡评估工具第5版（Child SCAT5）旨在评估5至12岁疑似脑震荡的儿童。然而，仅有有限的实证证据表明Child SCAT5在急性脑震荡评估中的价值。因此，我们研究的目的是在疑似脑震荡当天，检查脑震荡和未脑震荡的中学生之间Child SCAT5评分的差异，并评估其诊断特性。
我们的参与者包括34名脑震荡儿童（21名男孩，13名女孩；年龄 = 12.8 ± 0.86岁）和44名未脑震荡儿童（31名男孩，13名女孩；年龄 = 12.4 ± 0.76岁），这些儿童在疑似脑震荡时接受了Child SCAT5评估。Child SCAT5评分由症状评估（总症状数、总严重程度）、儿童版脑震荡标准化评估（SAC-C）和改良平衡误差评分系统（mBESS）计算得出。比较了脑震荡组和未脑震荡组的Child SCAT5评分。计算非参数效应量（[公式：见原文]）以评估每次比较的差异大小。还计算了每个Child SCAT5评分的诊断特性（敏感性、特异性、诊断准确性、预测值、似然比和诊断比值比）。
与未脑震荡儿童相比，脑震荡儿童认可更多症状（p < 0.001，[公式：见原文]=0.45）、更高的症状严重程度（p < 0.001，[公式：见原文]=0.44），并且在mBESS的双腿（p = 0.046，[公式：见原文]=0.23）、单腿（p = 0.035，[公式：见原文]=0.24）和总分（p = 0.022，[公式：见原文]=0.26）方面更高。SAC-C评分未观察到显著差异（p值≥0.542）。认可症状的数量和严重程度在Child SCAT5评分中具有最佳的诊断准确性（AUC = 0.76 - 0.77）、阴性预测值（NPV = 0.84 - 0.88）和阴性似然比（-LR = 0.22 - 0.31）。
临床医生应优先解读Child SCAT5的症状评估表，因为它是在疑似脑震荡当天区分脑震荡和未脑震荡中学生的最有效组成部分。
