Concussion symptom inventory: an empirically derived scale for monitoring resolution of symptoms following sport-related concussion.
Self-report post-concussion symptom scales have been a key method for monitoring recovery from sport-related concussion, to assist in medical management, and return-to-play decision-making. To date, however, item selection and scaling metrics for these instruments have been based solely upon clinical judgment, and no one scale has been identified as the "gold standard". We analyzed a large set of data from existing scales obtained from three separate case-control studies in order to derive a sensitive and efficient scale for this application by eliminating items that were found to be insensitive to concussion. Baseline data from symptom checklists including a total of 27 symptom variables were collected from a total of 16,350 high school and college athletes. Follow-up data were obtained from 641 athletes who subsequently incurred a concussion. Symptom checklists were administered at baseline (preseason), immediately post-concussion, post-game, and at 1, 3, and 5 days post-injury. Effect-size analyses resulted in the retention of only 12 of the 27 variables. Receiver-operating characteristic analyses were used to confirm that the reduction in items did not reduce sensitivity or specificity. The newly derived Concussion Symptom Inventory is presented and recommended as a research and clinical tool for monitoring recovery from sport-related concussion.
Randolph
Christopher
C
Department of Neurology, Loyola University Medical Center, Chicago, Maywood, IL 60611, USA. crandol@lumc.edu
Millis
Scott
S
Barr
William B
WB
McCrea
Michael
M
Guskiewicz
Kevin M
KM
Hammeke
Thomas A
TA
Kelly
James P
JP
D001265:Athletic Injuries / Q000175:diagnosis*; D001924:Brain Concussion / Q000175:diagnosis*; D016022:Case-Control Studies; D019992:Databases as Topic; D003943:Diagnostic Techniques, Neurological; D005260:Female; D006801:Humans; D008297:Male; D038223:Post-Concussion Syndrome / Q000175:diagnosis*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013334:Students; D013997:Time Factors