Caccese Jaclyn B, Garcia Gian-Gabriel P, Kontos Anthony P, Port Nicholas, Valerio Kate, Broglio Steven P, McCrea Michael, McAllister Thomas W, Pasquina Paul F, Buckley Thomas A
School of Health & Rehabilitation Sciences, The Ohio State University College of Medicine, Columbus, Ohio.
H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia.
Clin J Sport Med. 2023 Jan 1;33(1):52-60. doi: 10.1097/JSM.0000000000001084. Epub 2022 Nov 6.
(1) To determine test-retest reliability of individual Sport Concussion Assessment Tool-Third Edition (SCAT-3) symptom scores and symptom severity scores, (2) to examine the specificity/sensitivity of individual SCAT-3 symptom severity scores acutely (24-48 hours) postconcussion, and (3) to develop a model of symptoms best able to differentiate concussed from nonconcussed student athletes and cadets.
Prospective, longitudinal, and cross-sectional.
Twenty-six civilian schools and 3 US service academies.
Collegiate student athletes (n = 5519) and cadets (n = 5359) from the National Collegiate Athletic Association-Department of Defense Grand Alliance: Concussion Assessment, Research and Education Consortium, including 290 student athletes and 205 cadets, assessed 24 to 48 hours postconcussion.
Concussed and nonconcussed student athlete and cadet groups.
Sport Concussion Assessment Tool-Third Edition individual symptom severity scores, total symptom scores, and symptom severity scores.
Results indicated poor test-retest reliability across all symptom scores (intraclass correlation coefficient = 0.029-0.331), but several individual symptoms had excellent predictive capability in discriminating concussed from nonconcussed participants (eg, headache, pressure in the head, and don't feel right had area under the curve >0.8, sensitivity >70%, and specificity >85%) regardless of baseline testing. These symptoms were consistent with Chi-square Automatic Interaction Detector classification trees with the highest mean probability.
Findings support the excellent diagnostic accuracy of honest symptom reporting, notwithstanding the known limitations in symptom underreporting, and suggest that there may be added value in examining individual symptoms rather than total symptom scores and symptom severity scores alone. Finally, findings suggest that baseline testing is not necessary for interpreting postconcussion symptom scores.
（1）确定个体运动性脑震荡评估工具第三版（SCAT - 3）症状评分和症状严重程度评分的重测信度；（2）检查脑震荡后急性期（24 - 48小时）个体SCAT - 3症状严重程度评分的特异性/敏感性；（3）建立一个最能区分脑震荡与未脑震荡学生运动员和学员的症状模型。
前瞻性、纵向和横断面研究。
26所民用学校和3所美国军事院校。
来自美国国家大学生体育协会 - 国防部大联盟：脑震荡评估、研究与教育联盟的大学生运动员（n = 5519）和学员（n = 5359），其中包括290名学生运动员和205名学员在脑震荡后24至48小时接受评估。
脑震荡和未脑震荡的学生运动员及学员组。
运动性脑震荡评估工具第三版个体症状严重程度评分、总症状评分和症状严重程度评分。
结果表明所有症状评分的重测信度较差（组内相关系数 = 0.029 - 0.331），但有几个个体症状在区分脑震荡与未脑震荡参与者方面具有出色的预测能力（例如，头痛、头部压迫感和感觉不适的曲线下面积>0.8，敏感性>70%，特异性>85%），无论基线测试情况如何。这些症状与具有最高平均概率的卡方自动交互检测器分类树一致。
研究结果支持如实报告症状具有出色的诊断准确性，尽管存在症状报告不足的已知局限性，并表明单独检查个体症状可能比仅检查总症状评分和症状严重程度评分更有价值。最后，研究结果表明解释脑震荡后症状评分无需进行基线测试。
