Bhandari Sachin, Mak Soo Yit Gustin, Heron Neil, Rogers John
Salford Royal NHS Foundation Trust, Northern Care Alliance, Stott Lane, Salford M6 8HD, UK.
Barlow Medical Centre, 828 Wimslow Road, Manchester M20 2RN, UK.
Sports (Basel). 2025 Jun 23;13(7):201. doi: 10.3390/sports13070201.
The UK Department for Digital, Culture, Media, and Sport (DCMS) grassroots concussion guidance, May 2023, advised that all community-based sport-related concussions (SRCs) be diagnosed by a healthcare practitioner. This may require that general practitioners (GPs) diagnose and manage SRCs. Diagnosing SRCs in primary care settings in the United Kingdom (UK) presents significant challenges, primarily due to the lack of validated tools specifically designed for general practitioners (GPs). This scoping review aims to identify diagnostic and management tools for SRCs in grassroots sports and primary care settings.
To identify tools that can be used by GPs to diagnose and manage concussions in primary care, both adult and paediatric populations.
A scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScRs). Five databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, Google Scholar) were searched from 1946 to April 2025. Search terms included "concussion", "primary care", and "diagnosis". Studies that discussed SRCs in community or primary care settings were included. Those that exclusively discussed secondary care and elite sports were excluded, as well as non-English studies. Two reviewers independently screened titles, abstracts, and full texts, with a third resolving any disagreements. Data were extracted into Microsoft Excel. Studies were assessed for quality using the Joanna Briggs critical appraisal tools and AGREE II checklist.
Of 727 studies, 12 met the inclusion criteria. Identified tools included Sport Concussion Assessment Tool 6 (SCAT6, 10-15 min, adolescent/adults), Sport Concussion Office Assessment Tool 6 (SCOAT6, 45-60 min, multidisciplinary), the Buffalo Concussion Physical Examination (BCPE, 5-6 min, adolescent-focused), and the Brain Injury Screening Tool (BIST, 6 min, ages 8+). As part of BCPE, a separate Telehealth version was developed for remote consultations. SCAT6 and SCOAT6 are designed for healthcare professionals, including GPs, but require additional training and time beyond typical UK consultation lengths (9.2 min). BIST and BCPE show promise but require UK validation.
SCAT6, SCOAT6, BIST, and BCPE could enhance SRC care, but their feasibility in UK primary care requires adaptation (e.g., integration with GP IT systems and alignment with NICE guidelines). Further research is required to validate these tools and assess additional training needs.
英国数字、文化、媒体和体育部（DCMS）2023年5月发布的基层脑震荡指南建议，所有社区层面与运动相关的脑震荡（SRC）均应由医疗从业者进行诊断。这可能要求全科医生（GP）对SRC进行诊断和管理。在英国的初级医疗环境中诊断SRC存在重大挑战，主要原因是缺乏专门为全科医生设计的经过验证的工具。本范围综述旨在确定基层体育和初级医疗环境中SRC的诊断和管理工具。
确定全科医生可用于在初级医疗中诊断和管理成人及儿童脑震荡的工具。
按照系统评价和Meta分析扩展版的系统评价优先报告项目（PRISMA-ScR）进行范围综述。检索了1946年至2025年4月的五个数据库（MEDLINE、EMBASE、CINAHL、Cochrane图书馆、谷歌学术）。检索词包括“脑震荡”“初级医疗”和“诊断”。纳入讨论社区或初级医疗环境中SRC的研究。排除专门讨论二级医疗和精英运动的研究以及非英语研究。两名评审员独立筛选标题、摘要和全文，第三名评审员解决任何分歧。数据提取到Microsoft Excel中。使用乔安娜·布里格斯批判性评价工具和AGREE II清单对研究质量进行评估。
727项研究中，12项符合纳入标准。确定的工具包括运动脑震荡评估工具第6版（SCAT6，10 - 15分钟，青少年/成人）、运动脑震荡办公室评估工具第6版（SCOAT6，45 - 60分钟，多学科）、布法罗脑震荡体格检查（BCPE，5 - 6分钟，以青少年为重点）以及脑损伤筛查工具（BIST，6分钟，8岁及以上）。作为BCPE的一部分，还开发了一个单独的远程医疗版本用于远程会诊。SCAT6和SCOAT6是为包括全科医生在内的医疗专业人员设计的，但需要超出英国典型会诊时长（9.2分钟）的额外培训和时间。BIST和BCPE显示出前景，但需要在英国进行验证。
SCAT6、SCOAT6、BIST和BCPE可改善SRC的护理，但它们在英国初级医疗中的可行性需要调整（例如，与全科医生信息技术系统集成并与英国国家卫生与临床优化研究所（NICE）指南保持一致）。需要进一步研究来验证这些工具并评估额外的培训需求。
